Rates of secondhand smoke exposure high among college students

Jul 21 2009

Secondhand smoke (SHS) is not only a nuisance, but a potential health concern for many college students, and administrators should be taking steps to reduce students' exposure, according to a new study by researchers at Wake Forest University School of Medicine.

It is the first study to provide evidence of the high rates of SHS exposure, and correlates of exposure, among college students in the United States.

Funded by the National Institute on Alcohol Abuse and Alcoholism, the study can be found online today and will appear in the July 23 issue of Nicotine & Tobacco Research, a publication of the Society for Research on Nicotine and Tobacco.

"It is well-known that there are some serious health issues surrounding secondhand smoke," said Mark Wolfson, Ph.D., lead author on the study, professor and section head for the Section on Society and Health in the Department of Social Sciences and Health Policy. "While some college campuses are smoke free, others have virtually no restrictions on smoking, not even in the residence halls. There is a growing national movement to move away from that, but it still very much varies by campus. In this first study to evaluate SHS exposure among college students, we were really kind of floored to see how many, and how frequently, students are exposed to it."

For the study, researchers surveyed 4,223 undergraduate college students from 10 North Carolina universities - eight public and two private. They were asked questions about their drinking and smoking habits, demographics (age, gender, race, parents' education level), lifestyle (residence on- or off-campus, living in a substance-free dormitory, participation in a fraternity or sorority) and SHS exposure.

Of the participants, 83 percent reported having been exposed to SHS at least once in the seven days preceding the survey. Most of those exposures (65 percent) happened at a restaurant or bar, followed by exposure at home or in the same room as a smoker (55 percent) and in a car (38 percent).

Daily and occasional smokers were more likely than nonsmokers to report exposure, perhaps not surprising given that they are more likely than other students to have friends who smoke and to frequent or live in locations where smoking occurs, according to the study. Similarly, students who binge drink were more likely than other students to report exposure to SHS, likely reflective of the co-occurrence of smoking and drinking among college students.

Other factors that appeared to be associated with increased exposure to SHS included living in residence locations where smoking is allowed or locations associated with smoking, such as Greek houses and off-campus housing, being female, of white race, having parents with higher education levels and attending a public versus private school.

Nearly all nonsmokers (93.9 percent) and the majority of smokers (57.8 percent) reported that SHS was somewhat or very annoying.

"We were really shocked to see that 83 percent of students reported at least some exposure during the previous week," Wolfson said. "That said, we don't know if the exposure was at a nuisance level or at a level that might influence health. Either way, knowing what we know about SHS, lowering the rates of smoking is definitely something we should be seriously looking at on college campuses."

SHS contains at least 250 chemicals that are either toxic or carcinogenic and is, itself, considered a human carcinogen. In nonsmokers, exposure to SHS is estimated to be responsible for 3,000 deaths annually from lung cancer and 35,000 deaths from coronary heart disease, respiratory infections, asthma, sudden infant death syndrome and other illnesses in children in the United States, according to the Centers for Disease Control and Prevention, 2002.

Recent studies suggest that most colleges do not have a comprehensive ban on smoking. In fact, in another study of the largest public university in each of the 50 states, researchers found that only 54 percent of schools banned smoking inside student housing and 50 percent banned smoking outside building entrances. As a result, college students are likely to be exposed to SHS regularly.

More than 10 million individuals were enrolled in 4-year degree-granting institutions in fall 2002, thus colleges represent a key setting for preventing exposure to SHS to promote public health.

Although college administrators may be limited in their ability to affect exposure in some locations, they have a responsibility to provide a safe and healthy environment for students, the authors wrote in their study, and should consider looking at ways to take steps to reduce smoking and concomitant exposure to SHS among their students. Such steps include enacting smoke-free campus policies and offering smoking cessation services, such as those recommended by the American College Health Association.

The NC Health and Wellness Trust Fund's Tobacco Free Colleges initiative promotes work to prevent initiation of tobacco use among young adults, eliminate exposure to secondhand smoke on college campuses, promote cessation and reduce health disparities among college students attributable to tobacco use.

Additionally, a new law in North Carolina prohibiting smoking in nearly all restaurants and bars will go into effect January 2, 2010.

"Debates about smoking restrictions, especially on college campuses, often revolve around considerations of individual choice," Wolfson said. "However, the issue of SHS exposure brings in the rights of all to a healthy environment. This is an issue which is beginning to resonate with many college administrators."

Co-authors on the study were Thomas P. McCoy, M.S. and Erin L. Sutfin, Ph.D., both of the School of Medicine.