Tobacco use behavior and impact of tobacco-free campus policy among college students in high tobacco use prevalence and producing environment

To address the stalled decline in smoking rate (19.3% in 2010) and attain the Healthy People 2020 goal of 12% national smoking rate, it is necessary to reduce tobacco use among population sub-groups, especially college students between 18 and 24 years old with high smoking rate (20.1% in 2010). This necessity becomes absolute if population sub-group is in higher smoking prevalence places such as Central Appalachian region of Tennessee, the third largest tobacco producer. We utilized a case study approach to understand tobacco use and impact of first tobacco-free campus policy in Tennessee among college students at East Tennessee State University (ETSU), located in a region with 27% smoking rate in 2011. An internet-based survey was sent to 15,234 students of ETSU in 2011 for data on their knowledge, behavior and attitudes toward tobacco use and impact of tobacco-free policy. Descriptive statistics and logistic regression analysis were performed to delineate determinants of tobacco use and to assess the impact of policy on tobacco use behavior among the students. Preliminary results indicate that smoking prevalence among students was very high (48.1%) and only 64.3% favored the policy, which is likely due to inadequate measures for implementation and enforcement. This study not only highlights importance of tobacco-free campus policies in tobacco environments and elsewhere but also assists college administrators and public health community to identify gaps in implementation and enforcement of such policies. Moreover, it promotes development of strong and comprehensive tobacco-free policies with high compliance rates in all higher educational institutions.