By Carolyn Crist

(Reuters Health) – Most U.S. four-year colleges and universities as well as community colleges don’t have tobacco-free or smoke-free policies on campus, a new study finds.

About 35 percent have tobacco-free policies that prohibit all tobacco use. Ten percent have smoke-free policies that prohibit cigarettes but not all tobacco. And 54 percent don’t have any policy, researchers report in the American Journal of Public Health.

“Despite years of public health effort, only 59 percent of the U.S. population is covered by smoke-free non-hospitality workplace, restaurant and bar laws in 2018,” said senior study author Kelvin Choi, a researcher with the National Institute on Minority Health and Health Disparities in Bethesda, Maryland, in email to Reuters Health.

Previous studies have found that smoke-free policies help smokers quit and prevent new smokers from making it a habit, Choi said, particularly in postsecondary educational institutions. Although some adolescents try cigarettes at younger ages, many teens and young adults form a long-term habit around ages 18-24.

Choi and colleagues surveyed 605 universities, colleges and community colleges. They found that 229 were tobacco-free, 57 were smoke-free, and 319 were not smoke-free. Schools in the western U.S. were less likely to have smoke-free policies, whereas schools in the south and midwest were more likely to have a policy. Institutions offering only associate’s degrees (versus bachelor’s degrees) were also more likely to have smoke- or tobacco-free policies.

In a further analysis, the researchers found that schools with higher proportions of racial and ethnic minority students were less likely to have a tobacco-free policy, which could compound health disparities for these groups, the authors note. For-profit schools and historically black colleges and universities were less likely to have a smoke-free policy.

“Many minority students attend for-profit educational institutions,” Choi said. “And often, institutions have policies related to smoking, but these policies have not been updated to best promote a tobacco-free culture among their employees and students.”

Institutions should continue to consider tobacco-free and smoke-free policies, the study authors wrote, especially when it comes to the changing tobacco product market and the emergence of new products such as e-cigarettes. Choi and colleagues are currently looking at what proportion of U.S. postsecondary education institutions have expanded their policies to include vaping items.

“Some people view e-cigarettes as harmless and cool, and stealth vaping is becoming a cool and rebellious thing to do at school,” said Stanton Glantz of the Center for Tobacco Control Research and Education at the University of California, San Francisco.

Glantz, who wasn’t involved with this study, has studied the associations of campus tobacco policies with secondhand smoke exposure, the intention to smoke on campus and attitudes about outdoor smoking restrictions.

In particular, tobacco-free policies should expand to cover marijuana as well, Glantz noted in a phone interview. Marijuana and blunt use is increasing among youth in high school and college, which also gives off harmful secondhand smoke, he said.

“The normative changes and social norms embodied in smoke-free policies (are) important,” Glantz said. “Particularly during young adulthood, that educational environment is also a crucial social environment where we can spread tobacco-free policies and habits.”

SOURCE: American Journal of Public Health, online August 23, 2018.