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Tobacco-Free U: 2013 New York State Dean’s List was written by Michael Seserman, MPH, RD, Director of Strategic Health Alliances at the American Cancer Society, Eastern Division. Thank you to all of the contributors to the report especially Sarah Scarpace, Pharm.D., as well as Blair Horner, Jennifer L. Sullivan, Barry Kinlan, Emilija Postolovska, Breanna Zych, David Bombard II, Laura Burns, Grayam Dorschel, Jason Warchal, Paul McGee, Russ Sciandra, Kim McMahon and Alvaro Carrascal. A special thanks to the New York State Tobacco-Free Community Partners, Ruth DeRosa of the NYS College Consortia as well as Anne Kearney and Linda Dudman of the New York State College Health Association for their assistance with the survey.
For more information about Tobacco-Free U: 2013 New York State Dean’s List and to access the report, visit www.cancer.org/nynj To get tips on how to quit smoking, contact the American Cancer Society at 1-800-2272345 or log onto www.cancer.org
© 2013, American Cancer Society, Eastern Division.
Smoke-free (SF) or tobacco-free (TF) campus policies are a growing trend across the country. A SF campus policy means no smoking is allowed anywhere on college property or in college vehicles. In contrast, a TF campus policy prohibits all forms of tobacco use, including smokeless forms anywhere on college property or in college-owned vehicles. As of January 1, 2013, there are 67 smoke-free or tobacco-free colleges in New York State, and at least 825 throughout the United States where smoking is not allowed anywhere on the campus. Public and private institutions of higher education are recognizing the important health and economic Secondhand tobacco smoke is benefits of having a SF/TF campus policy. classified by the Secondhand tobacco smoke is classified by the Environmental Protection Environmental Protection Agency as a Class A Agency as a Class A carcinogen, the same as asbestos, and there is no carcinogen, the same as level of exposure considered to be safe. Recent asbestos, and there is no level evidence suggests that short-term exposure to of exposure considered to be secondhand smoke, even outdoors, puts people at safe. risk, especially those with pre-existing cardiac and pulmonary illness. In addition to reducing exposure to secondhand smoke, SF/TF campus policies help to reduce the initiation of tobacco use among young people and assist youth and adults who are trying to quit smoking. This past year has been a monumental one for tobacco-free campuses in the state. In September, the City University of New York began implementing a tobacco-free policy on all 23 of its campuses. On June 12, 2012 the State University of New York (SUNY) Board of Trustees passed a resolution to support a “Tobacco-Free SUNY” policy and the development of New York State legislation that bans the use of tobacco on grounds and facilities and in vehicles owned, leased, or controlled by SUNY. If such legislation was enacted, SUNY would become the largest public university system in the country to adopt a comprehensive tobacco-free policy. The purpose of this report is to document the prevalence of smoke-free and tobacco-free policies at New York State colleges and to encourage the adoption of such policies by recognizing those colleges that have implemented them.
Major Findings Forty-eight colleges in New York State receive an “A” grade for the establishment of a 100% tobacco-free campus policy (see Appendix). These colleges represent nearly one in four colleges in New York. One third of all colleges in New York (67) are either smoke-free or tobacco-free.
Almost half of New York’s colleges (47%) have implemented or are in the process of enacting either a 100% SF or a TF campus policy. There has been more than a 30-fold increase in the number of colleges in New York State that have adopted SF/TF policies since 2005. Public campuses in NYS are more likely than privates to be SF/TF with 38 reporting a policy in place (46% of public institutions) while 29 private colleges (24%) met the criteria for a SF/TF campus policy. New York State has the largest number of SF or TF college campuses in the country.
Recommendations All colleges should adopt a tobacco-free campus policy to protect the entire campus community. Colleges should not implicitly support the initiation of a long-term addiction to tobacco which puts vulnerable young people at risk of respiratory infections, chronic diseases, and premature death. Independent colleges in New York State are lagging behind public colleges in establishing TF campus policies. The Commission on Independent Colleges and Universities should highlight the benefits of TF campus policies and support its members to implement TF campus policies. The Governor and Legislature should boost support for SF/TF campus policies by increasing funding to the New York State Tobacco Control Program (TCP). The TCP provides vital educational and cessation services to save lives by reducing tobacco use and exposure to secondhand smoke. Three other states, Arkansas, Iowa and Oklahoma, have enacted new laws to make their respective states’ campuses TF and SF. The Governor and Legislature should ensure that New York State joins this growing list.
