The Tobacco-Free College
Campus Initiative
Making the Case for Your Campus
Going Tobacco-Free
Clifford E. Douglas, J.D.
Director, University of Michigan Tobacco Research Network
Lecturer, University of Michigan School of Public Health
Consulting Tobacco Control Policy Advisor to the Assistant Secretary
for Health, U.S. Department of Health and Human Services
May 29, 2013
ACHA 2013 Annual Meeting – Boston
Topics
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The tobacco epidemic
Commitment of the U.S. Department of
Health and Human Services
Acceleration of campus policies nationwide
Why go tobacco-free?
Effectiveness of campus policies
Economic costs and benefits
The Tobacco
Epidemic
AIDS
Car crashes
Heroin
Homicide
Alcohol
Fires
Cocaine
Suicide
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90% of all
smokers start
before age 18
99% of all
smokers start
before age 26
Cigarettes and other tobacco products are highly addictive
 More than 7,000 chemicals & chemical compounds in
tobacco smoke
 Young adults under age 30 who started smoking as teens
or in early twenties can develop …
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 Early cardiovascular disease
 Smaller lungs that don’t function normally
 Wheezing that leads to asthma
 DNA damage that can cause cancer
almost anywhere in the body
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Lifelong smokers get sicker and die
an average of 13 years younger than non-smokers
Acetone (solvent and paint
stripper)
Ammonia (poisonous gas and
toilet bowl cleaner)
Arsenic (potent ant poison)
Benzene (poisonous toxin)
Butane (flammable chemical in
lighter fluid)
Cadmium (carcinogenic
chemical in batteries; lung &
intestinal irritant)
Carbon monoxide (poisonous
gas in auto exhaust)
Formaldehyde (dead frogs love it)
Hydrogen cyanide (deadly
ingredient in rat poison)
Methanol (jet engine and rocket fuel)
Polonium-210 (radioactive
element and spy-killer)
Toluene (poisonous industrial solvent)
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One day’s inhalations: 10 per cigarette x 20 cigarettes
per day = 200
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One year’s inhalations = 200 inhalations x 365 days =
73,000
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50 years of smoke (by the average smoker’s mid-60s, if
still alive) = 3.65 million inhalations on 365,000
cigarettes
There is no safe level of tobacco use or exposure
to secondhand smoke
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24.8% of full-time college students aged 18-22 years old
were current smokers in 2010 (almost 1/3 aged 18-26)
The number of smokers who initiated smoking after age
18 increased from 600,000 in 2002 to 1 million in 2010
Progression from occasional to daily smoking almost
always occurs by age 26
Tobacco companies have carefully studied the attitudes and
behaviors of young people, particularly as they go through life
transitions, such as attending college.
“After years of steady progress, declines in youth
tobacco use have slowed for cigarette smoking and
stalled for use of smokeless tobacco. The latest
research shows that concurrent use of multiple
tobacco products is common among young people,
and suggest that smokeless tobacco use is increasing
among White males.”
- Surgeon General’s Report, 2012
There are approximately 8 million
smokeless tobacco users in the U.S.
If We Don’t Accelerate Our Progress
Based on current rates, more than 1 million
current college students are projected to die
prematurely from tobacco use
“If young people don’t start using tobacco by
age 26, they almost certainly will never start.”
- Surgeon General Regina Benjamin
Historic New
Commitment of the U.S.
Department of Health
and Human Services
Vision:
A society free of tobaccorelated death and disease
First Charge:
www.hhs.gov/ash/initia
tives/tobacco/tobaccos
trategicplan2010.pdf
Base the new HHS strategic
action plan on the tobacco
control goals set forth in
Healthy People 2020
*With due respect to previous founding fathers
Healthy People 2020’s Tobacco
Prevention Objectives
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Reduce tobacco use by adults and adolescents
Reduce the initiation of tobacco use by
children, adolescents, and young adults
Increase successful cessation attempts by
tobacco users; and
Reduce the proportion of non-smokers exposed
to secondhand smoke
A Key Pillar of HHS’s Plan is Leading
by Example (“Walking the Talk”)
• In July 2011, HHS established a comprehensive
tobacco-free campus policy covering all indoor
and outdoor properties
• The announcement stated: “Taking this action
will protect the health and safety of all HHS
employees, contractors and visitors and will
serve as a role model for workplaces
everywhere … Educational and promotional
efforts will be provided in support of the policy’s
implementation. We know that quitting tobacco
can be difficult for even the most motivated
people, and we want to help employees
succeed.”
Vision:
Widespread expansion of tobacco-free
policies to institutions of higher learning
across the U.S.
Goals:
1. Foster a collaborative, cooperative effort
among academic institutions and partners
in the public health community
2.
Expand awareness in academia and
among the public of the need for and
benefits of such policies
3.
