1. Clean Air and Bill of Health Proposal By: Maria Jorgensen MPH 515: Health Behavior Theory Dr. Hartigan February 25, 2015

2. Introduction Background on Health Issue Population Chosen & Justification Theory, Model or Framework chosen (basic constructs, principles etc…) Use of Theory, Model or Framework in Current Practice to address Health Issue (Literature Review Summary) Basic Constructs of Proposed Health Promotion Program Conclusion & Recommendations

3. Background Information on Health Issue The State of Colorado has a smoking ban in place that covers workplaces, restaurants and bars, and public areas. – Not well enforced – Does not cover universities and colleges Currently 5 States have Smoke Free Bans for Campuses Only 5 Universities and colleges in Colorado have smoke free bans

4. Target Population More than 12 million students are enrolled in U.S. colleges and universities (Wechsler, Rigotti, Gledhill-Hoyt, & Lee, 1998) Cigarette use in this population is increasing nationally. College students are likely to be exposed regularly to SHS. National efforts, to reduce the number of people smoking and keep students from starting, need to be extended to the university level.

5. Theory of Reasoned Action The Theory of Reasoned Action uses two concepts to determine health behaviors which include: and individuals’ beliefs about health behaviors and the social influence and norms surrounding the behavior. The Theory of Reasoned Action includes the following components: – Beliefs and Evaluations – Attitude Toward Behavior – Normative Beliefs and Motivation to Comply – Subjective Norm – Behavioral Intention – Actual Behavior (DiClemente, Salazar, & Crosby, 2013)

6. Constructs of Health Program Using the Theory of Reasoned Action Program goals and strategies: Using a campus wide survey determine current perceived severity and susceptibility of smoking and secondhand smoke and determine compliance and support level of a smoking ban policy. Develop a higher perceived severity and susceptibility by developing an informative campaign on the dangers of smoking and the effects of secondhand smoke on the body and individual health. Modify current state smoking ban legislation to include public university campuses, common areas and parking lots. Annually administer perceived susceptibility and severity survey to determine differences from initial survey.

7. Literature Review “Although the implementation of a smoking ban on any university campus is a significant change, the health benefits of such a policy are as clear as the devastating effects of second hand smoke” (North Dakota State University, 2010). “As of January 1, 2015, there are at least, 514 100% smoke free campuses. Of these, 1,014 are 100% tobacco-free, and 587 prohibit the use of e- cigarettes anywhere on campus. This number has grown from the 586 campuses with 100% smoke free campus policies in October 2011 and 446 campuses in October 2010” (American Nonsmokers' Rights Foundation, 2015) In a national survey to determine student support of smoke free proposals, “a majority of students supported each of the seven proposed policies. More than three quarters of students supported a ban on smoking in all campus buildings, including residence halls and dining areas” (Rigotti, Regan, Moran, & Wechsler, 2003).

8. Conclusion Extending the number of Colorado colleges and universities that have smoke free policies can be universally attained by creating state law to protect the health of the student population. It is vital to protect the student population from the harmful health effects of smoking and secondhand smoke.

9. References American Lung Association. (2014). Colorado Smoking Restrictions. American Lung Association. Retrieved from http://www.lungusa2.org/slati/statedetail.php?stateId=08 American Nonsmokers' Rights Foundation. (2015). Smoke free and Tobacco-Free U.S. and Tribal Colleges and Universities. Berkeley. Retrieved from http://no- smoke.org/pdf/smokefreecollegesuniversities.pdf Center for Disease Control and Prevention. (2014, November 24). Health Effects of Secondhand Smoke`. Retrieved from Center for Disease Control and Prevention: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/index. htm#overview DiClemente, R. J., Salazar, L. F., & Crosby, R. A. (2013). Health Behavior Theory for Public Health. Burlington, MA: Jones and Bartlett Learning. North Dakota State University. (2010). Policy 153 "A Smoke Free Campus": The Campus Community has Spoken. Retrieved from http://www.ndsu.edu/fileadmin/pharmacy/Smoking_ban_brochure- 1_Final_For_Booth_1_.pdf Rigotti, N. A., Regan, S., Moran, S. E., & Wechsler, H. (2003). Students' opinion of tobacco control policies recommended for US colleges a national survey. Tobacco Control, 12, 251-256. doi:doi: 10.1136/tc.12.3.251 Wechsler, H., Rigotti, N. A., Gledhill-Hoyt, J., & Lee, H. (1998, November). Increased Levels of Cigarette Use Among College Students. The Journal of the American Medical Association, 280(19), 1673-1678. doi: doi:10.1001/jama.280.19.1673. Wolfson, M., McCoy, T. P., & Sutfin, E. L. (2009, August). College students' exposure to secondhand smoke. Nicotine and Tobacco Research, 11(8), 977-984. doi:doi: 10.1093/ntr/ntp100