Increasing rates of alternate tobacco use products among college freshmen

Background: Tobacco use rates are highest among young adults, aged 18-24 years in the United States (US), and one-third of these young adults attend college. College years represent a major transition from intermittent to regular smoking as college students become independent and engage risky behaviors. However, tobacco use behavior, and beliefs about tobacco and tobacco control during this critical transitional phase has not been adequately examined, especially in a high tobacco use and producing environment. Therefore, the study aimed to assess beliefs and attitudes towards tobacco use and control among college freshmen.

Methods: Internet-based surveys were administered to all incoming freshmen in 2011, 2013, and 2014 to obtain information on their tobacco use/attitudes/perceptions about tobacco control. Descriptive statistics, frequencies, proportions along with 95% CI were calculated using SAS 9.4. Also, Chi-square and t-tests were conducted to identify differences in tobacco use among freshmen. Finally, multivariable logistic regression models were conducted to identify determinants and beliefs about tobacco use and control among college freshmen.

Results: Of 485 college students surveyed, 29.9% were users of cigarettes, 10.3% chewed, sniffed and dipped tobacco, 26.7% were users of cigars, cigarillos, and little cigars, 17.7% have used e-cigarette, 0.9% (not including 2011) have used bids and kreteks. Tobacco use estimates did not vary across years (p=0.636) nor have beliefs.

Conclusion: Study findings identify increasing use of alternate tobacco products including e-cigarettes among college-going students, and necessitate need for addressing the emerging burden of alternate tobacco products use in educational settings in the US.