Tobacco-free university campus policies: A systematic review

Abstract

Objective: This systematic review aims to provide an update of the scientific evidence regarding tobacco-free/smoke-free campus policies (TFC/SFC), using a complex interventions approach. Participants/methods: We searched the PubMed, Scopus and Web of Science databases using a combination of ‘tobacco-free’ or ‘smoke-free’, ‘campus’, ‘university or college’ and ‘policy’ search terms on all indexed articles published up until June 2023. Studies were included if they presented research on pre-/post-implementation of TFC/SFC or policy components. Two coders extracted and synthesized the data and assessed the risk of bias. Results: A total of 113 studies were included, reporting data from 2005 to 2023 across 17 countries. The data was categorized into three of the four phases of the Medical Research Council (MRC) framework, i.e. “feasibility (n=24), “implementation” (n=34), and “evaluation” (n=69). This review finds that a policy draft, communication, enforcement strategies, and cessation services are critical policy components. TCF/SFC are effective for reducing tobacco use and secondhand smoke exposure, but they also increase vaping. Little research has investigated the effect of TFC/SFC on smokeless tobacco use. Conclusion: This review addresses remaining uncertainties in evidence on the TFC/SFC implementation process. We go on to provide a series of recommendations for university administrators.

Keywords:

• Tobacco-free/smoke-free campus
• smoking
• students
• complex intervention

Conflict of interest disclosure

The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of France.

Ethical approval

This research did not involved any human-subjects nor laboratory animals and thus did not need specific permissions.

Notes

1 https://no-smoke.org/colleges-universities-list-criteria/.

2 https://no-smoke.org/wp-content/uploads/pdf/smokefreecollegesuniversities.pdf.

3 https://www.fda.gov/tobacco-products/youth-and-tobacco/results-annual-national-youth-tobacco-survey.

Additional information

Funding

This work was supported by the French National Cancer Institute under grant (INCa/16312).