EXAMINING ATTITUDES, PERCEPTIONS, AND OBSERVATIONS OF TOBACCO USE AND COMPLIANCE AT A SMALL PRIVATE LIBERAL ARTS COLLEGE IN KENTUCKY WITH A DESIGNATED AREA TOBACCO POLICY

A multitude of higher education institutions have adopted comprehensive smoke- and tobacco-free policies to minimize tobacco use, increase quit attempts, and reduce exposure to secondhand smoke on campus. However, the majority of campuses across the U.S. still have non-comprehensive policies and/or designated tobacco use areas. Given the limited research in this area, the purpose of this dissertation was to assess the attitudes, perceptions, tobacco use behaviors, and actual observational compliance of students, faculty, and staff on a college campus that possesses a designated area tobacco policy. This two-phased cross-sectional study included both direct observations and online survey data collection. For Phase I, to assess on-campus tobacco use behaviors and compliance with a designated tobacco area policy, during the Fall semester 2018 direct observations were made in 10-minute intervals throughout the typical work/class day during Mondays, Wednesdays, and Fridays for two consecutive weeks in the designated tobacco use areas on campus. Data were summarized using descriptive statistics and chi-squared tests for independence. For Phase II, a 36-item online survey was emailed to all staff, faculty, and students to assess their overall attitudes and perceptions regarding a designated tobacco area policy. Data were analyzed using descriptive statistics and individual chi-squared assessments for each item. Items were also combined to create relevant subscales; ANOVA was used for comparison purposes between demographic factors. Phase I: A total of 239 tobacco observations were made on campus during the two-week period. Significant relationships were discovered between sex and location (p \u3c 0.01), sex and compliance (p \u3c 0.01), time and location (p \u3c 0.01), as well as time and compliance (p \u3c 0.05). Males were more likely to be found using tobacco in general, either in compliance with the designated tobacco area policy or in violation of the policy. Phase II: A total of 185 staff, 88 faculty, and 332 students completed the online survey. Response rate was 33% for employees and 20% for students. Significant differences emerged when looking at the appeal of the designated areas on campus when comparing staff, faculty, or student status (p = 0.00) as well as tobacco use status (p = 0.00). Social influences yielded significance when comparing campus status (staff, faculty, or student; p = 0.00) as well as when comparing tobacco-users to non-users (p = 0.001). A significant difference was also found when comparing perceptions of designated tobacco areas (gazebos) and tobacco use between tobacco-users and non-users (p = 0.03). Findings provide quantitative evidence that tobacco is being used on campus, in both designated and non-designated areas. Male students were observed more frequently, regardless of compliant status. In addition, there was a strong correlation with observations and certain times of day as well as the location of observations, reinforcing the need for compliance efforts and availability of tobacco treatment. Additional research on college campuses with designated tobacco areas is necessary in order to better understand the overall impact that such policies have on college campuses, including whether designated policies may make it difficult for individuals on campus to either quit using tobacco or to stay quit. In addition, given the number of individuals using tobacco on campus, it would be beneficial to collect air quality data on campuses with designated areas, in comparison to campuses with comprehensive tobacco-free policies