Cigarette smoking among college students

Last updated
A student smoking a cigarette on the campus of Clark University Student smoking a cigarette.jpg
A student smoking a cigarette on the campus of Clark University
1840 woodcut of a medical student smoking a cigarette A foppish medical student smoking a cigarette; denoting a ca Wellcome V0010932.jpg
1840 woodcut of a medical student smoking a cigarette

The majority of lifelong smokers begin smoking habits before the age of 24, which makes the college years a critical time for tobacco companies to convince college students to pick up the habit of cigarette smoking. [1] Cigarette smoking in college is seen as a social activity by those who partake in it, and more than half of the students that are users do not consider themselves smokers. [2] This may be because most college students plan to quit smoking by the time that they graduate. [3]

Contents

The prevalence of cigarette smoking by college students increased through the 1990s, but has since leveled off and seen decreases in recent years. [4] Education on the dangers of cigarettes is seen as a leading cause for this decrease. This activity is being seen as less socially acceptable than it was in the past. [4]

Cigarette smoking on college campuses has become an important public health issue and there has been increase in campus wide smoking bans and other preventive programs to reduce the rates of students smoking. The cause of these bans are now starting to be discovered and there is controversy that goes along with implementing them across various schools in the United States. [5] Protests against smoking bans are seen as a possible threat at schools such as the University of Vermont and the University of Massachusetts at Amherst. [5] Some smokers may also choose to neglect the bans and continue to smoke cigarettes regardless. [4]

Statistics

The percentage of college students that smoke has fluctuated greatly over the years. Studies in 1993 and 1997 showed that the percent of U.S. college students who smoked were 22 percent and 28 percent respectively. The Harvard School of Public Health concluded the percentage of college students who used tobacco products at least once a month was about 33 percent. [6]

A study points out that from 2002 to 2016 tobacco use among college students has decreased by 47.4%. [7] Most of the college students age 18-24. [8] For this particular age group, the Centers for Disease Control and Prevention (CDC) says that 8 of 100 (8.0%) are currently smoking in 2019. [9]

Predictors associated with youth tobacco usage

Certain social, economic, and environmental factors can be associated with the prediction of youth and an increased use in tobacco. Risk factors include: [10]

Stress and emotion

Students note that smoking cigarettes reduces anxiety, and smoking often occurs after stressful events or in stressful situations. Studies find that depressed college students are more likely to smoke and have a more difficult time quitting than non-depressed college students.. The reason that depressed students have trouble quitting smoking is because smoking cigarettes releases a chemical called dopamine which contributes to the feeling of pleasure and an upgraded level of satisfaction. [11] 31.9% of college smokers attribute their smoking behavior as a means to alleviate their depression. [12]

Weight loss

For women in particular, smoking is a tool for weight loss and weight management. [13] Nicotine in cigarettes is a successful appetite suppressant, which contributes to the use of cigarettes as a dieting tool. The pressure to be thin along with a need for social approval drives many young college women to smoke. [13] Body-conscious college women are also shown to be at higher risk for the continuation of smoking. Women who discontinue the use of nicotine as an appetite suppressant tend to gain weight initially, and women who are especially concerned with body weight will see this as a reason to continue smoking. [14] The media and tobacco advertising play an increasing role in perpetuating the thin body ideal. Studies show the more exposure women have to images of thin women, the lower their body satisfaction, and the more likely they are to want to diet. [14]


Variation of Smokers' Intelligent Quotient.

Research proves that smoking cigarettes lowers the potential of a person who's trying to learn new information as well as prevents them from properly and completely retrieving the information they already have but it doesn't necessarily stop smokers from creating new memories. Making things clearer, smoking cigarettes negatively affects retrospective memory but it neutral towards prospective memory. As a whole, these factors both have a bulk effect on smoker's IQs thus the IQ level is lowered because of the loss of retrospective memory. [15]

Field of study

Some studies suggest even a student’s field of study may correlate to their smoking. The highest rates of smoking are found in students majoring in Communications, languages, or Cultural Studies, (37.4%) and the lowest rates of smoking are found in students majoring in Mathematics, Engineering, and sciences (21.0%). [16] A study conducted at the University of Saint Joseph in Connecticut found that only 4% of nursing and bio-medical or health majors smoked cigarettes while up to 12% of students in other majors smoked. [17]

Social activity

Smoking is viewed, by some students, as a way to socialize and take study breaks. [18]

