A review of interventions to reduce tobacco use in colleges and universities.
BACKGROUND
Interventions have been designed to reduce the prevalence of smoking in college/university students. This review presents a summary and synthesis of the interventions published in English from 1980 to the present.


METHODS
Seven databases were searched for relevant published articles, and reference lists were examined for additional published studies. The studies were categorized as (1) individual approaches, such as on-campus cessation programs, and (2) institutional approaches, such as smoke-free policies. The studies were categorized by type of institution and geographic location, study design, sample demographics, and outcomes.


RESULTS
Fourteen studies were identified; only five received a "satisfactory" rating based on evaluation criteria. Most studies were based on convenience samples, and were conducted in 4-year institutions. Seven studies used comparison groups, and three were multi-institutional. Individual approaches included educational group sessions and/or individual counseling that were conducted on campus mostly by healthcare personnel. None used nicotine replacement or other medications for cessation. The quit rates for both smokeless tobacco and cigarette users varied, depending on definitions and duration of follow-up contact. Institutional interventions focused mainly on campus smoking restrictions, smoke-free policies, antitobacco messages, and cigarette pricing. Results indicated that interventions can have a positive influence on student behavior, specifically by reducing tobacco use (i.e., prevalence of cigarette smoking and use of smokeless products, amount smoked) among college students, and increasing acceptability of smoking policies and campus restrictions among both tobacco users and nonusers.


CONCLUSIONS
While some promising results have been noted, rigorous evaluations of a wider range of programs are needed, along with studies that address cultural and ethnic diversity on campuses.
Murphy-Hoefer
Rebecca
R
Centers for Disease Control and Prevention, Office on Smoking and Health, and Division of Adolescent and School Health, Atlanta, GA 30341, USA. zfg1@cdc.gov
Griffith
Reba
R
Pederson
Linda L
LL
Crossett
Linda
L
Iyer
Shanthalaxmi R
SR
Hiller
Marc D
MD
D000293:Adolescent; D000328:Adult; D005260:Female; D005858:Germany / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention; D013333:Student Health Services / Q000706:statistics & numerical data*; D013557:Switzerland / Q000453:epidemiology; D020340:Tobacco Use Cessation / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000517:prevention & control*; D014030:Tobacco, Smokeless; D014481:United States / Q000453:epidemiology