H. Wechsler et al., INCREASED LEVELS OF CIGARETTE USE AMONG COLLEGE-STUDENTS - A CAUSE FOR NATIONAL CONCERN, JAMA, the journal of the American Medical Association, 280(19), 1998, pp. 1673-1678
Context.-Adolescent smoking prevalence is tracked annually and has inc
reased since 1991. In contrast, little is known about trends in smokin
g among college students, a group that has previously been more resist
ant to tobacco use than other young adults. Objective.-To examine chan
ges in cigarette smoking among college students between 1993 and 1997
and among different types of students and colleges. Design.-Seif-admin
istered survey (Harvard School of Public Health College Alcohol Study)
. Setting.-One hundred sixteen nationally representative 4-year colleg
es. Subjects.-A total of 15 103 randomly selected students in 1993 (70
% response rate) and 14 251 students in 1997 (60% response rate). Main
Outcome Measures.-Self-reports of cigarette smoking in the past 30 da
ys and in the past year, age at smoking first cigarette, and number of
attempts to quit. Results.-Over 4 years, the prevalence of current (3
0-day) cigarette smoking rose by 27.8%, from 22.3% to 28.5% (P<.001).
The increase was observed in 99 of 116 colleges and was statistically
significant(P<.05) in 27 (23%) of them. Current smoking increased acro
ss all student subgroups (defined by sex, race/ ethnicity, and year in
school) and in all types of colleges. Smoking is rising faster in pub
lic schools (from 22.0% to 29.3%) than in private schools (from 22.9%
to 26.8%). Eleven percent of college smokers had their first cigarette
and 28% began to smoke regularly at or after age 19 years, by which t
ime most were already in college. Half of current smokers tried to qui
t in the previous year; 18% had made 5 or more attempts to quit. Concl
usions.-Cigarette use is increasing on campuses nationwide in all subg
roups and types of colleges. Substantial numbers of college students a
re both starting to smoke regularly and trying to stop. National effor
ts to reduce smoking should be extended to college students.