Cigarette Smoking and Associated Health Risk Behaviors Among Students at Five Universities

PURPOSE: This paper examines smoking and related health risks and behaviors among students at five universities in the U.S. and Canada.

METHODS: A Health Screening Survey (HSS) was completed by 2091 college and graduate school student volunteers seeking routine care at their university health centers. Independent variables were analyzed descriptively and in regression analyses with three levels of smoking (none, <1 cigarette per day, and >1 cigarette per day) and degree of tobacco dependence (based on morning craving to smoke) to determine predictors and associated risks.

RESULTS: Nearly a quarter (23%) of students reported current smoking, with 41% of them smoking less than one cigarette per day (cpd). Of those who smoked daily, 80% smoked fewer than 10 cpd, but almost half (45%) reported waking up in the morning wanting to smoke. Any smoking was associated with high-risk alcohol use, experience of emotional or physical abuse, depression, less exercise, and higher utilization of emergency and mental health services. In regression analyses, dependent smokers were more than twice as likely to be depressed (OR=2.32, p<.001) report emotional or physical abuse (OR=2.17, p<.001) or seek counseling for mental health issues (OR=2.07, p<.001), compared with non-dependent smokers.

CONCULSIONS: College students who smoke, even occasionally, are at risk for tobacco dependence and long-term sequelae of smoking, as well as more immediate harms due to associated health risks and behaviors. Health care providers have an opportunity to help students quit smoking and prevent or mitigate many of these adverse outcomes.