Facilitate information flow and access to
technical assistance
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Lead Partners
◦ U.S. Department of Health
and Human Services
◦ American College Health
Association
◦ University of Michigan
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Sponsors
◦ American Legacy Foundation
◦ Americans for Nonsmokers’
Rights
◦ Campaign for Tobacco-Free
Kids
◦ National Center for Tobacco
Policy
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Other Partners
◦ American Lung Association
◦ The BACCHUS Network
◦ California Youth Advocacy
Network (CYAN)
◦ Center for Social Gerontology
(Smoke-Free Environments
Law Project)
◦ Global Advisors on
Smokefree Policy (GASP)
◦ Montana State University
◦ Partnership for Prevention
◦ State University of New York
Upstate Medical University
◦ Tobacco Control Legal
Consortium
Acceleration of
Campus Policies
Nationwide
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As of April 2013
◦ 1,159 campuses in U.S. are 100% smoke-free with no exemptions,
including residential housing facilities (where applicable)
◦ Of those, 783 – almost 68% – have a 100% tobacco-free policy
◦ Examples of large campuses that already are or are becoming
tobacco-free:
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University of California (all 10 campuses)
City University of New York (all 24 campuses)
University of Arizona
University of Oregon
University of Oklahoma
University of Kentucky
Montana State University
University of Florida (“Gators don’t chew. They chomp!”)
Emory University
Ohio State University (pending)
Source: Americans for Nonsmokers’ Rights Foundation,
http://www.no-smoke.org/pdf/smokefreecollegesuniversities.pdf
Opportunity
There are 4,583 colleges, universities and
other institutions of higher learning in the U.S.,
according to the U.S. Department of Education
Why Go
Tobacco-Free?
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“There is no safe tobacco product, and the Initiative
encourages adoption of comprehensive tobacco-free
policies. It is also recognized that each institution
must make its own decisions when it comes to
promoting health and preventing disease in its
students, faculty, employees and visitors.”
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“Tobacco-free policies go further in promoting a
culture of health and wellness while reducing
exposure to the variety of non-smoked forms of
tobacco that cause cancer, heart disease and other
serious illnesses.”
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Tobacco that is not burned (combusted)
◦ Traditional smokeless products
 *Chew (“spitting tobacco,” placed between cheek and gums)
 *Snuff (dry snuff sniffed through nose; moist snuff, or “dip,”
placed between cheek and gums)
 Snus (finely ground tobacco placed in small packets)
◦ New generation of products
 Dissolvables (lozenges, orbs, sticks, strips)
 E-cigarette (not called “smokeless tobacco,” but is similarly not
combusted and has been ruled a “tobacco product” subject to
FDA regulation)
*Currently dominate the U.S. smokeless tobacco market
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Addictive
Not a safe alternative to cigarette smoking
Most smokeless tobacco products contain carcinogens
(at least 28 identified, and nitrosamine levels are higher
in smokeless tobacco than in cigarettes)
Most smokeless tobacco products cause oral,
esophageal, and pancreatic cancer
Use of these products causes precancerous lesions of
the mouth (leukoplakia), as well as gum recession, gum
disease, and tooth decay
Use also associated with greater risk of fatal heart
attacks and stroke
◦ An individual, non-smoking smokeless tobacco user experiences
lower overall disease and mortality risks than a smoker, but …
the health effects depend on the properties of the specific
product (they vary considerably) and how the product is used
◦ In 2010, almost 60 percent of young adults who used smokeless
tobacco in the past month also smoked cigarettes during the
same period
◦ Many smokers who begin using smokeless tobacco products
neither successfully quit tobacco use nor transition to exclusive
use of smokeless tobacco
◦ Many users remain stuck in a pattern of dual use of smoked and
non-smoked tobacco products, instead of turning to FDAapproved nicotine replacement therapy (NRT) options
◦ This behavior effectively increases the user’s health risks
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Tobacco industry promotes dual use
Ads promote use of smokeless tobacco
products not to replace cigarettes but
as a way for smokers to satisfy
addiction wherever they cannot smoke
“There is a need to clearly
position the [smokeless tobacco]
product as a situational substitute
for cigarettes rather than a
replacement.”
- R.J. Reynolds spokesman, 2009
Effectiveness of
Campus Policies
• Study compared two Big Ten campuses with similar
demographics … Purdue University (no policy) and Indiana
University (tobacco-free policy implemented in 2008)
• Indiana University smoking rate: 16.5% in 2007; 12.8% in 2009
(-3.7)
• Purdue University smoking rate: 9.5% in 2007; 10.1% in 2009
(+0.6)
• Indiana University consumption rate: 6.6 cigs/day in 2007; 5.9
cigs/day in 2009 (-0.7)
• Purdue University consumption rate: 5.2 cigs/day in 2007; 6.8
cigs/day in 2009 (+1.6)
• Study showed significant favorable change in attitudes among
Indiana University students regarding elimination of smoking in
public places and university property
Source: Dong-Chul Seo et al., The Effect of a Smoke-free Campus Policy on College
Students’ Smoking Behavior and Attitudes, Preventive Medicine 2011;53:347-352.
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89% of faculty/staff and 83% of students supported policy
72% of faculty/staff and 65% students noticed decrease of
smoking on campus
Smoking by faculty and staff dropped from 6% to 4%
• Among continued smokers, 29% reduced consumption
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13% of faculty/staff reported policy influenced them to quit
or attempt to quit smoking
16% of students reported policy influenced them to quit or
attempt to quit smoking
Source: University of Michigan, “Smoking Declines After U-M Campus Ban, May 9, 2013
Economic Costs
and Benefits
Economic Benefits of TobaccoFree Campus Policies
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Reduced employee health care costs
Reduced absenteeism
Increased employee productivity
Cost savings in grounds and building
maintenance
Reduced risk of fires
Please Visit TFCCI’s Website:
TobaccoFreeCampus.org