1. 1 U.S. Colleges’ Compliance with Recommended Tobacco Control Policies Abigail Halperin MD MPH Nancy Rigotti MD National Conference on Tobacco or Health, 2002 Funded by the American Legacy Foundation (AH) and the Heart, Lung & Blood Institute (NR)

2. 2 Questions to be Addressed  Which tobacco control policies are recommended for U.S. college campuses?  How do colleges and universities measure up?  What are some of the factors that may influence (encourage or impede) the development of campus policies?

3. 3 Which tobacco control policies are recommended for U.S. college campuses? Question 1:

4. 4 National Recommendations by ACHA, ACS & CASA No tobacco sales, sampling or distribution on college campuses No tobacco advertising in college publications No smoking inside campus buildings, including residence halls and Greek houses No smoking outside building entrances No tobacco company investments, donations or sponsorships of campus events Free tobacco cessation treatment for students

5. 5 How do U.S. colleges and universities measure up? Question 2:

6. 6 Smoke Free Campuses Initiative Survey of key informants at 50 state universities about tobacco policies –Indoor and outdoor smoking restrictions –Sale of tobacco products on campus –Advertising of tobacco in student newspapers –Tobacco promotions and sponsorships –Student health center cessation services

7. 7 Sample Characteristics One large public university from each of the 50 U.S. states selected for the sample Total of 1.3 million students enrolled –77% undergraduate students –Average of 25,100 students at each IHE –Comprise 9% of all higher education students –2/3 of all college students in the U.S. attend public institutions

8. 8 Prevalence of Tobacco Control Policies on 50 Campuses

9. 9 Policies Restricting Indoor and Outdoor Smoking Indoors –98% prohibit smoking in all campus buildings –54% prohibit smoking in all residence halls Outdoors –50% restrict smoking outside buildings Specify certain distance (10-50 feet) from entrances, doorways and/or air intake vents Policy implementation and enforcement vary

10. 10 Increase in Smoke-Free Residence Halls, 1994-2003

11. 11 Sale and Advertising of Tobacco Campus Tobacco Sales –34% of universities sell tobacco –69% of those who sell allow students to use their meal or other account cards to purchase tobacco products Tobacco Advertising in Campus Publications –68% of student newspapers accept tobacco ads –16% have a written policy banning tobacco ads

12. 12 Tobacco Company Investments and Sponsorships Only four universities (8%) divested from tobacco company stocks No universities ban all tobacco company sponsorships of campus events –Awareness of such activities very low –Six schools (12%) limit certain events –Informants knew of specific activities at only seven schools (14%)

13. 13 What are some of the factors that may influence the development of campus policies? Question 3:

14. 14 Strength of Tobacco Control Policies by State 0-1 Policy 2 Policies 3 Policies 4 Policies 5 Policies

15. 15 Regional Location and State Measures of Tobacco Control Complete smoking ban less likely in southern colleges but more likely in western schools Composite tobacco policy score lower in tobacco producing states Composite scores correlated with higher tobacco excise tax and smoking bans in worksites

16. 16 Motivations for Policy Change Smoke-free student housing –State laws or county ordinances –Student demand –Liability and other financial concerns Ending tobacco sales on campus –Conflict of interest Divestment of tobacco stocks –Ethical and financial concerns

17. 17 Barriers to Policy Change State tobacco interests Exemption from state laws Budget concerns –Profit from tobacco sales and ads –Support for programs and activities Competition for student enrollment Greek system not under university jurisdiction

18. 18 Conclusions Recent progress in policy-making on campuses –Increase in smoke-free student housing –Decrease in campus tobacco sales Public universities still fall far short of national recommendations Regional disparity in campus policies, which can impact students’ smoking and exposure to ETS More research and advocacy needed to support colleges in developing tobacco control policies

19. 19 Student Enrollment and Campus Policies by Region