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A review of interventions to reduce tobacco use in colleges and universities

      Background

      Interventions have been designed to reduce the prevalence of smoking in college/university students. This review presents a summary and synthesis of the interventions published in English from 1980 to the present.

      Methods

      Seven databases were searched for relevant published articles, and reference lists were examined for additional published studies. The studies were categorized as (1) individual approaches, such as on-campus cessation programs, and (2) institutional approaches, such as smoke-free policies. The studies were categorized by type of institution and geographic location, study design, sample demographics, and outcomes.

      Results

      Fourteen studies were identified; only five received a “satisfactory” rating based on evaluation criteria. Most studies were based on convenience samples, and were conducted in 4-year institutions. Seven studies used comparison groups, and three were multi-institutional. Individual approaches included educational group sessions and/or individual counseling that were conducted on campus mostly by healthcare personnel. None used nicotine replacement or other medications for cessation. The quit rates for both smokeless tobacco and cigarette users varied, depending on definitions and duration of follow-up contact. Institutional interventions focused mainly on campus smoking restrictions, smoke-free policies, antitobacco messages, and cigarette pricing. Results indicated that interventions can have a positive influence on student behavior, specifically by reducing tobacco use (i.e., prevalence of cigarette smoking and use of smokeless products, amount smoked) among college students, and increasing acceptability of smoking policies and campus restrictions among both tobacco users and nonusers.

      Conclusions

      While some promising results have been noted, rigorous evaluations of a wider range of programs are needed, along with studies that address cultural and ethnic diversity on campuses.
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      References

