title: Students' attitude and smoking behaviour following the implementation of a university smoke-free policy: a cross-sectional study.
abstract: OBJECTIVE
  In view of the high-smoking rate among university students in Lebanon and the known adverse effects of second-hand smoking, the American University of Beirut (AUB) decided to implement a non-smoking policy on campus. This study sought to examine the students' compliance and attitudes following the ban.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A private university in Lebanon.
  
  
  METHODS
  545 randomly selected students were approached. A stratified cluster sample of classes offered in the spring semester of the 2008/2009 academic year was selected. Students completed a self-administered paper and pencil survey during class time.
  
  
  METHODS
  The main outcomes were compliance with and attitudes towards the ban. Other secondary outcomes were the perception of barriers to implementation of the ban and attitudes towards tobacco control in general.
  
  
  RESULTS
  535 students participated in the study. Smokers were generally compliant with the ban (72.7%) and for some (20%) it led to a decrease in their smoking. Students' attitude towards the ban and the enforcement of a non-smoking policy in public places across Lebanon varied according to their smoking status whereby non-smokers possessed a more favourable attitude and strongly supported such policies compared with smokers; overall, the largest proportions of students were satisfied to a large extent with the ban and considered it justified (58.6% and 57.2%, respectively). While much smaller percentages reported that the ban would help in reducing smoking to a large extent (16.7%) or it would help smokers quit (7.4%). Perceived barriers to implementation of the non-smoking policy in AUB included the lack of compliance with and strict enforcement of the policy as well as the small number and crowdedness of the smoking areas.
  
  
  CONCLUSIONS
  An education campaign, smoking cessation services and strict enforcement of the policy might be necessary to boost its effect in further reducing students' cigarette use.
authors.affiliation: Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
authors.forename: Monique
authors.initials: M
authors.lastname: Chaaya
authors.forename: Maysam
authors.initials: M
authors.lastname: Alameddine
authors.forename: Rima
authors.initials: R
authors.lastname: Nakkash
authors.forename: Rima A
authors.initials: RA
authors.lastname: Afifi
authors.forename: Joanna
authors.initials: J
authors.lastname: Khalil
authors.forename: Georges
authors.initials: G
authors.lastname: Nahhas