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Tobacco Use Common Among College Students Cigarette Use Most Common; Cigar Use Also Substantial

CHICAGO -- Nearly half of college students surveyed report using tobacco products within the past year, according to an article in the August 9 issue of The Journal of the American Medical Association (JAMA), a theme issue on tobacco.

Nancy A. Rigotti, MD, director of Tobacco Research and Treatment at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School in Boston, and colleagues examined data from surveys submitted by randomly selected students from 119 four-year colleges in the United States in 1999. The data were from the Harvard School of Public Health College Alcohol Survey, which was designed to assess alcohol and other substance use -- including tobacco use. The survey also includes questions about demographic and background characteristics, satisfaction with education and students' interests and lifestyle choices. Of the students randomly selected, 60 percent (14,138 students) responded.

Dr. Rigotti presented the study here today at a JAMA media briefing on tobacco during the World Conference on Tobacco OR Health.

More than half (61.0 percent) of those who responded to the survey have tried a tobacco product, nearly half (45.7) percent reported using tobacco products in the past year and one-third (32.9) percent reported using tobacco products within the past 30 days. Concerning cigarette use, 38.1 percent reported smoking in the past year and 28.5 percent reported smoking within the past 30 days. Among the students who reported being current smokers (having smoked within the past 30 days), 32.0 percent reported smoking less than one cigarette per day, 43.6 percent reported smoking one to ten cigarettes per day and 12.8 percent reported smoking one or more packs of cigarettes per day.

After cigarettes, cigars were the most commonly used tobacco products by the survey respondents. More than one third (37.1 percent) reported having ever smoked a cigar, 23.0 percent reported smoking a cigar within the past year and 8.5 percent reported smoking a cigar within the past 30 days. According to the authors, this is the first national study to report on cigar use among college students. The high rate of cigar smoking by college students is consistent with other data that show a 50 percent increase in cigar consumption in the U.S. between 1993 and 1998, following a 30-year decline. The authors note that until the 1990s, cigar use was rare in young adults and women, but this is no longer the case.

"This study contains several new findings," the researchers write. "It demonstrates that tobacco use among college students is more prevalent than previously appreciated, because tobacco use is not limited to cigarettes. Cigar smoking is substantial, and smokeless tobacco (and, rarely, pipes) are also used. Most tobacco users use more than one tobacco product, with cigars and cigarettes being the most common combination. ... This study also reports some good news. Cigarette use by college students, which increased dramatically between 1993 and 1997, stabilized between 1997 and 1999."

Of the respondents, men reported using tobacco more than women. More than half of the men (53.0 percent) reported having used tobacco in the past year compared with 41.3 percent of women; 37.9 percent of men and 29.7 percent of women reported using tobacco within the past 30 days. "The sex difference in total tobacco use is entirely attributable to a higher prevalence of non-cigarette tobacco use [greater use of cigars, smokeless tobacco products and pipes] among men, because men and women have nearly identical cigarette smoking rates," the authors write.

The researchers found that tobacco use was associated with certain demographic and background characteristics, levels of satisfaction with education and students' interests and lifestyle choices. "Male and white students are more likely to use tobacco than female and non-white students [students that are Hispanic, Asian or black]," according to the authors. "Students who use tobacco are also more likely to smoke marijuana, binge drink, have more sexual partners, have lower grades, rate parties as important and spend more time socializing with friends. Tobacco users are less likely than nonusers to rate athletics or religion as important and to be satisfied with their education."

"College appears to be a time when many students are trying a range of tobacco products and are in danger of developing lifelong nicotine dependence," the authors write. "National efforts to monitor and reduce tobacco use of all types should expand to focus on college students and other young adults."

One solution recommended by the authors is to make all college buildings, including dormitories, smoke-free. Not only would this protect nonsmoking students from the second-hand smoke exposure, but it would also reduce the visibility of smoking on college campuses. They suggest that this might discourage students from starting to smoke, help those who do smoke to stop, and even reduce the hazard of fires in dorms.

Citing other sources, the authors note that: "Tobacco use is increasing among young Americans. Cigarette smoking rates among adolescents increased by 32 percent between 1991 and 1997. Cigarette smoking by young adults (18-24 years) increased by 16 percent between 1995 and 1997. ... If this trend continues, it threatens to reverse the decline in smoking prevalence among U.S. adults that has occurred during the past half century."

(JAMA. 2000; 284: 699-705)

Editor's Note: This study was supported by a grant from the Robert Wood Johnson Foundation. Dr. Rigotti currently receives grant support from Glaxo Wellcome Inc. In the past, she received support from SmithKline Beecham Consumer Healthcare and received honoraria for lectures from McNeil, Glaxo Wellcome and SmithKline Beecham.

Media Advisory: To contact Nancy A. Rigotti, MD, call Jacki Flowers at 617/724-2753. On Tuesday, August 8, call the Science News Department at 312/464-5374.

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For more information about The Journal of the American Medical Association or to obtain a copy of the study, please contact the American Medical Association's Brian Pace at 312/464-4311 or E-mail Brian_Pace@ama-assn.org.