        • Wechsler H.
        • Rigotti N.A.
        • Gledhill-Hoyt J.
        • Lee H.
        Increased levels of cigarette use among college students.
        JAMA. 1998; 280: 1673-1678
        • Rigotti N.A.
        • Lee J.E.
        • Wechsler H.
        U.S.college students’ use of tobacco products.
        JAMA. 2000; 284: 699-705
        • Douglas K.A.
        • Collins J.L.
        • Warren C.
        • et al.
        Results from the 1995 National College Health Risk Behavior Survey.
        J Am College Health. 1997; 46: 55-66
        • Centers for Disease Control and Prevention
        Youth risk behavior surveillance.
        MMWR Surveill Summ. 1997; 46: 1-54
        • Glover E.D.
        • Laflin M.
        • Flannery D.
        • Albritton D.L.
        Smokeless tobacco use among American college students.
        J Am College Health. 1989; 38: 81-85
        • Jamner M.S.
        Cigar smoking among college students.
        Prev Med. 1999; 29: 187-194
        • U.S. Department of Health and Human Services
        National Health Interview Survey. Centers for Disease Control and Prevention, National Center for Health Statistics, Atlanta GA2000
        • Centers for Disease Control and Prevention
        Trends in Cigarette smoking among high school students—United States, 1991–2001.
        MMWR Morb Mortal Wkly Rep. 2002; 51: 409-412
        • Johnston L.D.
        • O’Malley P.M.
        • Bachman J.G.
        National survey results on drug use from the Monitoring the Future Study, 1975–1998.
        in: College Students and Young Adults. Vol. 2. U.S. Department of Health and Human Services, Washington DC1999
        • U.S. Department of Health and Human Services
        Preventing tobacco use among young people. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta GA1994
        • U.S. Department of Health and Human Services
        Women and smoking. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta GA2001
        • Sepe E.
        • Glantz S.A.
        Bar and club tobacco promotions in the alternative press.
        Am J Public Health. 2002; 92: 75-78
        • Katz S.K.
        • Lavack A.M.
        Tobacco related bar promotions.
        Tob Control. 2002; 11: i92-i101
        • Cummings K.M.
        • Morley C.P.
        • Horan J.K.
        • Steger C.
        • Leavell B.R.
        Marketing to America’s youth.
        Tob Control. 2002; 11: i5-i17
        • Chaloupka F.J.
        • Cummings K.M.
        • Morley C.P.
        • Horan J.K.
        Tax, price and cigarette smoking.
        Tob Control. 2002; 11: i62-i72
        • DeBernardo R.L.
        • Aldinger C.E.
        • Dawood O.R.
        • Hanson R.E.
        • Lee S.J.
        • Rinaldi S.R.
        An e-mail assessment of undergraduates’ attitudes toward smoking.
        J Am College Health. 1999; 48: 61-66
        • Knapp L.G.
        • et al.
        Postsecondary institutions in the United States. U.S. Department of Education, National Center for Education Statistics, Washington DC2001
        • Chaloupka F.J.
        • Wechsler H.
        Price, tobacco control policies and smoking among young adults.
        J Health Econ. 1997; 16: 359-373
        • Darmody D.L.
        • Ehrich B.
        Snuffing it out.
        J Am College Health. 1994; 43: 27-30
        • Greenberg J.A.
        • Pollack B.
        Motivating students to not smoke.
        J Drug Educ. 1981; 11: 341-359
        • Hellmann R.
        • O’Shea R.M.
        • Kunz M.L.
        • Schimpfhauser F.T.
        • et al.
        University health service physician intervention with cigarette smokers.
        J Am College Health. 1988; 37: 91-93
        • Rutter S.
        Cigarette-smoking reduction in university students.
        Psychol Rep. 1990; 66: 186
        • Cohen L.M.
        • Collins Jr, F.L.
        • Britt D.M.
        The effect of chewing gum on tobacco withdrawal.
        Addict Behav. 1997; 22: 769-773
        • Kane J.
        • Hodges J.
        • Srebro K.
        • Fruhwirth M.
        • Chambliss C.
        Attempts to reduce cigarette smoking among college students. Clearinghouse Counseling and Personnel Services, PA1999
        • Kane J.
        • Hodges J.
        • Srebro K.
        • Authier C.
        • Chambliss C.
        Individualized attempts to reduce cigarette smoking among college students. Clearinghouse Counseling and Personnel Services, PA1999
        • O’Neill H.K.
        • Gillispie M.A.
        • Slobin K.
        Stages of change and smoking cessation.
        Am J Health Promotion. 2000; 15: 93-96
        • Williams N.J.
        • Arheart K.L.
        • Klesges R.
        A smokeless tobacco cessation program for postsecondary students.
        Health Values. 1995; 19: 33-42
        • Walsh M.M.
        • Hilton J.F.
        • Masouredis C.M.
        • Gee L.
        • Chesney M.A.
        • Ernster V.L.
        Smokeless tobacco cessation intervention for college athletes.
        Am J Public Health. 1999; 89: 228-234
        • Apel M.
        • Klein K.
        • McDermott R.J.
        • Westhoff W.W.
        Restricting smoking at the University of Koln, Germany.
        J Am College Health. 1997; 45: 219-223
        • Etter J.F.
        • Ronchi A.
        • Perneger T.V.
