The end of the daily smoker?

Based on the Spring 2014 National College Health Assessment data, daily smokers are only 3.4 percent of the student population. This number, along with any smoking in the past 30 days, has been steadily decreasing for over a decade. Currently, only about 12 percent of students smoked in the past month. About half of those smoke an average of one time per week or less. Surprised?

What Does This Mean?

It means that almost three-quarters of college smokers are not daily smokers, most identifying as “social smokers.” This population has perplexed researchers and tobacco control professionals for years. Since many social smokers do not consider themselves smokers and are, to some degree, able to control when and how frequently they smoke, presenting them with a need to quit can be a great challenge.

Gone are the days of chain-smoking one’s way through study sessions. It’s almost as if tobacco has become more of a recreational drug, to be used occasionally, rather than a daily compulsion. What’s more confounding is that this goes against what we have preached for so long—that cigarettes are so powerfully addictive that you will become a daily smoker after just a few cigarettes. For some that is true, but these statistics simply do not reflect that. Cigarettes are powerfully addictive. It’s not clear as to why so many who use them do not turn into daily users. We also do not know what happens to these social smokers after graduation. Do they quit? Do they continue to use occasionally? Do they increase use? This raises more questions than answers.

E-Cigarette Use and Vaping on College Campuses

The wild card in all this analysis is the role of e-cigarettes. The survey data analyzed for this article did not include questions about e-cigarette use, or vaping. It is unclear how vaping and the emerging use of e-cigarettes among college students is impacting traditional tobacco use or even how students interpret questions about smoking when they primarily use e-cigarettes.

What We Know: Tobacco-Free and Smoke-Free Policies on College Campuses

It’s clear that tobacco-free campus policies are having a positive effect. Typically there is a decrease in total use, and it appears that they also alter the perception of how many students actually smoke. The profound over-estimate of how many and how much peers smoke has declined over the past ten years. In addition, tobacco-free policies help sustain the new norm of declining smoking rates.

Smokeless Tobacco Use and Cessation

Unfortunately, one possible side effect of increased focus on secondhand smoke is the uptick in smokeless (chew, dip) use. Though not a large jump, any use within the 30-day period went up from 3.1 percent in 2004 to 5.2 percent in 2014. Certain populations, particularly athletes, are more likely to use chew or dip, and localized efforts to reduce smokeless tobacco use should be employed. Sadly, few resources exist nationally to help chew users quit, though some smoking cessation options can be adapted for smokeless cessation.

Other Considerations: Non-College Populations and Socio-Economic Factors

In addition, there are large disparities in tobacco use in the US. Unfortunately, populations most susceptible to unhealthy behaviors and environments are also the most likely to use tobacco, as well as the least likely to attend and graduate from college. For a variety of socio-economic reasons, the heaviest tobacco users typically are not the ones to go to college.

The gains that we in higher education have seen in tobacco prevention have not been similarly realized within non-college populations. This is something that we should not feel good about and should utilize what influence we have to help decrease the devastation caused by tobacco in our wider communities.

What Next?

Step 1: Continue to pass tobacco-free campus policies.

Even just ten years ago, the thought of having a completely tobacco-free campus seemed a little far-fetched. Now, though, there are 1,577 campuses with 100% smoke-free policies, 1,079 of which are 100% tobacco free. Campus policy change accelerates norm change. And it’s making a difference.

Step 2: Identify ways to reach non-daily smokers and discover their motivations for tobacco cessation.

There simply is not a foolproof strategy for getting young adult non-daily smokers to quit. For any tobacco user, quitting is a very personal event, and helping the person discover self-motivations for cessation is the crucial first step.

Talk to students. Find out what they like about smoking, when they tend to do it, what they hope they’ll gain from it, what they don’t like about it, when they would know it was time to stop permanently, and how motivated they are to make a quit attempt. From there, action plans can be made.

Step 3: Offer evidence-based resources for cessation that match the population.

For many years, we have primarily referred tobacco users to telephone quitlines for cessation assistance. These are tremendous resources and have helped millions of people through quit attempts. However, younger generations are less likely to utilize the telephone for voice communications. There is more reluctance to call a counselor via the quitline. Campuses must embrace and promote other technologies, such as text message, app, web-based, or social media-based cessation assistance programs. Healthline recently came out with a list of the Best Quit Smoking Apps, which feature free mobile applications such as Livestrong MyQuit Coach and Quit It Lite.

Step 4: Provide as much cessation assistance as we can while students are within our care.

Colleges have many touch points and opportunities to help students with a multitude of behaviors. Helping individuals learn to effectively deal with stress and to do so without tobacco will benefit them greatly in the future. The sooner someone stops using tobacco, the greater the opportunity for health improvement and repairs to the body. Promote student wellness on campus, and institute programs and knowledge-sharing that aim to help students feel more resilient and well-balanced.

Step 5: Take a genuine interest in decreasing tobacco death and disease across all populations and work with the community to implement evidence-based practices for prevention and smoking and tobacco cessation.

It is a privilege to attend college and, by default, benefit from many protective factors that go along with it. As described above, many communities within our cities are constantly dealing with health-impairing products, behaviors, and environments. Peer educators, student leaders, and concerned citizens can assist efforts to improve the overall public health. We encourage this as opportunity for civic engagement and outreach.

Additional Resources for Your Tobacco Prevention & Cessation Efforts

The BACCHUS Store has pamphlets, giveaway items and other resources to enhance your tobacco-related programming.

NASPA also offers trainings and technical assistance to help campuses at all phases of the tobacco policy process. We also offer our Certified Peer Educator training for student leaders. Please visit our website to learn more.

National Tobacco and Smoking Cessation Resources

• Smokefree.gov – A national resource with web-based information, downloads, a smartphone app, and a text message-based cessation tool, smokefreeTXT.
• Becomeanex.org – A partnership of the Truth Initiative and the Mayo Clinic, with customized quit plans, peer support and virtual discussion groups.
• 1-800-QUIT NOW – The national quitline number that automatically routes to the caller’s state quitline.​
• NASPA has also recently compiled a list of recent happenings and campaigns from the world of tobacco prevention and cessation, including new research, evidence-based strategies, and proven national campaigns: What’s Happening in Tobacco Prevention & Cessation?

Upcoming Related Events

• NASPA Alcohol, Other Drug, and Violence Prevention Conference: A NASPA Strategies Conference – Equipping student affairs practitioners with the knowledge and skills necessary to address and prevent substance abuse among college students.