Universities across the United States have been slow to adopt anti-tobacco policies on campuses, researchers say, despite public health efforts to curb tobacco use, especially among teens and young adults.
Just 16.7% of accredited universities in the U.S. had introduced a total ban on smoking or use of other tobacco products including e-cigarettes on campus by 2017, according to research published in the journal Tobacco Control.
“We know that campus smoke-free protections have increased over time,” lead author Dr. Kelly Blake of the National Cancer Institute told Reuters Health in an email. “What we didn’t know, until now, was the proportion of institutions of higher education in the U.S. that have 100% smoke-free or 100% tobacco-free designations. This was important to investigate and to document, so that we have a baseline on which to measure progress.”
Most smokers start and get hooked before age 26, Blake’s team writes. Banning smoking has been shown to deter people from picking up the habit, encourage smokers to quit and protect nonsmokers from exposure to secondhand smoke, they note.
Since 2009, the American College Health Association has promoted 100% smoke-free campuses. In 2012, the U.S. Department of Health and Human Services launched the Tobacco-Free College Campus Initiative to promote voluntary adoption of such policies nationwide.
To assess the effects of such efforts, Blake’s team analyzed data from the American Nonsmokers’ Rights Foundation (ANRF) and the Tobacco-Free U.S. and Tribal Colleges and Universities List.
They found that 823 accredited institutions representing 1,816 campuses, sites and schools, had complete bans on cigarettes or tobacco products in 2017. As a result, about 14.9 million students (27%) and 8.9 million faculty and staff (25%) were protected by 100% smoke-free or tobacco-free campus policies and state laws.
Advocates of tobacco-free campuses hope that by making use of tobacco products on campus unacceptable, they can spawn a cultural shift that protects new generations from becoming addicted.
“Smoke-free environments change perceptions of peer tobacco use and de-normalize smoking,” Blake said. “The only way to fully protect non-smokers from secondhand smoke is to eliminate smoking in indoor workplaces and public places.”
Cianti Stewart-Reid of Truth Initiative, a nonprofit public health organization that works to stem tobacco use among young people, noted that preparation on the part of universities before they settle on a tobacco policy is important.
“We work with universities to craft tobacco policies that work for them,” she said on a phone call. “We spend time educating students and making sure that they really understand, for example, that hookah is a tobacco product and that one hour of hookah equals a hundred cigarettes. That is mind blowing for many students!”
Stewart-Reid, who was not involved in the study, noted that most universities do a campus-wide assessment to understand tobacco use in their community, which can help negate pushback once rules are enforced.
Michael Staufacker, director of health management at Emory University in Atlanta, Georgia, said that after adopting a tobacco-free policy in 2012, the university offered resources to smokers looking to quit and removed designated smoking areas and cigarette disposal bins.
“Faculty and staff who are on the Emory medical plan and use tobacco pay an additional $50 per month . . . . This also contributed to the decrease in the number of people who used tobacco,” he said in an email.
Nosse Ovienmhada, who oversees tobacco-free campus programs at the University of Texas at Austin, said the university receives “hundreds of anonymous reports a semester” flagging campus locations that may require additional “no tobacco” signage or surveillance. “With a campus the size of many Texas towns, we continue to work on improving education, awareness and compliance,” she said.
Study coauthor Cynthia Hallett, CEO of ANRF in Berkeley, California, said in recent years there has been limited opposition to campus tobacco bans. “Five to 10 years ago, there was greater pushback from some who expressed they could lose alumni support or funding,” she said.
“The greatest pushback happens when it seems that the policy is developed in a vacuum, without community input.”