Still Lighting Up

Cigarettes on Campus

Today’s college students are the generation of the Internet, credit card debt, SUVs, the war on terrorism and reality TV.

They are also the generation of DARE, the Truth campaign and the war on big tobacco.

Yet after years of anti-smoking ad campaigns and educational programs, America’s college students are still lighting up in significant numbers. Estimates of the number of college students who smoke vary, but a 2003 study completed Monitoring the Future, a research group funded by the National Institute on Drug Abuse, found that 27 percent of college students smoke. Sixteen percent smoke daily and 8 percent smoke at least a half a pack each day. In 1999 the Harvard College Alcohol Study found that nearly half of college students – 47.5 percent – had smoked within the previous year. The rate of smoking among college students is 5 percent higher than the general population (though it is 5 percent lower than for young adults not in college). Perhaps more troubling, the Harvard study found that smoking rates among college students were on the rise. While their smoking habits and attitudes toward cigarettes may be different from their parents’, college students are still trying cigarettes, falling into addiction and struggling to quit.

In Ithaca, N.Y., Ithaca College and Cornell University report rates of  daily smoking that are slightly below the national average. According to a 2006 study, 5.6 percent of Ithaca College students are daily smokers, while a 2004 study at Cornell found 3.5 percent smoking at least 6 times per week. A number of changes that occurred over the past few years seem to have reduced the number of smokers at the two schools. Still, health professionals say student smoking remains a concern, as they tackle the phenomenon of “social smoking” and look for effective approaches to anti-smoking advertising and education.

The road to addiction

College students know the dangers of smoking. Nearly all received some sort of anti-smoking education in primary and secondary school. In addition they have been bombarded by ads paid for with tobacco-industry money, following the multi-billion dollar settlements between states and tobacco companies in 1998.

Rachel Rauch, a sophomore at Ithaca College who has been smoking since she was 16, has no illusions about cigarettes. “I know it’s awful,” she says. “It’s kind of like you disappoint yourself, because you don’t want to have that crutch on something, but you do.”

Like many young smokers, Rauch didn’t plan on getting addicted when she first started smoking regularly. She was spending a summer in New York City when she and a friend happened upon an unclaimed pack of cigarettes. The two took the pack.

“It’s a really lame story,” she says. “But I haven’t stopped smoking since.”

Rauch first started smoking for the look.

“It just looked really chic,” she explains. “And I was like, ‘I want to look really chic.’”

Soon, she realized that the cigarettes helped her cope with stress. And once she came to college Rauch had plenty of stress to handle. Being out of her parents’ sight was also enabled her to smoke more. Now, Rauch goes through a pack in a day and a half.

But Rauch is in the minority of smokers at Ithaca College and Cornell. Most smokers at IC and Cornell smoke occasionally.  In the 2006 survey, 11.3 percent of Ithaca College students reported smoking three times per week, while close to 30 percent had smoked within the past 30 days. At Cornell in 2004, 13.3 percent of students said they smoked less than once a week, and 3.1 percent smoked 1 to 6 times per week.

The high proportion of occasional smokers at both schools lines up with national trends. Seventy percent of college smokers are social smokers, meaning they smoke primarily while partying or with friends, according to a recent study by Tk organization researchers in the Journal of American College Health.

This pattern of smoking is unique to our age group, says Priscilla Quirk, coordinator of Health Promotion Services Prevention Program at Ithaca College.

While she says occasional smoking could be relatively harmless, there is always the danger of use increasing. “I don’t think it’s tremendously risky, but what you’ve done is said, ‘some smoking is ok for me.’ Once you start smoking, it will be easier for you to pick up with frequency,” she said.

C.J., a junior at Ithaca College, who asked that his last name not be used to protect his privacy, is this sort of smoker. He smokes on weekends at parties and when he is under a lot of stress. While he knows the dangers of smoking, he’s not concerned about his own habits. He’s had no signs of physical addiction, he says, and he believes his consumption is low enough that he’ll avoid any negative health effects.

“I could be completely wrong about this, but I don’t think the amount I smoke could have any long-term damage,” he says. “I have never felt any bodily addiction to it.

“The thought of addiction doesn’t cross my mind very often. If I noticed I was smoking more often, that would probably cross my mind, and I would reconsider what I was doing.”

But Jan Talbot, a health educator at Cornell’s Gannett Health Center, says occasional smoking can do more harm than students think. She cites a study that estimated that 50 percent of occasional smokers go on to smoke for 6 to 10 years. Occasional smokers are also susceptible to health risks like increased coughing, damaged lungs, a weakened heart and more frequent illness.

Spreading the word

With close to a third of college students not “just saying no” to cigarettes, students and health professionals are raising questions about the effectiveness of the anti-smoking campaigns today’s college students grew up with. Some students believe that the inundation with anti-smoking propaganda was actually counterproductive in some cases.