Social smokers

Today’s smoking culture includes a subpopulation of smokers called “social smokers”. Although there may be different explanations of what a social smoker is, many college students define “social smokers” as those who use tobacco in more social activities and find it essential for socializing, rather than using tobacco on a regular basis, dictated by nicotine dependence. [18] Social smokers are not addicted to smoking, or worried about the social acceptability of their smoking habits. [18] In a study conducted in 2004, 51% of current college smokers stated that they primarily smoked with other people and in social activities. 71% of occasional smokers smoked in a social situation, compared to daily smokers, 19% of which smoke in social environment. Students who started smoking within the past two years of the study were more than twice as likely to be social smokers than students who had been smoking for a longer period of time prior to the study. Characteristics of social smokers have been found to include more females and non-Hispanic whites than other demographic characteristics, spent more time socializing with friends, were binge drinkers and had a high importance for the arts. Lastly, social smokers don’t perceive themselves at risk to tobacco related illnesses, nor believe they will ever become nicotine dependent. Since social smokers don’t think they’ll become dependent on nicotine, they don’t plan on quitting during college, but have intentions to quit once they graduate. [19]

Smoking and perceived gender disparities

Studies have shown that there are social differences in the smoking behaviors of males and females in college. In a 2006 study, qualitative analysis data showed that males and females have certain perceptions of their sex or the opposite sex smoking. From both male and female students’ perspectives, there were negative feelings towards women smoking and it was considered “unladylike”. However, if men were smoking, the perception was positive, and they were considered cool or gave off a “tough guy” image. In addition to drinking alcohol at parties, male students appeared in control if they had a cigarette in the other hand. Even though there were negative perceptions of female students smoking, smoking at parties is considered more of a female behavior rather than a male behavior. Despite negative perceptions of females smoking, students thought that when females smoke in groups of girlfriends it wasn’t trashy. Rather, when female students smoked in groups of girlfriends it appeared as though individual’s smoking habits were regulated by the group, instead of the individual’s dependence on nicotine. These perceived gender differences are inextricably linked with social environments where smoking and alcohol consumption occur. The perceptions of cigarette smoking in male and female students reflect similar perceptions of alcohol use in college students. [20]

Targeting by the tobacco industry

1952 Philip Morris advertisement in the Duke Chronicle, a student newspaper Duke Chronicle 1952-01-11 page 9.jpg
1952 Philip Morris advertisement in the Duke Chronicle , a student newspaper

The tobacco industry is particularly concerned with younger audiences because they constitute the future of smoking and tobacco profits. In an insider document from Philip Morris written in 1981, the company states:

It is important to know as much as possible about teenage smoking patterns and attitudes. Today's teenager is tomorrow's potential regular customer, and the overwhelming majority of smokers first begin to smoke while still in their teens... The smoking patterns of teenagers are particularly important to Philip Morris. [21]

Replacement smokers

The industry refers to new smokers as “replacement smokers” because they are in effect, replacing smokers who have quit or died, whether from smoking or other causes, over the years. [22] Young people, including college students, constitute the majority of replacement smokers, and tobacco companies have created marketing campaigns targeting this age group. These advertisements show smoking as modern, hip, cool, fun, and adventurous. [22]

Alternative press

Tobacco companies use “alternative press” and brand recognition as another way to advertise toward college-aged students. Companies put their logo on everyday items like towels, clothing, and accessories, and this memorabilia is then given for free during events. [22] These logos can also be seen in restaurants and bars, which are places young people frequent. During the 1980s and 1990s, tobacco companies aggressively advertised their products in bars and nightclubs, mostly targeting younger audiences. [23] According to insider documents from tobacco companies RJ Reynolds and Philip Morris, tobacco companies had several strategies for targeting youth. They handed out free samples, sponsored parties at bars and fraternities on campuses, and hosted many events in popular spring break towns. [23] Tobacco companies have also been known to increase their presence in post-secondary institutions in North America between 1996–1999 by making donations to universities and holding appointments within educational institutions. [24]

Smoking bans

Each year, approximately 440,000 deaths and $193 billion in healthcare costs are related to cigarette smoking, including smoking on college campuses [25] (even though taxed tobacco amount to an excess of over $245 billion locally and is funded on the behalf of cancer research). Many campuses in the United States are attempting to reduce smoking rates among students by implementing campus-wide smoking bans. Various forms of smoking bans have been around for hundreds of years. The first recorded legislation prohibiting tobacco use was in the Spanish colonies in 1575, passed by the Roman Catholic Church.[ citation needed ]