College students at risk Evidence suggests that if a youth does not begin smoking by the age of 26, it is very unlikely that he or she will ever smoke.1 Therefore, college campuses are an important target of the tobacco industry due to the number of young adults they can legally reach with their aggressive marketing. Each year cigarette manufacturers need to addict more than 400,000 new users in the U.S. to replace those who have died from long-term use of tobacco. The tobacco industry attempts to take advantage of college age youth, understanding that this period is when many long-term lifestyle choices are made and solidified. This period has been labeled as a dynamic time in the lives of college students.2 Use of tobacco for the first time and regular use of tobacco has been seen to increase while in college from freshman to senior year.3 Not only does that put the 18-24 age group at high risk for initiating and strengthening an addiction to tobacco but it simultaneously endangers non-smokers on campus from secondhand smoke and contributes to a costly litter and image problem on campus.
In 2011, college age youth in New York State had a smoking prevalence rate of 21.6%. That rate is 58% higher than the 12.5% smoking rate found among New York State high school students suggesting that a large number of youth are initiating cigarette use when they attend New York’s colleges.
There have been impressive reductions in the smoking rates among New York State’s 1824 age group – a drop by 37% between 2001 and 2009.4 Yet, young adults continue to have the highest smoking rates of any group. In 2011, college-age youth in New York had a smoking prevalence rate of 21.6%.5 That rate is 58% higher than the 12.5% smoking rate found among the state’s high school students6 suggesting that a large number of youth are initiating cigarette use when they attend New York’s colleges. A tobacco-free policy ensures that campuses are not unintentionally supporting the initiation of lifelong tobacco addiction among students as a result of weak smoking policies. Studies have found tobacco-free policies to be an effective way to reduce tobacco use among college students.7 Hundreds of U.S. colleges and universities have gone smoke-free or tobacco-free. Tobacco-free campuses are a growing trend for private and state run colleges across the country. There are at least 825 completely smoke-free or tobacco-free campuses in the U.S. Of these campuses, 608 have a 100% tobacco-free policy. Three states now require that all public colleges and universities be 100% smoke-free including Iowa, whose law also covers private colleges.8 Since 2010, the number of SF/TF college policies in the U.S. has nearly doubled. 9
The growing evidence of harm The tobacco-free campus trend in the U.S. caused by tobacco use and appears correlated with the increase in state secondhand smoke has resulted in and local clean indoor air legislation, changing at least 825 smoke-free or social norms, and recent scientific studies detailing the harmful effects of even short-term tobacco-free campuses in America. exposure to secondhand tobacco smoke. Secondhand tobacco smoke is classified by the Environmental Protection Agency as a Class A carcinogen, the same as asbestos, with no known safe level of exposure. Recent evidence suggests that short term exposure to secondhand smoke, even outdoors, puts people at risk, especially those with pre-existing cardiac and pulmonary illness.10 Consequently, liability concerns may also be a growing factor associated with institutions adopting such policies.
