A COMPREHENSIVE APPROACH TO CAMPUS TOBACCO
PREVENTION
A comprehensive strategy for campus tobacco prevention combines
traditional tobacco education/cessation programs with efforts
to create a physical, social, and policy environment that
supports tobacco-free campuses. This powerful approach acknowledges
the importance of the environment (physical, social and policy)
on students’ individual decisions regarding tobacco
use.
Overview of Approach
College health center directors have begun to identify smoking
as a major health problem that needs to be addressed on their
campuses (Wechsler, 2001). The college years are a crucial
time when many young adults either establish or abandon tobacco
use. Campuses provide an opportune setting for interventions
that help young adults make healthful decisions about tobacco
use.
Historically, tobacco prevention efforts have centered on
individually-focused education and cessation programs. The
field of public health recognizes that health-related behaviors
are influenced by multiple factors: individual factors, peer
factors, institutional factors, community factors, and public
policy. Successful prevention programs address all of these
factors in a comprehensive approach.
One of the most important elements of a comprehensive approach
is addressing the environment in which students make decisions
about tobacco use. Sometimes called “environmental management,”
these strategies aim to create a physical, social, and policy
environment that promotes and supports healthful decisions
about tobacco use.
Environmental management strategies have already been applied
to tobacco prevention at the state and local level. Laws and
policies to restrict tobacco use in workplaces, public schools,
and other locations can be credited in large part for the
national decline in smoking prevalence and consumption levels.
Following this lead, some colleges have already begun to implement
policy changes to promote a tobacco-free environment on campus.
A comprehensive approach to tobacco prevention combines individually-focused
programs (e.g., education and cessation programs) with environmental
management strategies (e.g., creating a tobacco-free normative
environment, developing and enforcing tobacco-related rules
and policies) to create a campus environment that promotes
healthful decisions about tobacco use.
We have outlined five primary strategies for comprehensive
campus tobacco prevention. Every campus is unique, so it is
important that each institution analyze the factors at work
in its community to determine which combination of strategies
to pursue.
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Five Strategies for Comprehensive
Campus Tobacco Prevention
1. Create a tobacco-free normative environment
2. Restrict tobacco sales, advertising,
and promotion
3. Increase and enforce sound tobacco-related
rules and policies
4. Educate students about tobacco prevention
5. Offer tobacco cessation programs designed
for college students
Other campus
tobacco prevention approaches to consider
1. Create a tobacco-free normative
environment
Many students mistakenly believe that tobacco use is more
common on campus than is actually the case. The high visibility
of smoking, popular media portrayals of smoking, and heavy
marketing practices of the tobacco industry to college students
perpetuate this widespread belief. This misperception may,
in turn, create an environment that promotes smoking.
In fact, most college students do not smoke. Correcting misperceptions
about smoking prevalence is an important part of creating
a healthier tobacco-free normative environment, where tobacco
use is viewed as the exception rather than the rule. To this
end, some schools have implemented social norms marketing
campaigns to bring student perceptions about smoking prevalence
and consumption in line with actual behaviors.
Correcting misperceptions can alleviate pressure to “fit
in” with the perceived norm about campus smoking. Helping
nonsmokers realize that they are in the majority may encourage
them to speak out in support of tobacco control policies on
campus.
Changing the physical environment so that campus buildings
are tobacco-free can also improve the normative environment
on campus. One study found that students who live in smoke-free
dorms are 40% less likely to start smoking (Wechsler, 2001).
In conjunction with restricting smoking in campus buildings
it is important to assure that smokers do not cluster at building
entrances. In addition to exposing passersby to secondhand
smoke, the high visibility of smokers at building entrances
can bolster the misperception that a great many people smoke.
Some campuses are experimenting with designated smoking areas
located away from high traffic areas.
In making decisions about creating smoke-free spaces, it
is important to consider not only students but also the positive
benefit of smoke-free work environments for faculty and staff.
All schools should familiarize themselves with local and state
tobacco laws. As of June 2003, 1609 communities nationwide
had passed local clean indoor air laws that place restrictions
on tobacco use in locations such as workplaces and restaurants
(Americans for Nonsmokers’ Rights).
Suggested Strategies.
Return to Five Strategies
2. Restrict tobacco sales, advertising,
and promotion
The tobacco industry strategy of marketing to young adults
has been well-documented. Advertisements, media presentations,
and tobacco-related promotions are prominent both on- and
off-campus. The 1998 Master Settlement Agreement restricted
advertising to those under 18 years old; since then, the tobacco
industry has made a visible push to advertise to 18-24 year
olds, including college students.