In the United States, the first smoking bans were made around the early twentieth century and have been increasing ever since. In 1973, Arizona became the first state in the current era to pass a comprehensive law restricting smoking in public places. [26] The numbers of smoking bans on college campuses across the country have been increasing. Between 2006 and 2008, the number of smoke-free campuses quadrupled from 34 to 160, [27] but approximately 365 US colleges and universities have implemented some kind of anti-smoking rule, both indoor and outdoor [28] as well as around 500 campuses have smoke-free policies set in place for their residential housing. [29]

On the other hand, some students feel that these smoking bans violate their rights. The tobacco industry agrees that individuals should be able to avoid ETS or SHS, but believe that complete campus-wide bans "go too far". [29] A study from 2005 found that other forms of intervention to decrease the rates of tobacco use on campus, such as restriction of tobacco distribution and restriction of smoking within 20 feet from entrances weren’t as effective as other programs like smoking cessation programs in influencing college students’ smoking behaviors. [30] When prevention-oriented education was present on college campuses, students were 23% less likely to smoke compared to their peers who were not exposed to this kind of education. [30] In addition to campus wide smoking bans, other interventions include health promotion programs that teach students the benefits of avoiding smoking and environments with smoke and create a general healthy college community. [31]

Related Research Articles

<span class="mw-page-title-main">Tobacco smoking</span> Practice of burning tobacco and breathing the resulting smoke

Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is generally done with pipes and cigars. The practice is believed to have begun as early as 5000–3000 BC in Mesoamerica and South America. Tobacco was introduced to Eurasia in the late 17th century by European colonists, where it followed common trade routes. The practice encountered criticism from its first import into the Western world onwards but embedded itself in certain strata of a number of societies before becoming widespread upon the introduction of automated cigarette-rolling apparatus.

<span class="mw-page-title-main">Smoking cessation</span> Process of discontinuing tobacco smoking

Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine, which is addictive and can cause dependence. As a result, nicotine withdrawal often makes the process of quitting difficult.

<span class="mw-page-title-main">Nicotine replacement therapy</span> Treatment for tobacco use disorder

Nicotine replacement therapy (NRT) is a medically approved way to treat people with tobacco use disorder by taking nicotine through means other than tobacco. It is used to help with quitting smoking or stopping chewing tobacco. It increases the chance of quitting tobacco smoking by about 55%. Often it is used along with other behavioral techniques. NRT has also been used to treat ulcerative colitis. Types of NRT include the adhesive patch, chewing gum, lozenges, nose spray, and inhaler. The use of multiple types of NRT at a time may increase effectiveness.

<span class="mw-page-title-main">Nicotine marketing</span> Marketing technique

Nicotine marketing is the marketing of nicotine-containing products or use. Traditionally, the tobacco industry markets cigarette smoking, but it is increasingly marketing other products, such as electronic cigarettes and heated tobacco products. Products are marketed through social media, stealth marketing, mass media, and sponsorship. Expenditures on nicotine marketing are in the tens of billions a year; in the US alone, spending was over US$1 million per hour in 2016; in 2003, per-capita marketing spending was $290 per adult smoker, or $45 per inhabitant. Nicotine marketing is increasingly regulated; some forms of nicotine advertising are banned in many countries. The World Health Organization recommends a complete tobacco advertising ban.

<span class="mw-page-title-main">Health effects of tobacco</span> Circumstances, mechanisms, and factors of tobacco consumption on human health

Tobacco products, especially when smoked or used orally, have serious negative effects on human health. Smoking and smokeless tobacco use is the single greatest cause of preventable death globally. As many as half of people who smoke tobacco or use it orally die from complications related to such use. It has been estimated that each year, in total about 6 million people die from tobacco-related causes, with 600,000 of these occurring in non-smokers due to secondhand smoke. It is further estimated to have caused 100 million deaths in the 20th century.

<span class="mw-page-title-main">Menthol cigarette</span> Cigarette flavored with the compound menthol

A menthol cigarette is a cigarette infused with the compound menthol which imparts a “minty” flavor to the smoke. Menthol also decreases irritant sensations from nicotine by desensitizing receptors, making smoking feel less harsh compared to regular cigarettes. Some studies have suggested that they are more addictive. Menthol cigarettes are just as hard to quit and are just as harmful as regular cigarettes.

Tobacco harm reduction (THR) is a public health strategy to lower the health risks to individuals and wider society associated with using tobacco products. It is an example of the concept of harm reduction, a strategy for dealing with the use of drugs. Tobacco smoking is widely acknowledged as a leading cause of illness and death, and reducing smoking is vital to public health.