In addition to reducing exposure to secondhand smoke, the understanding that institutional policies play an important role in developing lifelong behaviors may be an important driver. Evidence suggests that SF/TF campus policies reduce the initiation of tobacco use among young people and assists those who are trying to quit smoking and avoid relapse.11 The adoption of tobacco-free college campus policies may also be facilitated by the increased focus of large employers on worksite wellness initiatives to reduce spiraling healthcare costs. Studies indicate that businesses experience substantially higher healthcare costs and lower rates of productivity as a result of tobacco use among employees.12 The CDC estimates that each smoking employee costs companies at least $4,500 more per year compared to non-smoking workers in healthcare expenses and lost productivity.13 A tobacco-free policy on college campuses may also lead to reductions in upper respiratory infections and other tobacco-related illnesses, lower rates of smoking among employees, lower maintenance and cleaning costs, decreased risk of fires, a more attractive campus and work environment, and reduced insurance rates.14 History of College Tobacco Control in New York State Over the past decade, there have been various grassroots efforts in New York State to enhance tobacco-related policies in the college setting. In 2001, the American Cancer Society (ACS) initiated a two-year project called the New York State College Alliance Against Tobacco which worked with many campuses across the state to change tobaccorelated policies. At that time the major focus was to make dormitories smoke-free. Later that year ACS conducted a survey of all colleges in NYS regarding their smoking policies. The survey suggested that no colleges had a SF/TF campus policy in place. By 2005, there were only two colleges in central New York with a smoke-free property policy: a small private school and a state medical school and hospital. A state law was enacted in 2008 mandating that all dormitories at public and private colleges be completely smoke-free.15 Over the years many tobacco free community partners or coalitions around the state encouraged and supported advocates in colleges who wanted to protect themselves and others from secondhand smoke. In 2009, the New York State Tobacco Control Program began funding an initiative called Colleges for Change (C4C). Seven contractors were funded to work with college students to promote tobacco-free norms and policies. ACS and C4C created the NYS Colleges Tobacco-free Initiative
(CTFI) in 2010 to collaboratively promote tobacco-free campus policies across the state. Unfortunately the C4C program was terminated in 2011 due to budget cuts to the State tobacco control program. Nonetheless, CTFI in partnership with the NYS Tobacco Free Community Partners and the National Center for Tobacco Policy have continued to support many colleges in their efforts to clear the air on college campuses.
RESULTS Statewide Findings: 67 colleges have adopted smoke-free or tobacco-free policies and 29 colleges are preparing to implement the policy. In New York State, there are 204 colleges and universities; 82 public and 122 private. ACS was able to acquire data on more than 98% of schools. Sixty-seven colleges (33%) have adopted a completely smoke-free or tobacco-free campus policy (Table 1) while 29 colleges (14%) were “in-progress” or preparing to implement the policy in the near future. Overall 96 out of 204 or 47% of college campuses were either SF/TF or progressing towards a SF/TF policy. Of the 67 colleges in New York that have SF/TF campus policies, 48 are TF and 19 are SF. Public campuses in NYS were more likely than privates to be SF/TF with 38 reporting a policy in place (46% of public institutions) while 29 private colleges (24%) met the criteria for a SF/TF campus policy. The data indicate that New York’s public colleges are more likely to be in the process of establishing a new SF/TF policy than their private or independent college counterparts. Overall, 17% of public colleges compared to 12% of private colleges reported having an active tobacco committee working on enacting a SF/TF policy. This is important to note because there are 45% more private colleges in the state than there are public schools. With 100% of CUNY schools already TF and the SUNY Board of Trustees recently voting in support of legislation requiring a system-wide TF policy by 2014, the trend portends that the majority of private colleges will stand alone as the last bastion of colleges that allow and support tobacco use on campuses in the state.
Table 1: Number and Percentages of Colleges with Tobacco-Free or Smoke-Free Policies, By Type
Public Total Colleges Total Colleges % Smoke-Free Smoke-Free % Tobacco-Free Tobacco-Free% SF or TF SF/TF % In Progress in Progress % Total SF/TF or In Progress Total SF/TF or In Progress % 82 40% 7 9% 31 38% 38 46% 14 17% 52 63% Private 122 60% 12 10% 17 14% 29 24% 15 12% 44 36% Total 204 100% 19 9% 48 24% 67 33% 29 14% 96 47%
Publicly-funded institutions of higher education include the SUNY system of 59 campuses and CUNY which has 23 separate campuses. SUNY schools reported that 15 or 25% of campuses had enacted smoke-free or tobacco-free policies. CUNY schools had 100% of their campuses designated as TF as a result of implementing a system-wide policy at the beginning of the current academic year (Table 2).
