Abstract
Purpose
Smoke- and tobacco-free policy (SFP) is an effective strategy that can reduce tobacco-related health disparities among young adults.
Design
Longitudinal design using administrative, survey, policy data sources, and geocoded tobacco outlet and American Community Survey data
Setting
California community colleges (CC) and cities/communities where colleges are located, 2003-2019.
Sample
114 California CCs
Data
School-level (i.e., student population and demographics) and community-level data (socio-demographics, local tobacco control policy, tobacco-related norms and availability, and health resources) from 2003 to 2019.
Measures
Key outcome is the year CC adopted a 100% SFP.
Analysis
Bivariate and multivariate Cox survival models were used to analyze timing of SFP adoption.
Results
By 2019, 61 out of 114 (53.5%) CCs were 100% SFP. While community smoking prevalence and tobacco availability were not significant, CCs in rural areas were less likely to be smoke-free. CCs located in cities with stronger tobacco policies (hazard ratio (HR) = 1.08, P < .05), which reported higher student health fees (HR = 2.00, P < .05) and received technical assistance for SFP (HR = 4.59, P < .01) were significantly associated with having 100% SFP.
Conclusion
Findings suggest that key community factors (strong city tobacco policies) and school and community resources (student health fees, SFP technical assistance) are associated with the presence of 100% SFP at CCs. Resources from the community or within a college might support remaining CCs in becoming 100% smoke-free.
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