<span class="mw-page-title-main">Electronic cigarette</span> Device that vaporizes a liquid nicotine solution for inhalation

An electronic cigarette (e-cigarette) or vape is a device that simulates tobacco smoking. It consists of an atomizer, a power source such as a battery, and a container such as a cartridge or tank. Instead of smoke, the user inhales vapor. As such, using an e-cigarette is often called "vaping". The atomizer is a heating element that vaporizes a liquid solution called e-liquid, which quickly cools into an aerosol of tiny droplets, vapor and air. The vapor mainly comprises propylene glycol and/or glycerin, usually with nicotine and flavoring. Its exact composition varies, and depends on several things including user behavior.

<span class="mw-page-title-main">Smoking</span> Practice of inhaling a burnt substance for psychoactive effects

Smoking is a practice in which a substance is combusted and the resulting smoke is typically inhaled to be tasted and absorbed into the bloodstream of a person. Most commonly, the substance used is the dried leaves of the tobacco plant, which have been rolled with a small rectangle of paper into an elongated cylinder called a cigarette. Other forms of smoking include the use of a smoking pipe or a bong.

<span class="mw-page-title-main">Ventilated cigarette</span> Cigarette that delivers a lower concentration of chemicals than regular cigarettes

Ventilated cigarettes are considered to have a milder flavor than regular cigarettes. These cigarette brands may be listed as having lower levels of tar ("low-tar"), nicotine, or other chemicals as "inhaled" by a "smoking machine". However, the scientific evidence is that switching from regular to light or low-tar cigarettes does not reduce the health risks of smoking or lower the smoker's exposure to the nicotine, tar, and carcinogens present in cigarette smoke.

<span class="mw-page-title-main">Muʽassel</span> Syrupy tobacco mixture used in hookahs

Muʽassel, or maassel, is a syrupy tobacco mix containing molasses, vegetable glycerol and various flavourings which is smoked in a hookah, a type of waterpipe. It is also known as "shisha".

Smoking in China is prevalent, as the People's Republic of China is the world's largest consumer and producer of tobacco. As of 2022, there are around 300 million Chinese smokers, and 2.4 trillion cigarettes are sold there every year, 46% of the world total.

<span class="mw-page-title-main">Youth smoking</span> Overview article

Smokingamong youth and adolescents is an issue that affects countries worldwide. While the extent to which smoking is viewed as a negative health behavior may vary across different nations, it remains an issue regardless of how it is perceived by different societies. The United States has taken numerous measures, ranging from changes in national policy surrounding youth cigarette access to changes in media campaigns, in attempts to eliminate the use of tobacco products among teenagers. Approximately 90% of smokers begin smoking prior to the age of 18.

<span class="mw-page-title-main">Cigarette smoking for weight loss</span> Weight control method

Cigarette smoking for weight loss is a weight control method whereby one consumes tobacco, often in the form of cigarettes, to decrease one's appetite. The practice dates to early knowledge of nicotine as an appetite suppressant.

<span class="mw-page-title-main">Smoking in Syria</span> Legality, popularity and history of smoking in Syria

Smoking in Syria is steadily increasing in popularity amongst the Syrian population, mainly in the forms of cigarettes or narghiles. In Syria, the General Organization of Tobacco manages the growth and exportation of tobacco products. Syrians collectively spend about $600 million per year on tobacco consumption. As of 2010, 20% of women and 60% of men smoke and 98% of the overall population is affected by passive smoking. Narghiles and cigarettes are the two main forms of tobacco consumption. Despite the assumption that smoking, specifically the narghile, is embedded in Syrian culture, this phenomenon has only recently become widespread. Health officials are currently working on smoking cessation programs and policies, to remove this idea that smoking in Syria is an essential part of the culture, to educate regarding health effects, and to prevent citizens from smoking in public places.

<span class="mw-page-title-main">Smoking in Egypt</span> Overview of smoking in Egypt

The use of tobacco products in Egypt is widespread. It is estimated that approximately twenty percent of the population uses tobacco products daily. Cigarettes are the most common form of tobacco consumption in Egypt, with an estimated twenty billion cigarettes smoked annually in the country. After cigarettes, shisha water-pipes are the most common form of tobacco consumption.

