Young adults smoke at rates higher than any other age group, and virtually all adult daily smokers began before age 26. As marketing to individuals under age 18 has become more difficult for the tobacco companies, they have increased their marketing to young adults. Although young adult smoking prevalence decreased for many years, that progress recently stalled. The US Department of Health and Human Services announced a new initiative supporting tobacco-free campuses in September 2012. Tobacco-free campus policies reduce secondhand exposure, lower smoking prevalence and have the potential to be high impact interventions. Policy implementation is an important but often overlooked part of the policy process, and necessary to achieve optimal outcomes. Several studies indicated that compliance with these policies is a major issue.
The objectives of this study are: (1) To identify determinants of success and barriers to adoption and implementation of comprehensive tobacco-free policies, and (2) To determine which policy implementation strategies are associated with policy compliance.
Even in California, a longstanding leader in tobacco control, there is a great deal of variation in college tobacco policies. The sample for this study will be 18 California colleges with varying tobacco policies, including tobacco-free, smokefree, smokefree with exemptions and indoor smoking ban only. The first aim will be addressed through an analysis of the written record (policy and preliminary drafts, meeting minutes, and enforcement plans) and public discussion of the policy (articles in the student newspapers). This analysis will be followed by campus visits to conduct 15-20 key informant interviews with policy stakeholders. To address the second aim, cigarette butts and smokers will be counted at 10 spots on each campus. The effectiveness of the implementation strategies used by each campus will be compared based on the result of this compliance monitoring to objectively assess effectiveness of implementation strategies.
This work will lead to the identification of best practices for adoption and implementation of tobacco-free policies.