Table 2: Tobacco-Free or Smoke-Free Colleges by Affiliation
SUNY Colleges CUNY Colleges Private Colleges Total Total Percent
Total Colleges Smoke-Free Tobacco-Free SF or TF In Progress SF/TF AND In progress 59 7 8 15 14 29
12% 14% 25% 24% 49%
23 0 23 23 0 23
0 100% 100% 100% 100%
121 12 17 29 15 43
10% 14% 24% 12% 36%
204 19 48 67 29 96
9% 24% 33% 14% 47%
In addition, 14 SUNY campuses were found to be in progress for developing a tobaccofree policy. Consequently, 49% of all SUNY campuses are either already SF/TF or in progress. Regional Findings: New York City has the highest number of tobacco or smoke-free colleges, while the Rochester/Finger Lakes region has the highest percentage of colleges planning to enact a tobacco-free policy. These data also were analyzed by regions in New York State (Table 3). All colleges were categorized into the following six regions based on the location of the school’s main campus: (1) Greater Capital Region, (2) Southern Tier, (3) Western, (4) Greater New York City Metro/lower Hudson Valley (NYC Metro/HV), (5) Rochester/Finger Lakes, and (6) Central/Northern region. NYC Metro/HV has the most colleges at 109 followed by Central/Northern with 32 and the Capital Region with 22 colleges. Rochester/Finger Lakes, Western, and Southern Tier regions have 17, 16 and 8, respectively. NYC Metro/HV has the highest number of smoke-free or tobacco-free campuses with 42 followed by Central/Northern with 7 colleges. Each of the other regions have between 3 and 6 Smoke-free or tobacco-free colleges. NYC Metro/HV also has the highest proportion of colleges that are SF or TF (39%) followed by the Western Region and Southern Tier with 38%. Colleges in the process of planning to enact a SF/TF policy (“In Progress”) varied greatly by region. As a proportion, the Rochester/Finger Lakes Region has the highest percent of colleges that are planning to go tobacco-free (35%). The next most active region for future implementation is Greater Capital (27%) followed by Central/Northern at 19%.
Table 3: Smoke Free and Tobacco Free Colleges by New York State Region
Greater New York City Metro/ Lower Hudson Valley (4) 109 12 30 42 8 50 53% 11% 28% 39% 7% 47%
Greater Capital (1) Number of Colleges SmokeFree TobaccoFree SF/TF In Progress TOTAL SF/TF & In Progress
Southern Tier (2)
Rochester/ Finger Lakes (5) 17 1 2 3 6 9 8% 6% 12% 18% 35% 53%
Central and Northern (6) 32 3 4 7 6 13 16% 9% 13% 22% 19% 41%
22 0 6 6 6 12
11% 0% 27% 27% 27% 55%
8 1 2 3 1 4
4% 13% 25% 38% 13% 50%
16 2 4 6 2 8
8% 13% 25% 38% 13% 50%
In terms of campuses that are SF/TF AND actively planning to enact the policy, Greater NYC/Hudson Valley has the most colleges in this group with 50 followed by CentralNorthern with 13 and the Greater Capital Region with 12 colleges. Fifty-five percent of all schools in the Greater Capital Region are SF/TF or “in progress” followed by Rochester/Finger Lakes Region with 53% of schools.
Over the past several years, numerous colleges in New York State have established policies that curb tobacco use and protect students and staff from secondhand smoke. This report indicates that 67, or one out of three colleges have implemented a smoke-free or tobacco-free campus policy. In the past seven years New York State has seen more than a 30-fold increase in SF/TF campus policies. That trend appears to have accelerated in the past two years. Even more dramatic is One third of New York colleges are the change in the number of colleges that are now smoke or tobacco-free, a 30expecting to go TF on their campus in the near future. Currently 47% of all colleges in NYS fold increase since 2005. are either already SF/TF or actively working on getting there. These data also suggest that 62% of all colleges in the state will likely be SF/TF within the next few years when SUNY implements an expected system-wide tobacco-free campus policy that will impact an additional 30 campuses. The disparity between public and private institutions implementing SF/TF policies is significant and growing. At present 46% of public institutions have a SF/TF policy in place compared to 24% for the independent or private colleges (a 23 percentage point difference). That gap will increase in the near future given that a higher proportion of public schools are in the pipeline to go tobacco-free compared to the privates (17% vs. 12%). On a regional basis, the SF/TF trend appears to be occurring in a fairly uniform way. All major regions have between 41% and 55% of campuses either already SF/TF or “in progress” suggesting a