Smoking in South Korea has decreased overall for both men and women in the past decades. However, a high prevalence of tobacco use is still observed, especially with the rise of novel tobacco products such as e-cigarettes and heat-not-burn tobacco products. There are socioeconomic inequalities in smoking prevalence according to gender, income, education, and occupational class. Advocates call for measures to reduce the smoking rates and address smoking inequalities using a combination of monitoring and tobacco control policies. These measures include significant price hikes, mandatory warning photos on cigarette packs, advertising bans, financial incentives, medical help for quitting, and complete smoking bans in public places.

The scientific community in the United States and Europe are primarily concerned with the possible effect of electronic cigarette use on public health. There is concern among public health experts that e-cigarettes could renormalize smoking, weaken measures to control tobacco, and serve as a gateway for smoking among youth. The public health community is divided over whether to support e-cigarettes, because their safety and efficacy for quitting smoking is unclear. Many in the public health community acknowledge the potential for their quitting smoking and decreasing harm benefits, but there remains a concern over their long-term safety and potential for a new era of users to get addicted to nicotine and then tobacco. There is concern among tobacco control academics and advocates that prevalent universal vaping "will bring its own distinct but as yet unknown health risks in the same way tobacco smoking did, as a result of chronic exposure", among other things.

<span class="mw-page-title-main">Tobacco-free college campuses</span>

Tobacco-free college campuses are colleges and universities that have implemented policies prohibiting the use of tobacco products at all indoor and outdoor campus locations. Tobacco is known to be harmful to the health of smokers, bystanders, and the environment. Since this issue was first recognized, colleges have been creating policies for tobacco use on campus in an effort to improve health standards, provide more enjoyable campus conditions, and to reduce the negative environmental effects of tobacco.

Electronic cigarettes are marketed to smoking and non-smoking men, women, and children as being safer than cigarettes. In the 2010s, large tobacco businesses accelerated their marketing spending on vape products, similar to the strategies traditional cigarette companies used in the 1950s and 1960s.

