Conflicting Data Complicates the Debate About Smoke-Free Campuses
Despite a gradual decrease in the overall rates of smoking in the U.S., cigarette use among college students surged during the 1990s and remains prevalent today; depending on your source of information, between one in three to one in five students have used tobacco products in the past month. There is no longer much room to dispute the detriment to health that both smoking and exposure to second-hand smoke can cause. According to the American Cancer Society, one in three smokers will die prematurely from tobacco use and second-hand smoke has been classified as a Class-A carcinogen. ACHA’s 2005 position statement on tobacco on campuses recommends a number of tactics to address the high levels of college-age smokers; one of these is banning tobacco use in all public areas on campus, including residence halls.
A smoke-free campus will clearly decrease students’ exposure to second-hand smoke. But will it reduce rates of smoking? Common sense might dictate that it should, but studies concerning the effectiveness of prohibiting smoking in residence halls have had contradictory findings. A Harvard School of Public Health study from 2001 found that non-smokers are 40 percent less likely to become smokers if they live in smoke-free dormitories. However, another study, published in BioMed Central (BMC) Public Health in 2005, found that prohibiting smoking in residence halls had no significant effect on influencing students’ smoking behaviors, and only preventative education programs were associated with lower odds of smoking.
It should be noted that none of the institutions featured in either of these studies appeared to have completely smoke-free campuses; instead, they restricted smoking to certain designated areas. One factor that might explain the difference in results of these studies might be the location of these designated areas. The 2005 study in BMC found that campuses that had designated smoking areas actually had an increased rate of current smokers by 45 percent. Anecdotal evidence suggests that if designated smoking areas are in the middle of campus, it could make smokers more visible and even make smoking appear to be a sociable and cliquey activity, to say nothing of changing the perceived social norm.
Cabrillo College in California introduced restrictions on smoking on campus in 1997 and since then has incrementally tightened the policy to make the entire campus smoke free, with the exception of certain designated parking lots. Says Kate Hartzell, RN, MSN, FNP-BC, director of Cabrillo’s student health services:
“The designated parking lots only make up about two percent of campus space, and these restricted areas are so far from the center of things that it is hard to notice the folks that are there; they get no high profile exposure,” she explains. With reference to the possible negative impact of designated smoking areas, Hartzell indicates that it’s a matter of practicality rather than compromise. “If you don’t provide areas for smoking, those that cannot give it up will smoke in non-smoking areas,” she notes.
Nor has Cabrillo College found that designated smoking areas have detracted from the overall campaign. Their experience with implementing a smoke-free campus has been a positive one, although Hartzell admits that it may be due to factors other than the ban.
“We live in a community that is very smoke-intolerant,” she says. “Our campus smoking rate is very low, but may be related to the community norm rather than the non-smoking policy.”
This chicken and egg situation aptly illustrates an important question: does the success of the policy depend upon existing attitudes, or should the policy seek to change those attitudes? And additionally, should the success of a smoke-free campus be tied to the percentage of students that smoke, or is that dependent on demographics and extra-campus norms that an institution can only hope to influence in a minor way?
The recent studies on smoking on campus do not address this question. They do, however, address another part of transitioning to – and maintaining - a smoke-free campus: the availability of preventative education and successful cessation programs. Researchers involved in the 2001 studies published in the Journal of American College Health pointed to room for improvement in the cessation programs that were offered by the institutions under scrutiny. In particular, they needed to be better marketed and more closely tailored to the needs of the student. This may speak more about the availability of resources, both human (in the form of dedicated health promotions) and financial (to support the marketing efforts) at many colleges trying to implement such a policy.
Regardless of whether smoke-free campuses actually reduce the number of student smokers, enforcing a policy that reduces trash and fire hazards, and ensures clean air for everyone, a particular boon for allergy and asthma suffers, is becoming more and more popular. Recent feedback on the SHS student health listserv, hosted by the University of Tennessee, Knoxville, indicates that most institutions that have implemented this policy have seen great results ranging from a more realistic student perception of how (un)common smoking is amongst their peers to fewer sick days, and few have encountered too much trouble enforcing the rules. As part of a healthy campus, particularly one aiming to meet the Healthy Campus 2010 objectives, transitioning to a smoke-free campus is a great goal even if its impact on smoking rates remains an unknown variable.
Kate Hartzell's top three tips for planning for a
smoke-free campus:
- Involve smokers in the decision making process.
- Provide areas for smoking, otherwise those that cannot give it up will smoke in non-smoking areas.
- Plan for smokers in inclement weather, otherwise you will have them in doorways and under balconies when it rains!