broad-based and consistent trend. More than twice as many campuses have a tobacco-free policy (no tobacco products allowed) compared to schools that simply prohibit smoking. Moreover, far more tobacco-free campus policies have been established in the past two years compared to SF policies. The trend towards tobacco-free suggests the desire to treat tobacco products consistently since all tobacco products are addictive and harmful. Colleges may also want to avoid potentially driving students to use more smokeless tobacco and avoid the need to amend a smoke-free policy in the future to add all forms of tobacco. A tobaccofree policy is prudent given national statistics show a 33% increase in the sale of moist snuff between 2000 and 2007. In addition, young adults (18- to 24-year-olds) are two times more likely to use smokeless products than those 26 years of age or older.1 The rapid pace of tobacco-free policy adoption in New York prompts the question about what factors may be driving the strong trend in the state. The work of many tobacco control advocates and students over the past decade probably laid the groundwork for many of the changes. Statewide policy changes such as clean indoor air laws, tobacco tax increases, and tobacco self-service display bans have helped to reduce smoking rates in all age groups, especially among youth.16 Other factors include significant changes in societal norms for smoking and the benefit of having local tobacco-free models. In the mid to late 2000s, many hospitals in NYS, some with medical schools, adopted tobacco11
free grounds policies. In NYS, the smoking rate among high school students has declined by more than 50% in the past decade16 so the opposition to a tobacco-free policy has been diminished while supporters may feel more empowered to promote it. With 67 colleges now prohibiting smoking or banning all tobacco products, New York State represents the largest uptake of voluntary SF/TF campus policies in the country.9 Moreover, when the SUNY system implements their expected tobacco-free policy in 2014 it will be the largest network of campuses in the U.S. to implement a tobacco-free campus rule. With 67 colleges now prohibiting smoking or With so many colleges choosing to voluntarily make banning all tobacco products, their campuses SF/TF, the NYS legislature should New York State represents the enact legislation requiring all college campuses to largest uptake of voluntary be TF or SF, as three other states (Iowa, Arkansas, smoke-free and tobacco-free and Oklahoma) have done. campus policies in the country. The trend in SF/TF college campuses is the latest, but perhaps one of the most salient steps toward a tobacco-free society. Colleges represent what has been called the latest battleground in the tobacco wars. New York has been very successful at delaying smoking initiation among high school age children. Yet, young adults are now major targets for the tobacco industry who count on attracting new legal customers as early as possible to replace customers who have died or quit. SF/TF policies provide fewer opportunities for youth to become addicted, essentially weakening the tobacco industry’s recruitment strategy. Tobacco use restrictions also help denormalize the behavior, further attenuating the impact of aggressive marketing by tobacco manufacturers and retailers.2 With such a robust trend, it is unfortunate that the state has cut nearly 50% from its tobacco control program budget in recent years. Institutions of higher education need a great deal of guidance, support, and access to resources to transition to a tobacco-free environment. Consider the increased needs for training staff, purchasing signage, and providing consultation to enhance or create cessation services on campus and improve access to cessation pharmacotherapy treatments. A 2011 report by the NYS Tobacco Control Program shows that the 18-24 age group has the highest smoking rate among adults but uses effective cessation treatment options like counseling and medications the least.17 All of these services, especially those pertaining to the college setting, have been cut or eliminated recently. Meanwhile, the state takes in more than $2.5 billion each year from tobacco settlement and tobacco taxes but spends just 2 cents on the dollar to help people quit, reduce secondhand smoke exposure, and assisting institutions like colleges to become tobacco-free.18 Cost-saving initiatives like tobacco control should be expanded to reduce healthcare costs and boost worker productivity.