References

  1. "Research Reveals When and Why Students Smoke in Effort to Help Them Quit". medicine.missouri.edu. Archived from the original on 2016-04-03. Retrieved 2016-03-22.
  2. Levinson, Arnold H.; Campo, Shelly; Gascoigne, Jan; Jolly, Olivia; Zakharyan, Armen; Tran, Zung Vu (2007-08-01). "Smoking, but not smokers: identity among college students who smoke cigarettes". Nicotine & Tobacco Research. 9 (8): 845–852. doi:10.1080/14622200701484987. ISSN   1462-2203. PMID   17654297.
  3. "Research Reveals When and Why Students Smoke in Effort to Help Them Quit". medicine.missouri.edu. Archived from the original on 2016-04-03. Retrieved 2016-03-24.
  4. 1 2 3 "Do college campus smoking bans work? - The Boston Globe". BostonGlobe.com. Retrieved 2016-03-22.
  5. 1 2 "Smoking bans spark controversy". USA TODAY College. Retrieved 2016-03-22.
  6. Schorr, Melissa. "A Third of College Students Smoke". ABC. Retrieved July 4, 2013.
  7. Odani, S., Soura, B., Tynan, M., Lavinghouze, R., King, B., & Agaku, I. "Tobacco and Marijuana Use Among US College and Noncollege Young Adults, 2002–2016".{{cite web}}: CS1 maint: multiple names: authors list (link)
  8. National Center for Education Statistics. "Total fall enrollment in degree-granting postsecondary institutions, by attendance status, sex, and age: Selected years, 1970 through 2026".
  9. The Centers for Disease Control and Prevention (22 August 2022). "Current Cigarette Smoking Among Adults in the United States".
  10. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994
  11. "Smokers' Brains Change in Response to High Levels of Nicotine". Mayo Clinic News Network. 2012-02-24. Retrieved 2022-02-17.
  12. Morrell, Holly E.R.; Cohen, Lee M.; McChargue, Dennis E. (2010). "Depression vulnerability predicts cigarette smoking among college students: Gender and negative reinforcement expectancies as contributing factors". Addictive Behaviors. 35 (6): 607–611. doi:10.1016/j.addbeh.2010.02.011. PMC   2838988 . PMID   20181432.
  13. 1 2 Zucker, Alyssa N.; Harrell, Zaje A.; Miner-Rubino, Kathi; Stewart, Abigail J.; Pomerleau, Cynthia S.; Boyd, Carol J. (2001). "Smoking in College Women: The Role of Thinness Pressures, Media Exposure, and Critical Consciousness". Psychology of Women Quarterly. 25 (3): 233–241. doi:10.1111/1471-6402.00024. S2CID   145246251.
  14. 1 2 Pomerleau, Cynthia S.; Ehrlich, Emily; Tate, James C.; Marks, Judith L.; Flessland, Karen A.; Pomerleau, Ovide F. (1993). "The female weight-control smoker: A profile". Journal of Substance Abuse. 5 (4): 391–400. doi:10.1016/0899-3289(93)90007-x. PMID   8186673.
  15. Weiser, Mark; Zarka, Salman; Werbeloff, Nomi; Kravitz, Efrat; Lubin, Gad (2010). "Cognitive test scores in male adolescent cigarette smokers compared to non-smokers: a population-based study". Addiction. 105 (2): 358–363. doi: 10.1111/j.1360-0443.2009.02740.x . ISSN   1360-0443. PMID   19919595.
  16. Berg, Carla J.; Klatt, Colleen M.; Thomas, Janet L.; Ahluwalia, Jasjit S.; An, Lawrence C. (September 2009). "The Relationship of Field of Study to Current Smoking Status among College Students". College Student Journal. 43 (3): 744–754. ISSN   0146-3934.
  17. USJ Majors and Smoking Study 2012 (4)
  18. 1 2 3 Moran, Susan; Wechsler, Henry; Rigotti, Nancy A. (2004). "Social Smoking Among US College Students". Pediatrics. 114 (4): 1028–1034. doi:10.1542/peds.2003-0558-l. PMID   15466101. S2CID   11451274.
  19. Moran, Susan; Wechsler, Henry; Rigotti, Nancy (October 1, 2004). "Social Smoking Among US College Students". Pediatrics. 114 (4): 1028–1034. doi:10.1542/peds.2003-0558-L. PMID   15466101. S2CID   11451274 . Retrieved 13 September 2022.
  20. Nichter, Mimi; Nichter, Mark; Lloyd-Richardson, Elizabeth E.; Flaherty, Brian; Carkoglu, Asli; Taylor, Nicole (2006). "Gendered Dimensions of Smoking Among College Students". Journal of Adolescent Research. 21 (3): 215–243. doi:10.1177/0743558406287400. S2CID   144633560.
  21. Mackay J., & Eriksen M. (2002). The Tobacco Atlas. World Health Organization
  22. 1 2 3 "Recruiting the Replacement Smoker | Handout". Archived from the original on 2010-10-24. Retrieved 2010-04-27.
  23. 1 2 Sepe, Edward; Ling, Pamela M.; Glantz, Stanton A. (2002). "Smooth Moves: Bar and Nightclub Tobacco Promotions That Target Young Adults". American Journal of Public Health. 92 (3): 414–419. doi:10.2105/ajph.92.3.414. PMC   1447091 . PMID   11867322.
  24. Dilliott, Daniel; Fazel, Sajjad; Ehsan, Nazia; Sibbald, Shannon (7 August 2020). "The attitudes and behaviors of students, staff and faculty towards smoke-free and tobacco-free campus policies in North American universities: A narrative review". Tobacco Prevention & Cessation. 6 (August): 47. doi: 10.18332/tpc/125080 . PMC   7493649 . PMID   32954060.
  25. "Weekly report" (PDF). www.cdc.gov. November 13, 2009. Retrieved 2019-07-14.
  26. "Smoking Bans - A History". Archived from the original on 2010-04-25. Retrieved 2010-04-27.
  27. "Smoking's latest battleground: The college campus | StarTribune.com". Star Tribune . Archived from the original on 2009-08-24. Retrieved 2010-04-27.
  28. Cruz, Gilbert (December 14, 2009). "Campus Smoking Bans? Some Saying 'Lighten Up'". Time via content.time.com.
  29. 1 2 "More colleges stamp out smoking - USATODAY.com". usatoday30.usatoday.com.
  30. 1 2 Borders, Tyrone F.; Xu, K. Tom; Bacchi, Donna; Cohen, Lee; SoRelle-Miner, Danielle (July 7, 2005). "College campus smoking policies and programs and students' smoking behaviors". BMC Public Health. 5 (1): 74. doi: 10.1186/1471-2458-5-74 . PMC   1177969 . PMID   16001977.
  31. Martinelli, Angela Maria (1999). "An Explanatory Model of Variables Influencing Health Promotion Behaviors in Smoking and Nonsmoking College Students". Public Health Nursing. 16 (4): 263–269. doi:10.1046/j.1525-1446.1999.00263.x. PMID   10499015.