“I think there’s a better way to go about it then just scaring people, because that just makes people want to do it,” says Justin Wixson, a senior at Ithaca College and a daily smoker. “[They should] just put it out there in a neutral way and tell kids what’s wrong with smoking and why it’s a bad idea and not jump down people’s throats, because then it gets people excited to do it.”

Talbot agrees that many anti-smoking campaigns have been ineffective. “Scare tactics don’t work,” she says. “Whenever we make things exaggerated and distorted in terms of risks, people don’t believe it, and if people don’t believe it, it’s not going to have any effect on them. If you can give people accurate information – realistic risks based on real findings – it’s believable. The truth hits you.”

Nevertheless trying to scare students into rejecting drugs, or trying to stigmatize smokers and drug users, has been a popular approach. This was largely the tactic of the DARE program, a national initiative that drafts police officers into schools to teach 5th and 6th graders about drugs.

“DARE was not effective, but it was sexy enough that people in different communities thought it was great,” said Talbot. “There are still a lot of supporters for programs like that, even though we know they don’t have any effect.”

In 2003, the Government Accountability Office evaluated the DARE program and gave it a failing grade. “All of the evaluations suggested that DARE had no statistically significant long-term effect on preventing youth illicit drug use,” the report found.

Yet DARE continues to be used – and publicly funded. Twenty-six million students in America (and 10 million more in other countries) are participating in the program this year.

Talbot thinks there are better approaches. “Early on, we wanted to do a lot of education, but the problem is that with prevention, you really don’t know what’s going to work,” she explains. “I think it’s only been in the last couple of decades that we’ve been doing more evaluation and have come up with better theories that have been proven to be successful. So now we actually have best practices.”

One initiative that seems to be working is the Truth campaign. Funded by money from the tobacco settlements, the Truth ads revolve around statistics and facts about smoking, which are delivered in a straightforward, though often jarring way.

“I think those Truth ads are awesome,” says Wixson. “Of course I’m going to be biased and change the channel or something like that, but there’s a reason I feel like that when I see those commercials. That’s raw facts. The realism of that is scary.”

But it takes more than ads to get current smokers to quit. After all, Rauch and Wixson both say they buy the Truth campaign’s message, yet they’re still smoking. Such is the nature of addiction.

“Most people who smoke don’t want to smoke,” says Talbot. “They really want to stop. It’s just a matter of getting motivated, getting the right kind of support, maybe trying several times before they’re successful.”

Fighting back

The past several years at Cornell have seen an invigorated effort to address student smoking. After some troubling statistics came out of Cornell in the late 1990s, Talbot and her colleagues took steps to educate students and create a campus environment that discouraged smoking.

In 2002, they began an ad campaign targeting three groups of students – nonsmokers, occasional smokers and regular smokers. They also began carrying tobacco replacement products like nicotine patches and training their staff to counsel students wanting to quit. In 2004, they finally convinced the campus store to stop carrying tobacco products.

Another significant step came in 2003 when New York State passed the Clean Indoor Air Act, which prohibited smoking within any public building. The ban reinforced the non-smoking environment Talbot and her colleagues were already trying to produce.

“It couldn’t have been better timing, because by 2003 we had a lot of educational materials underway, we had beefed up our services at the health center, and we had already begun making some policy changes in trying to eliminate tobacco use,” says Talbot.

Similar changes have taken place at Ithaca College, although with Quirk as the only staff person in Health Prevention, anti-smoking efforts there have been less ambitious. This year, though, smoking was prohibited in all residence halls for the first time.

Some smokers appreciate the changes. Wixson, who lives in a residence hall, says the ban on indoor smoking has helped him cut back from smoking a pack a day to smoking a pack every two or three days. “That’s the best thing,” he says of living in a non-smoking dorm. “You don’t even think about smoking, because you know you can’t.”

While it’s hard to know what exactly caused the change, smoking rates at both Cornell and Ithaca College fell significantly after the Clean Indoor Air Act. From 2002 to 2004, the number of students at Ithaca College who smoked daily fell from 10.8 to 4.9 percent. At Cornell, the number of regular smokers dropped from 5.3 to 3.5 percent.

Since then, though, progress may have stagnated. In 2006, the number of daily smokers at Ithaca College rose slightly to 5.6 percent. Cornell’s figures for 2006 are not yet available.

But no matter what health officials at either school do, tobacco already has some students firmly in its grasp.

“I just haven’t had a reason to quit, and everyone else seems to have more willpower than I do,” says Rauch. “That’s my only weakness. It’s the one thing. I could stop drinking coffee if I wanted to. Easily. I could stop biting my nails. But [with cigarettes] I just can’t stop.”