Suggested Strategies.
- Ban tobacco advertising on campus, including the school
newspaper and other publications (e.g., ads for products,
tobacco promotions at bars, and tobacco company sponsored
events) and at campus events.
- Ban distribution of tobacco-related products, paraphernalia
with tobacco logos, or coupons on campus.
- Ban tobacco sales on campus: vending machines, campus
store(s). (Example: University
of Washington Case Study)
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3. Increase and enforce sound
tobacco-related rules and policies
It is important for college and universities to have written
rules and policies about tobacco use, and clearly defined
sanctions for violations. Tobacco-related rules, policies,
and sanctions should be developed with input from all campus
stakeholders. The school should take responsibility for publicizing
and enforcing tobacco-related rules and policies.
Suggested Strategies.
- Develop sound tobacco-related rules, policies, and related
sanctions with input from all stakeholders: students, faculty,
administration, staff, and parents.
- Publicize tobacco-related rules, policies and sanctions.
- Enforce sanctions for violating tobacco-related rules
and policies.
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4. Educate students about tobacco
prevention
Educating students about tobacco is an ongoing process. Educational
approaches may be especially useful in targeting “high-risk”
groups such as freshmen, students who are concerned with weight
loss, athletes, and others. Curriculum infusion is a tobacco
education method by which professors incorporate information
about tobacco and the tobacco industry’s marketing practices
into their classes. There are many creative examples of tobacco-related
curriculum infusion on campus in subjects ranging from economics
to theater.
Suggested Strategies.
- Implement campus-wide high quality tobacco prevention
education programs. (Example: Eastern
Washington University Case Study Brief)
- Implement targeted tobacco prevention education programs
for high-risk groups such as athletes (chew tobacco), freshmen,
fraternity and sorority members, students concerned with
weight loss, art and theater students, and Lesbian, Gay,
Bisexual and Transgender students.
- Work with professors to implement curriculum infusion.
(Example: University
of Cincinnati Case Study Brief)
- Involve students as peer educators and leaders. (Example:
Ohlone
College Case Study Brief)
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5. Offer tobacco cessation programs
designed for college students
Many students arrive on campus already addicted to nicotine
and a substantial percentage of students begin smoking when
they enter college. The availability of high-quality campus
cessation services is of critical importance. Implementing
environmental management strategies, which will create barriers
to smoking (e.g., smoke-free dorms) or might make smoking
less appealing (e.g., social norms marketing campaigns that
decrease perceived normative pressure to smoke), may prompt
students to seek out cessation services. Campuses should seek
out quality cessation services that are particularly geared
to college students, many of whom consider themselves “social
smokers,” do not consider themselves addicted, and erroneously
assume that quitting will be easy.
According to US Public Health Service Clinical Practice Guidelines,
smoking cessation programs should offer both counseling and
pharmacotherapy (e.g., nicotine gum, patch, spray, inhaler)
when possible.
Suggested Strategies.
- Offer a full-range of high-quality tobacco cessation programs—such
as individual and group counseling, nicotine replacement
therapy, referrals to local programs, internet-based programs—that
are easily accessible and well-publicized.
- Offer programs geared towards the unique needs of college
students. (Example: Penn
State University Case Study Brief)
- Track student tobacco use status at every college health
service visit, and offer tobacco users regular reminders
of campus tobacco cessation options.
- Train health care providers in motivational interviewing
techniques so they can conduct effective interventions at
each health center visit for students who smoke.
- Lobby for insurance coverage of cessation services for
students, faculty, and staff.
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Other campus tobacco prevention
approaches to consider
As noted above, each institution of higher learning is unique.
Some schools have opted to implement tobacco prevention policies
that include partial or total divestiture of tobacco company
stock (Example: University
of Michigan Case Study Brief) and to prohibit any department
or university organization from accepting monetary or in-kind
donations from tobacco companies for activities or programs.
Others have placed a total ban on both indoor and outdoor
smoking and have eliminated career recruitment by tobacco
company representatives. Some schools are working with off
campus venues such as local bars and Greek housing to eliminate
tobacco marketing, including tobacco product and paraphernalia
distribution.
References.
American Nonsmokers’ Rights Foundation. Americans for
Nonsmokers’ Rights (ANR) Website. Available online at:
http://www.no-smoke.org
Wechsler H, Lee J, and Rigotti N. "Cigarette Use by College
Students in Smoke-Free Housing: Results of a National Study."
American Journal of Preventive Medicine. 20:3 (2001):
202-207.
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