Does E-cigarette Use at Baseline Influence Smoking Cessation Rates among 2-Year College Students?

INTRODUCTION: This study evaluates the impact of baseline e-cigarette use on smoking cessation rates in a national sample of two-year college student smokers. METHODS: Participants were 1400 students from over 60 two-year colleges across 25 states who were current smokers enrolled in a web-assisted tobacco intervention (WATI) trial. Survey data were collected at baseline, 1-, 6-, and 12-months, with primary outcomes evaluated at 6-months. RESULTS: At 6-months, baseline e-cigarette users were more likely to report cessation of traditional cigarettes compared to non-users (OR 1.39, 95% CI 1.002-1.92). Cessation was also associated with higher baseline confidence in quitting and greater time to first cigarette in the morning. Baseline e-cigarette use was not found to be associated with self-reported cessation of all nicotine/tobacco products (OR 1.09, 95% CI 0.75-1.58) nor biochemically verified cessation of all nicotine/tobacco products (OR 0.83, 95% CI 0.47-1.47). Higher confidence was again associated with both self-reported and biochemically verified cessation of all nicotine/tobacco products. Female gender was associated only with biochemically verified cessation of all nicotine/tobacco products at 6-months. CONCLUSIONS: Two-year college students represent a priority population for cessation interventions. The findings from this study highlight the complexities of evaluating the impact of e-cigarette use on cessation.

Recruitment of Community College Students Into a Web-Assisted Tobacco Intervention Study.

BACKGROUND: United States college students, particularly those attending community colleges, have higher smoking rates than the national average. Recruitment of such smokers into research studies has not been studied in depth, despite a moderate amount information on study recruitment success with smokers from traditional four-year colleges. Recruitment channels and success are evolving as technology evolves, so it is important to understand how to best target, implement, and evaluate recruitment strategies. OBJECTIVE: The aim of this paper is to both qualitatively and quantitatively explore recruitment channels (eg, mass email, in-person referral, posted materials) and their success with enrollment into a Web-Assisted Tobacco Intervention study in this priority population of underserved and understudied smokers. METHODS: Qualitative research methods included key informant interviews (n=18) and four focus groups (n=37). Quantitative research methods included observed online responsiveness to any channel (n=10,914), responses from those completing online screening and study consent (n=2696), and responses to a baseline questionnaire from the fully enrolled study participants (n=1452). RESULTS: Qualitative results prior to recruitment provided insights regarding the selection of a variety of recruitment channels proposed to be successful, and provided context for the unique attributes of the study sample. Quantitative analysis of self-reported channels used to engage with students, and to enroll participants into the study, revealed the relative utilization of channels at several recruitment points. The use of mass emails to the student body was reported by the final sample as the most influential channel, accounting for 60.54% (879/1452) of the total enrolled sample. CONCLUSIONS: Relative channel efficiency was analyzed across a wide variety of channels. One primary channel (mass emails) and a small number of secondary channels (including college websites and learning management systems) accounted for most of the recruitment success. TRIAL REGISTRATION: ClinicalTrials.gov NCT01692730; https://clinicaltrials.gov/ct2/show/NCT01692730 (Archived by WebCite at http://www.webcitation.org/6qEcFQN9Q).

Tobacco Control at Community Colleges: Context and Opportunities.

INTRODUCTION: Tobacco use among United States college-aged students remains higher than that of the national average. While a majority of public health literature has explained smoking programs and policies at traditional four-year colleges and universities, little research exists on programs and policies at two-year community colleges. It is important to understand such efforts at these institutions as they have vastly different infrastructures and enroll a more diverse and at-risk student body compared to traditional four-year colleges. METHODS: The role of community colleges in health efforts aimed at smoking was examined at four community colleges. Qualitative research methods included 18 interviews and four focus groups (N=55), document review, and direct environmental observation. RESULTS: Community colleges offered a limited number of smoking cessation and secondhand smoke prevention initiatives. All colleges provided cessation literature, though additional programming varied by college. Indoor and outdoor smoking policies existed on all campuses though enforcement was problematic. Little evidence was found that current program and policy approaches are based upon best practices or are being employed successfully. CONCLUSIONS: Future tobacco control initiatives at community colleges need to require little infrastructure and minimal staffing, and be low cost. Cessation tools for students must be convenient, understandable, and accessible from multiple locations. Feasible approaches for future initiatives could include testing low cost technology such as Web Assisted Tobacco Interventions (WATI) and outside partnerships with community organizations and health agencies. Policy enforcement could be improved with tobacco policy education at orientation for students, faculty and staff.