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Prev Med. 2020 Jan 7;132:105954. doi: 10.1016/j.ypmed.2019.105954. [Epub ahead of print]

The effect of college attendance on young adult cigarette, e-cigarette, cigarillo, hookah and smokeless tobacco use and its potential for addressing tobacco-related health disparities.

Author information

1
Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, United States. Electronic address: ecleas@ucsd.edu.
2
Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, United States.
3
Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, United States; Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, United States.

Abstract

The goal of this study was to assess the effect of college attendance on tobacco use among young adults and across subpopulations with disparities in tobacco use. Using a cohort of US youth (<18 years) who aged into young adulthood (18-24 years) in the Population Assessment of Tobacco and Health (2013-14, 2015-16, n = 3619) and propensity score matching we estimated the effect of college attendance on past 30-day use of cigarettes, e-cigarettes, cigarillos, hookah and smokeless tobacco. In unmatched analysis, college attenders (vs. nonattenders) had lower risk of using any form of tobacco (Risk Difference (RD): -10.0; 95% CI: -13.2, -7.0), cigarettes (RD: -13.0; 95% CI: -15.4, -10.5), e-cigarettes (RD: -4.1; 95% CI: -6.8, -1.7), cigarillos (RD: -5.7; 95% CI: -7.6, -3.8), and smokeless tobacco (RD: -2.0; 95% CI: -3.4, -0.6), but not hookah (RD: -0.2; 95% CI: -2.1, 1.6). In matched analysis, these associations were all near-null, with the exception of cigarettes (matched RD: -7.1; 95% CI: -10.3, -3.9). The effect of college attendance on cigarette smoking was stable for all subpopulations we assessed including among those identifying as non-Hispanic Black or Lesbian, Gay or Bisexual as well as among those living in the South, Midwest or whose parents did not attend college. The results suggest that college attendance may reduce young adults' risk of cigarette smoking but may not reduce the risk of using other tobacco products.

KEYWORDS:

Cigarette smoking; Electronic nicotine delivery systems; Propensity score; Smoking water pipes; Social norms; Tobacco; Tobacco use; Universities; Young adult

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