1. Tobacco Use Among College Students Dan Herbert, Erin White, Nikki McDonald, Tyler Baerwolf

2. How is tobacco being used? Most common forms of tobacco use among college students Cigarettes Hookah

3. Cigarettes Targeted toward MalesTargeted toward Females -Filterless-Long and skinny -Filtered-Menthol -Lights-Cloves -Ultra-lights -Wides

4. Hookah Hookah is a water pipe with a smoke chamber, a bowl, a pipe and a hose. Specially made tobacco is heated, and the smoke passes through water and is then drawn through a rubber hose to a mouthpiece.

5. Hookah “The tobacco is no less toxic in a hookah pipe, and the water in the hookah does not filter out the toxic ingredients in the tobacco smoke. Hookah smokers may actually inhale more tobacco smoke than cigarette smokers do because of the large volume of smoke they inhale in one smoking session, which can last as long as 60 minutes.”

6. Hookah Hookah is considered a social event and many Hookah bars exist especially in college towns. -Unique tobacco flavors Cherry Cola Fruit Roll Up Apple Grape Sex on the Beach -Flavored Water Popsicles Juices

7. Hookah versus Cigarettes http://http://www.youtube.com/watch?v=Bgi2Y85Mbwkhttp://www.youtube.com/watch?v=Bgi2Y85Mbwk

8. Tobacco Use Facts -Tobacco use leads to disease and disability -Stroke, lung diseases, heart disease, cancer -Tobacco use is the leading preventable cause of death -5 million deaths per year due to tobacco use worldwide -440,000 deaths per year from cigarettes, 49,000 due to secondhand smoke -On average, smokers die 10 years earlier than non-smokers

9. So Who’s Smoking? 19.0% of all adults 21.6% of males, 16.5% females 29.0% of adults who live below the poverty level 17.9% of adults who live at or above the poverty level 31.5% non-Hispanic American Indian/Alaska Native 27.4% non-Hispanic multiple race 20.6% non-Hispanic white 19.4% non-Hispanic black 12.9% Hispanic 9.9% non-Hispanic Asian

10. Is Education a Factor? 45.3% of adults with a GED diploma 34.6% of adults with 9–11 years of education 23.8% of adults with a high school diploma 9.3% of adults with an undergraduate college degree 5.0% of adults with a postgraduate college degree

11. Is Age a Factor? 18.9% of adults aged 18–24 years 22.1% of adults aged 25–44 years 21.4% of adults aged 45–64 years 7.9% of adults aged 65 years and older

12. Why college students are at risk -Cigarette smoking among young adults is a major concern -1/3 of college age students ages 18-24 smoke cigarettes -College students are more likely to be exposed to second hand smoke due to bars, clubs, and college housing. -Many smoke on the weekends socially and while drinking alcohol. -Stress can increase tobacco use -Smoking among college students may be influenced by history of depression or depressive symptoms. -31.9% of undergraduate smokers reported smoking was used to manage depression.

13. So Who has the label? -Some tobacco users claim tobacco is used to alleviate stress, increase concentration, clear the mind, strengthen friendships, and/or reward themselves. -These same tobacco users do not identify themselves as “smokers” -This is because smoking is negatively perceived among others on campus -But….in other environments it is perceived positively (other smokers, around alcohol, parties) -Occasional smokers claim they are not smokers because they do not smoke “a pack a day” or are “someone who smokes everyday” -In reality, 25-50% will quit, but 35-50% will maintain occasional smoking patterns, and 15-25% will become daily smokers.

14. Influences and Biases Most common reasons for initiating smoking: peer pressure, curiosity, and family influence. Most common anti-smoking influences: Friends and family Avoid negative stigma Do not smoke on campus, but smoke at parties Many occasional smokers claim they would not date a daily smoker Will not smoke around non-smoking friends or family members. “have to deal with their attitudes”

15. Risk Perceptions College smokers can recognize the general risk for smoking Short term risks recognized were mainly about physical appearance When asked personal risk perceptions… Minimized personal risk perceptions Occasional smokers didn’t feel they were affected Others know risk, but feel “its still worth it”

16. In Reality… Smoking is the cause of one in three cancer deaths in the U.S. Smoking is estimated to cause 90% of deaths related to chronic obstructive pulmonary disease. Smoking increases: Coronary heart disease by 2-4 times. Stroke occurrence by 2-4 times. Death by COPD by 12-13 times.