        Short-term impact of a university based smoke free campaign.
        J Epidemiol Community Health. 1999; 53: 710-715
        • Rigotti N.A.
        • Regan S.
        • Moran S.E.
        • Wechsler H.
        Students’ opinion of tobacco control policies recommended for U.S. colleges.
        Tob Control. 2003; 12: 251-256
        • Halperin A.C.
        • Rigotti N.A.
        U.S. public universities’ compliance with recommended tobacco-control policies.
        J Am College Health. 2003; 51: 181-188
        • Hodges J.
        • Srebro K.
        • Kane J.
        • Fruhwirth M.
        • Chambliss C.
        Use of a visual prompt to reduce public cigarette smoking on a college campus. Clearinghouse Counseling and Personnel Services, PA1999
        • U.S. Preventive Services Task Force
        Guide to clinical preventive services. Williams & Wilkins, Baltimore MD1989
        • Cinelli B.
        • Rose-Colley M.
        Prevalence and patterns of smokeless tobacco use in Pennsylvania colleges and universities.
        Eta Sigma Gamman, Spring. 1991; 22: 16-19
        • Chakravorty B.
        • Chakravorty S.
        Cessation related perceptions and behaviors of former and current smokeless tobacco users.
        J Am College Health. 1997; 46: 133-138
        • Wechsler H.
        • Lee J.E.
        • Rigotti N.A.
        Cigarette use by college students in smoke-free housing.
        Am J Prev Med. 2001; 20: 202-207
        • Everett S.A.
        • Husten C.G.
        • Kann L.
        • Warren C.W.
        • Sharp D.
        • Crossett L.
        Smoking initiation and smoking patterns among U.S.college students.
        J Am College Health. 1999; 48: 55-60
        • Wechsler H.
        • Kelley K.
        • Seibring M.
        • Kuo M.
        • Rigotti N.A.
        College smoking policies and smoking cessation programs.
        J Am College Health. 2001; 49: 205-212
        • Foote J.A.M.
        • Harris H.B.
        • Gilles M.E.
        • et al.
        Physician advice and tobacco use.
        J Am College Health. 1996; 45: 129-132
        • McKillip J.
        • Vierke S.
        College smokers.
        J Am College Health Assoc. 1980; 28: 280-282
        • U.S. Department of Health and Human Services
        Reducing tobacco use. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta GA2000
        • Hellmann R.
        • O’Shea R.M.
        • Schimpfhauser F.T.
        • Kunz M.L.
        Self-initiated smoking cessation in college students.
        J Am College Health. 1983; 32: 95-100
        • Spencer L.S.
        College freshmen smokers versus nonsmokers.
        J Health Educ. 1999; 30: 274-281
        • Hilton J.F.
        • Walsh M.M.
        • Masouredis C.M.
        • Drues J.C.
        • Grady D.G.
        • Ernster V.L.
        Planning a spit tobacco cessation intervention.
        Addict Behav. 1994; 19: 381-391
        • Babrow A.S.
        • Black D.R.
        • Tiffany S.T.
        Beliefs, attitudes, intentions, and a smoking-cessation program.
        Health Communications. 1990; 2: 145-163
        • Black D.R.
        • Babrow A.S.
        Identification of campaign recruitment strategies for a stepped smoking cessation intervention for a college campus.
        Health Educ Q. 1991; 18: 235-247
        • Black D.R.
        • Loftus E.A.
        • Chatterjee R.
        • Tiffany S.T.
        • Babrow A.S.
        Smoking cessation interventions for university students.
        Prev Med. 1993; 22: 388-399
        • Hines D.
        Young smokers’ attitudes about methods for quitting smoking.
        Addict Behav. 1996; 21: 531-535
        • Martinelli A.M.
        An explanatory model of variables influencing health promotion behaviors in smoking and nonsmoking college students.
        Public Health Nurse. 1999; 16: 263-269
        • Prokhorov A.V.
        • Warneke C.
        • de Moor C.
        • et al.
        Self-reported health status, health vulnerability and smoking behavior in college students.
        Nicotine Tob Res. 2003; 5: 545-552
        • Emmons K.M.
        • Wechsler H.
        • Dowdall G.
        • Abraham M.
        Predictors of smoking among U.S.college students.
        Am J Public Health. 1998; 88: 104-107
        • Steptoe A.
        • Wardle J.
        • Cui W.
        • et al.
        An international comparison of tobacco smoking beliefs and risk awareness in university students from 23 countries.
        Addiction. 2002; 97: 1561-1571
        • Choi W.S.
        • Harris K.J.
        • Okuyemi K.
        • Ahluwalia J.S.
        Predictors of smoking initiation among college-bound high school students.
        Behav Med. 2003; 26: 69-74
        • Hancock L.
        Tobacco use reduction guide for college and universities. Virginia Commonwealth University, Richmond2000
      1. Centers for Disease Control and Prevention.
        Best practices. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta GA1999
        • U.S. Preventive Services Task Force
        The Guide to Clinical Preventive Services. Tobacco use prevention and control.
        Am J Prev Med. 2001; 20
        • Montazeri A.
        • McEwen J.
        Effective communication.
        Patient Educ Counseling. 1997; 30: 29-35