Examining Student Perceptions of Tobacco Policy Enforcement on College Campuses in Texas.

Background. Colleges across the country are adopting tobacco-free policies to prevent and decrease tobacco use among college-aged young adults. Aims. This study examines differences between nontobacco, single-product, and polytobacco users' perceptions of the importance of enforcing tobacco-free policies, support for various enforcement strategies, and success of policy enforcement on campuses. Method. A Kruskal-Wallis test was conducted to examine group differences on the importance of enforcing polices, support for enforcement strategies, and success of policy enforcement among 10,351 students attending 10 Texas colleges. Results. Findings show significant group differences on all dependent variables. Post hoc tests indicated that nontobacco users reported the most favorable responses, followed by single-product users, then polytobacco users. Discussion. Despite group differences, findings show all students feel it is important to enforce tobacco policies and support enforcement strategies but believe current campus enforcement efforts are only moderately successful. Conclusions. Findings may prompt administrators to adopt policy enforcement strategies to curb tobacco use on campuses.

Systematically Improving Tobacco Cessation Patient Services Through Electronic Medical Record Integration.

The Health Information Act of 2010 has presented an opportunity to discuss, establish, and promote innovative ways to incorporate tobacco cessation assistance to patients in the health care setting. This article provides an overview of the development and implementation of an electronic tobacco cessation protocol (the eTobacco protocol), into an electronic medical record (EMR) system, while evaluating the barriers and benefits encountered. The protocol was developed to facilitate the process of electronically referring patients to a state-funded quitline service by establishing a one-click connect for providers to use within the EMR system. While evaluating the implementation of the protocol, findings indicate that several barriers were encountered including disruption of clinic workflow, EMR limitations, and training complications. In spite of the barriers, the protocol shows promising results by increasing referrals to the quitline from 7 patients the year prior to implementation to 1,254 patients after the implementation of the electronic solution. Health care systems that have the ability to modify their EMR system can help lower tobacco use rates among their patients while meeting Meaningful Use requirements. Future research should examine if referrals through the eTobacco protocol are directly associated with patients' tobacco cessation rates.

Who uses snus? A study of Texas adolescents.

INTRODUCTION: Snus, a smokeless tobacco product, was introduced in the United States in 2006. Because it is available in a variety of flavors and is relatively easy to conceal, snus might be particularly attractive to adolescents. Yet, no studies have examined snus use in U.S. adolescents. This brief report examined (a) differences between adolescent snus users and non-snus users on a variety of demographic, behavioral, and intrapersonal factors and (b) prevalence of snus use among current users of various other tobacco products versus nontobacco users. METHODS: Participants were 8,472 6th- to 12th-grade students who voluntarily completed the 87-item Texas Youth Tobacco Survey during class time. RESULTS: Overall, 7.1% of students reported ever trying snus; of these, 77% were male, 68% were in high school, and 46% were White. Mixed-effects regression models indicated that the prevalence of cigarette, chew, cigar, and alcohol use was higher among snus users than among non-snus users. Compared with non-snus users, snus users performed more poorly in school and perceived snus, cigarettes, chew, and cigars to be less dangerous. Finally, current users of cigarettes, chew, and cigars had a higher prevalence of snus use than did their peers who did not use the respective products. CONCLUSIONS: Among U.S. adolescents, snus use may be part of a constellation of health compromising behaviors. Additional research is needed to determine who is using snus and identify the determinants and consequences of snus use, all of which can inform interventions and policies aimed at decreasing tobacco use among youth.