17. The Social Network Theory - Applies to the college environment - Individuals are influenced by their environment College Student (Nodes) Relationships (Ties) -Changing the ties can promote change or hinder it -Smoke-free campuses have been effective! Indiana University (2008) became smoke free campus Research (2009) showed students favorable changes in smoking behavior, perceptions of peer tobacco use, and smoking norms.

18. Healthy People 2020 - Tobacco Use and Environmental Health are both topics of Healthy People 2020 - Tobacco Use “Tobacco use is the single most preventable cause of death and disease in the United States.”

19. Healthy People 2020: Objectives 1. Tobacco Use Prevalence: Implementing policies to reduce tobacco use and initiation among youth and adults.

20. Healthy People 2020: Objectives 2. Health System Changes: Adopting policies and strategies to increase access, affordability, and use of smoking cessation services and treatments.

21. Healthy People 2020: Objectives 3. Social and Environmental Changes: Establishing policies to reduce exposure to secondhand smoke, increase the cost of tobacco, restrict tobacco advertising, and reduce illegal sales to minors.

22. Healthy People 2020: New Findings “The U.S. Food and Drug Administration (FDA) was granted the authority to regulate the sales, advertising, and ingredient content of all tobacco products marketed in the United States.” “The Federal Government increased the Federal tobacco excise tax by $0.61 to $1.01 per pack.” “25 states and the District of Columbia (DC) had comprehensive smoke-free laws eliminating smoking in workplaces, restaurants, and bars, and 14 States and DC had cigarette excise tax rates of at least $2 per pack.”

23. Healthy People 2020: Environment Health Obective: 1. Outdoor Air Quality “Poor air quality is linked to premature death, cancer, and long-term damage to respiratory and cardiovascular systems. Progress has been made to reduce unhealthy air emissions, but, in 2008, approximately 127 million people lived in U.S. counties that exceeded national air quality standards. Decreasing air pollution is an important step in creating a healthy environment.” “Secondhand smoke containing toxic and cancer-causing chemicals contributes to heart disease and lung cancer in nonsmoking adults.” “88 million nonsmokers are exposed to secondhand smoke each year.”

24. Healthy People 2020: New Findings “Between 2005–08 and 2009–10, exposure to secondhand smoke among children aged 3 to 11 years decreased 19.5 percent, from 52.2 percent to 42.0 percent, exceeding the Healthy People 2020 target. Exposure to secondhand smoke varies by race and ethnicity, country of birth, family income level, and health insurance status.”

25. References Brown, A. E., Carpenter, M. J., & Sutfin, E. (2011). Occasional smoking in college: Who, what, when and why?. Addictive Behaviors, 36, 1199-1204. Retrieved from ScienceDirect. Dale, L. (2012, July 20). Is hookah smoking safer than smoking cigarettes?. Retrieved from http://www.mayoclinic.com/health/hookah/AN01265 Hill, E. M., & Maggi, S. (2011). Emotional intelligence and smoking: Protective risk factors among Canadian young adults. Personality and Individual Differences, 51, Retrieved from ScienceDirect. Morrell, H., Cohen, L. M., & McChargue, D. E. (2010). Depression vulnerability predicts cigarette smoking amaong college students: Gender and negative reinforcement expectancies as contributing factors. Addictive Behaviors, 35, 607-611. Retrieved from ScienceDirect. Nichter, M., Nichter, M., Carkoglu, A., & Lloyd-Richardson, E. (2010). Smoking and drinking among college students: "it's a package deal". Drug and Alcohol Dependence, 106, 16-20. Retrieved from ScienceDirect. Seo, D., Macy, J. T., Torabi, M., & Middlestadt, S. E. (2011). The effect of a smoke-free campus policy on collegestudents' smoking behaviors and attitudes. Preventive Medicine, 53, 347-352. Retrieved from ScienceDirect.