METHODS The American Cancer Society developed a survey to gather information on college campuses tobacco policies in New York State. The initial surveys took place between July 2010 and July 2011. Contact was made via phone to specific departments on college campuses. These departments included residential life, health/wellness services, and student affairs. If a targeted college representative was not available, a voice message was left detailing the process and explaining the purpose of the call. Follow up e-mails and calls were made accordingly to increase participation and acquire accurate information. Any information not received from a campus contact was gathered via online student handbooks found on official college websites. Collecting data from student handbooks also helped to clarify answers from college representatives and, in some cases, were used as the primary source of information if a response from a college was never received. Also, a web-based version of the survey was developed via “Survey Monkey” for college contacts that preferred to answer online. The second and third rounds of data collection focused on follow-up of previous answers to describe progress toward the establishment of a tobacco-free policy and to validate previous findings. Updates were made to the initial college data between September and December 2012 using a combination of online surveys completed by college health services or counseling staff on each campus, calls to college contacts, and input from local tobacco control community partners and ACS staff who work locally with those campuses. ACS inquired about each campus policy related to tobacco. Questions included: (1) current policy regarding tobacco use on campus, (2) the policy on the use of tobacco products in any college owned multi-unit housing, (3) the process and participation in changing current tobacco policy, and (4) whether tobacco sales on campus and tobacco industry sponsorship of events is allowed. This report focuses on SF/TF policies. A college was deemed “smoke-free” if a college policy stated that smoking was not allowed anywhere on property owned by the college. If smoking and using any other tobacco products Next year, the American Cancer were prohibited anywhere on college property the Society’s Tobacco-Free U: New school was considered “tobacco-free”. York State Dean’s List will rank For the purpose of this analysis, it was assumed all colleges' and universities' that colleges without available data permit tobacco tobacco policies using the use in outdoor areas since that is the most common criteria listed in Appendix B. status and the minimum standard imposed by state law. Additionally, any college that reported having an active group sanctioned by the administration to discuss strengthening their tobacco policy was assumed to be “in-progress” of establishing a SF/TF policy on their grounds. Also was assumed that all online student handbooks referenced for data collection were up to date at the time of data collection.
Grading Criteria This 2013 report identifies colleges in New York State that have a 100% tobacco free policy on its campus as of January 1, 2013. Colleges and universities meeting that standard are reported at the end of the report (Appendix A). Next year, the American Cancer Society’s Tobacco-Free U: New York State Dean’s List will rank all colleges' and universities' tobacco policies with the criteria listed in Appendix B.
Limitations This report has some limitations. First, the data collected were largely self-reported by college staff. It is possible that some interviewees or respondents may have provided inaccurate information. However, when possible, the information was validated using other means such as an online student handbook or an individual in the tobacco control community who works with that particular school. Second, there may have been some inconsistencies between how data were collected and recorded. Finally, institutional changes seem to be happening quickly and a policy change process could have been initiated in some colleges after being interviewed. Yet, that is not probable since the American Cancer Society works closely with the NYS Tobacco-free Community Partners who would likely be involved or at least hear about the policy change effort.
Colleges in New York State with an “A” Grade (Tobacco-Free Policy) as of January 1, 2013
Public Colleges Buffalo State College Cayuga Community College Corning Community College SUNY Cortland Erie County Community College Niagara County Community College Upstate Medical University Westchester Community College Baruch College Borough of Manhattan Community College City College of New York CUNY Graduate Center CUNY Graduate School of Journalism CUNY School of Professional Studies Hunter College John Jay College of Criminal Justice Macaulay Honors College at CUNY The New Community College at CUNY CUNY School of Law LaGuardia Community College Queens College Queensborough Community College York College Brooklyn College Kingsborough Community College
Medgar Evers College New York City College of Technology Bronx Community College Hostos Community College Lehman College College of Staten Island Independent Colleges The College of Saint Rose Crouse Hospital School of Nursing Davis College Finger Lakes Health College of Nursing Long Island College Hospital of Brooklyn School of Nursing Maria College Marymount Manhattan College Memorial Hospital School of Nursing Monroe College New School Niagara University Nyack College Rensselaer Polytechnic Institute Roberts Wesleyan College Samaritan Hospital School of Nursing The Sage Colleges Trocaire College
2013 Tobacco-Free U: New York State Dean’s List Tobacco Use Policy Grading Criteria
Next year the American Cancer Society will grade each college campus on their smoking and tobacco use policies by utilizing the following criteria: A = 100% tobacco-free campus policy (no tobacco use of any kind allowed anywhere on college property and in college vehicles); B = 100% smoke-free campus policy (no smoking allowed anywhere on college property and in college vehicles); C = only allow smoking in specific, limited designated areas such as smoking huts, parking lots, etc; Incomplete = campuses that are in the process of establishing smoke-free or tobacco-free policies as evidenced by an active, administration-supported policy implementation committee; D = all other campuses with few (if any) outdoor restrictions such as smoke-free building entranceways.
