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Section 14
Smoking Cessation Strategies for College Students

Question 14 | Test | Table of Contents

Tobacco and Students
College students who tend to be frequent patrons of bars and clubs represent a large portion of the smoking public. Roughly 70% of college students have tried smoking. About one in five students who reported being current cigarette smokers also reported having smoked cigarettes daily. About half of the students who reported being current cigarette smokers, had also indicated having ever tried to quit (Everett & Husten, 1999). Everett and Husten (1999) reported on other studies conducted by Engels, Knibbe, DeVries, Drop (1998), and Zimmerman, Warheit, Ulbrich and Aus (1990) that heavy drinking and attendance at parties in which drinking occurs will tend to decrease the likelihood that these college smokers will try to quit and also decrease the chances of them being successful in quitting. Biasco and Hartnett (2002) reported that 69% of students surveyed at the University of West Florida agreed that smoking is unattractive, and 81% agreed it is unwise to smoke in an enclosed area. Over 34% agreed that there should be stricter laws against smoking.

Cessation Options: Counseling
In addition to NRT, another option for help to stop smoking is counseling. This option may include individual or group therapy in which smokers are aided by health professionals to quit. There is a correlation between the amount of counseling and the effectiveness of it (Fiore, Bailey, Cohen, 2000). Fiore et al. (2000), reported that four sessions of intensive clinical intervention containing 30 to 90 minutes of counseling was more effective for smoking cessation by two to three times as compared to those with no counseling. Counseling treatments are effective and their effectiveness increases with greater intensity of treatment (Treating Tobacco Use and Dependence: Summary, 2000). A University of Rochester study found that a telephone hotline makes a difference in the success for smokers trying to quit. After one year in the study the participants who were provided with a manual and a hotline averaged around 11.9% cessation rates, as compared 8.1 percent cessation rates for participants provided with only a manual (Study Shows Hotline, 1991).
There are various forms of smoking cessation options available to college students, including; nicotine gum, nicotine patch, nicotine inhaler, nicotine nasal spray, bupropion and counseling. Integrating these into a smoking cessation program on college campuses may help college students in quitting smoking. U.S. Public Health Service published A Clinical Practice Guideline that outlines treatments for nicotine addiction for health care professionals and individuals wanting to quit smoking (Treating Tobacco Use and Dependence: Summary, 2000). Most smokers want to quit but only about two percent accomplish it successfully each year. The guideline states that combining behavioral counseling and pharmacological treatment can produce 20% to 25% cessation rates in one year, as compared to rates of 5% to 10% for less intense treatments such as brief physician advice (Management of Nicotine Addiction Fact Sheet, 2000).

Current College Cessation Programs
A study measuring college smoking policies and cessation programs discovered that 55.7% of respondents reported that their college health centers offered some type of smoking cessation program for college students (Wechsler, Kelly, Seibring, Kuo, Rigotti, 2001). Approximately 48% indicated their school having support groups, 31% of schools offered individuals counseling, and 27.6% offered medical intervention, 5.3% reported schools having workshops, forums, and or lectures, 2.8% of schools had participated in incentive programs, 1.3% had used peer education, and only .4% had used curriculum integration as part of smoking cessation programs. Even with all of these smoking cessation options, 88% of schools with smoking cessation programs indicated they had no waiting list for the programs offered, and 6.2% of schools indicated that smoking cessation programs had been discontinued due to lack of demand for them (Wechsler et al., 2001).

The Goetz Plan
Smoking is a serious health issue plaguing our society. Students attending college could have a unique opportunity to quit smoking with a more effective college smoking cessation program. Cigarette use peaks at ages 18-25 and the average age for daily use is 18 (Baker, Thomas, Brandon, & Chassin, 2004). This is the traditional age range for college students; therefore integrating a smoking cessation program on college campuses is targeting a large portion of the smoking population. College campuses provide a good location for smoking cessation programs. With the majority of college students located on, or close to campus, providing an on campus smoking cessation program can provide a central location for students to participate in the program.

Greater results for a smoking cessation program might result if integrated into the college curriculum. Only about .4% of colleges who had smoking cessation programs actually integrated it into the curriculum (Wechsler et al., 2001). A two credit smoking cessation course would be a powerful motivation for college students who wanted to quit smoking. Motivational rewards have shown high short-term abstinence rates when used alone (Antonunccio, Boutillier, Ward, Morrill & Graybar, 1992). Combining the motivational reward of the credit hours received for the class and the other components of the program will help students quit smoking.

"Multicomponent treatments using motivational rewards have sometimes fared better than comparison treatments, but these comparisons are generally confounded by other factors." (Reducing Tobacco Use: a Report of the Surgeon General, 2000). This combination would also provide the students with the essential tools needed to aid in their smoking cessation efforts.

A smoking cessation class held twice a week for one-hour sessions, conducted by a qualified individual would likely add to the program's effectiveness. During one of the sessions during the week the instructor would provide various training to the students, including stress reduction, teaching the students about the health effects of smoking, and the possible smoking cessation aids available. Problem solving skills would also be integrated into the program. Problem solving skills have shown to have a beneficial impact on smoking cessation (Fiore et al., 2000). This program, offering strategies and coping skills is likely to aid in smoking cessation efforts. The other session during the week would be for peer counseling sessions. The students would interact in a controlled group therapy session in which they could share experiences they have had in trying to quit smoking as well as any troubles that they are having in current smoking cessation efforts. The course would also provide various smoking cessation aids at a reduced cost to the students to help them in their efforts. Each student will also be paired with a smoking cessation mentor. Programs that include social support and pharmacologic treatments have shown to considerably raise long term quit rates compared to treatments that do not include social support (Reducing Tobacco Use: A Report of the Surgeon General, 2000). The mentors will be past student smokers who have succeeded in quitting. The mentors will benefit the students in the program by providing support for them outside of the classroom. Mentors will be rewarded by monetary means for their involvement in the program, and at the end of the semester students who were successful in smoking will have the opportunity to become smoking cessation mentors as well.

Summary of Goetz Plan
• Offer a two credit smoking cessation course
• Training to students about health effects and cessation aids
• Problem solving and stress reduction training
• Peer-counseling
• Mentors for social support

Summary and Conclusion
Tobacco smoking is responsible for approximately 434,000 deaths per year in the United States (Fact Sheet, 1993). College students represent a large portion of the smoking public. Roughly 70% of college students have tried smoking (Everett & Husten, 1999). There are various methods available to assist in smoking cessation, some being, nicotine chewing gum, nicotine patches, nicotine inhaler, nasal sprays, some anti-depressant medications and counseling. Integrating these into a smoking cessation program on college campuses may help college students in quitting smoking. Most smokers want to quit, but few accomplish it successfully each year. A study done measuring college smoking policies and cessation programs discovered that 55.7% of respondents reported that their college health centers offered some type of smoking cessation program for college students (Wechsler et al., 2001). Cigarette use peaks at ages 18-25 and the average age for daily use is 18 (Baker, Thomas, Brandon, & Chassin, 2004). College students have the opportunity to participate in a smoking cessation program while attending school. Offering a two- credit smoking cessation course could provide motivation for students interested in quitting. Group therapy, problem solving and stress relief training, along with training about the health effects of smoking, and current cessation aids available included in the course would help students in their cessation efforts. Mentors provided can offer social support outside of the classroom for students trying to quit. Location, age, and motivation are all factors that may influence students into taking this college smoking cessation course, which, with other aspects mentioned may increase their chances of being successful in quitting smoking.
- Krohn, Franklin B.; Goetz, Kristin M.; The Goetz Plan: A Practical Smoking Cessation Program For College Students; College Student Journal; Jun2005;  Vol. 39 Issue 2

Personal Reflection Exercise #7
The preceding section contained information about smoking cessation strategies for college students.  Write three case study examples regarding how you might use the content of this section in your practice.
Reviewed 2023

Update
The effectiveness of tobacco cessation programs for
university students: A systematic review and meta-analysis

- Setchoduk, K., Pichayapinyo, P., Lapvongwatana, P., & Chansatitporn, N. (2023). The effectiveness of tobacco cessation programs for university students: A systematic review and meta-analysis. Tobacco induced diseases, 21, 73. https://doi.org/10.18332/tid/162001


Peer-Reviewed Journal Article References:
Evers-Casey, S., Schnoll, R., Jenssen, B. P., & Leone, F. T. (2019). Implicit attribution of culpability and impact on experience of treating tobacco dependence. Health Psychology, 38(12), 1069–1074.

Robinson, J. D., Li, L., Chen, M., Lerman, C., Tyndale, R. F., Schnoll, R. A., Hawk, L. W., Jr., George, T. P., Benowitz, N. L., & Cinciripini, P. M. (2019). Evaluating the temporal relationships between withdrawal symptoms and smoking relapse. Psychology of Addictive Behaviors, 33(2), 105–116.

Streck, J. M., Heil, S. H., Higgins, S. T., Bunn, J. Y., & Sigmon, S. C. (2018). Tobacco withdrawal among opioid-dependent smokers. Experimental and Clinical Psychopharmacology, 26(2), 119–124.

QUESTION 14
 What are the five core aspects of the Goetz Plan? To select and enter your answer go to Test.

Test
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