U.S. Department of Health and Human Services, Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General, Atlanta, GA: U.S. Department of Health and human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office of Smoking and Health, 2012. 2 Colder, Craig R., Flay, Brian R., Segawa, Eisuke, Hedeker, Donald & TERN M embers (2008). “Trajectories of S moking Among Freshmen College Students With Prior Smoking History And Risk For Future Smoking: data from the University Project Tobacco Etiology Research Network (UpTERN) study,” Addiction, 109,1534-154. DOI: 10.1111/j.13600443.2008.02280. 3 Clarkin, Patrick F., Tisch, Linda A. & Glicksman, Arvin S. (2008), ‘Socioeconomic Correlates of Current and Regular Smoking Among College Students in Rhode Island ,” Journal of American College Health, 57(2), 183-190. DOI: 10.3200/JACH.57.2.183-190. 4 New York State Department of Health, “Who Is Quitting in New York: A Decade of Progress Reducing smoking and Promoting Cessation,” February, 2011. 5 New York State Department of Health. Division of Chronic Disease Prevention, Bureau of Chronic Disease Evaluation and Research Division of Chronic Disease Prevention. Behavioral Risk Factor Surveillance System. 2011. 6 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Youth Risk Behavior Survey. 2011. 7 Seo, Chul, Macy, Jonathan T., Torabi, Mohammad R., & Middlestadt, Susan E. (2011). The effect of a smoke-free campus policy on college students’ smoking behaviors and attitudes. Preventive Medicine, 2011 Aug 9. doi:10.1016/j.ypmed.2011.07.015. 8 Statutes retrieved 11/13/12. Arkansas: http://www.arkleg.state.ar.us/assembly/2009/R/Acts/Act734.pdf, Oklahoma: https://www.sos.ok.gov/documents/executive/829.pdf, Iowa:http://coolice.legis.iowa.gov/CoolICE/default.asp?Category=BillInfo&Service=Billbook&ga=82&hbill=HF2212 9 American Nonsmokers’s Rights Foundation (2012). U.S. Colleges and Universities with Smoke-free Air Policies. ANRF 2011 Report, 1-5. Retrieved 10.27.12 from http://www.no-smoke.org/pdf/smoke-freecollegesuniversities.pdf. 10 Department of Health and Human Services (2006). Surgeon General’s Report States Secondhand Smoke Is a Serious Health Hazard. Office of Disease prevention and Health promotion, 21(1), 1-6. 11 New York State Department of Health, “Who Is Quitting in New York: A Decade of Progress Reducing smoking and Promoting Cessation,” February, 2011. 12 Americans for Nonsmokers’ Rights (2006). Business Costs in Smoke Filled Environments. Retrieved 10.28.11 from http://no-smoke.org/pdf/businesscosts.pdf. 13 Department of Health and Human Services. Center for Disease Control and Prevention. Coverage for Tobacco Cessation Treatments: Why, What, and How. 1999 estimates adjusted to 2012 using the consumer price index for medical services which was retrieved from: http://www.bls.gov/data/#prices on 11/1/12. 14 Americans for Nonsmokers’ Rights (2006). Business Costs in Smoke Filled Environments. Retrieved 10.28.11 from http://no-smoke.org/pdf/businesscosts.pdf. 15 American Lung Association (2008). Big Tobacco on Campus: Ending the Addiction. Tobacco Policy Project, 1-24. Retrieved on October 20th, 2011 from http://www.lungusa.org/stop-smoking/tobacco-control-advocacy/reportsresources/tobacco-policy-trend-reports/college-report.pdf. 16 New York State Department of Health. Youth Prevention and Adult Smoking in New York State. March 2011. Retrieved 11.1.11 from http://www.health.ny.gov/prevention/tobacco_control/docs/2011-03-11_ny_state_brief_report_prevention.pdf. 17 New York State Department of Health. Who is Quitting in New York: A Decade of Progress Reducing Smoking and Promoting Cessation. February 2011. 18 Sciandra R and Horner B. ‘Up in Smoke: New York Reaps Billions in Revenue While Short Changing Anti -Smoking Programs,” American Cancer Society. 2011.
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