The Goetz plan: a practical smoking cessation program for college students

College Student Journal, June, 2005 by Franklin B. Krohn, Kristin M. Goetz

Smoking is a serious health concern in today's society. College students represent a large portion of the smoking public and could have a unique opportunity to quit smoking with a college smoking cessation program.

One idea for a smoking cessation program is to offer a two-credit college smoking cessation course. The sessions would cover training about the health effects of smoking, smoking cessation aids available and include peer-counseling sessions. Student mentors, who were previous smokers, will provide support for students outside of the classroom and at the end of the semester students who were successful in quitting smoking will have the opportunity to become smoking cessation mentors themselves. Many smokers want to quit, but few succeed in it. Integrating this cessation program in a college course could aid student smokers in their quitting efforts.

Introduction

Tobacco smoking is responsible for approximately 434,000 deaths per year in the United States, which translates into about one in every five deaths. Environmental Tobacco Smoke (ETS) affects not only those who smoke, but those who are non-smokers as well. Because of their exposure to smoke given off by cigarettes, and smoke exhaled by those who smoke, non-smokers are forced to take part in "Passive Smoking". This exposure leaves them at risk to the consequent health effects of tobacco. Use of tobacco is known to cause adverse health effects such as lung cancer and heart disease. In 1992 the Environmental Protection Agency (EPA) issued a report indicating that exposure to environmental tobacco smoke presents a public health risk. Exposure to ETS is responsible for approximately 3,000 deaths per year in the United States due to lung cancer (Fact Sheet. 1993).

California, Texas, Massachusetts, and New York have all enacted smoke-free policies in indoor public places, including restaurants and bars. Tobacco companies and many restaurant and bar owners have strongly opposed such government regulation. Bar owners believe they will suffer an economic impact due to smoking customers not attending their establishment (Tang et al., 2003). However several studies have been conducted to examine the effect that smoking bans in bars and restaurants have, or possibly could have. Biener and Siegel (1997) demonstrated that approximately two-thirds of the 2356 respondents to a Massachusetts Adult Tobacco Survey reported that their patronage of bars and restaurants would not be affected if these facilities enacted smoke free policies. Due to the concerns of ETS approximately 40% of the respondents indicated that they avoided going to a place because of the tobacco smoke, and of these individuals, 40% had specified this as being bars or clubs (Beiner & Siegel, 1997).

Previous prohibitions in the United States included alcohol and various forms of drugs. Although smoking has not been nationally prohibited, the restrictions placed on it are a form of prohibition. Alcohol prohibition became effective on January 16, 1919 with the 18th amendment to the constitution. This amendment prohibited, "the manufacture, sale, or transportation of intoxicating liquors within, the importation thereof into, or the exportation thereof from the United States and all territory subject to the jurisdiction thereof for beverage purposes" (Schaffer, 2004). National prohibition continued until 1933. Studies have shown that while initially alcohol consumption dropped after prohibition went into effect, it then increased to about 60-70% of its initial consumption (Miron & Zwiebel, 1991). The overall goal of prohibition was unsuccessful. People found ways to manufacture, sell and transport alcohol although it was a violation of the United States Constitution.

Tobacco Facts

Each year smoking contributes to about 115,000 deaths from heart disease, 106,000 deaths due to lung cancer, 31,600 from other cancers, 57,000 from chronic obstructive pulmonary disease, 27,500 from stroke and 52,900 due to other conditions related to smoking. The risk of dying from lung cancer is 22 times higher among male smokers and 12 times higher among female smokers, as compared to those who have never smoked. Smoking cessation can increase one's life expectancy. After quitting smoking the risk of stroke returns to the level of those who have never smoked. Coronary heart disease is the leading cause of death in the United States, and smokers have twice the chance of dying due to this disease versus those who are non-smokers. The risk of respiratory infections such as pneumonia, influenza and bronchitis increases due to smoking, and quitting smoking can reduce the risk. The mortality rate from abdominal aortic aneurysm is also anywhere from two to five times higher in those who are current smokers as compared to those who have never smoked and this risk is reduced to half if smoking is stopped. A few studies have even shown that those who quit smoking after being diagnosed with cancer consequently reduce their risk of acquiring a second primary cancer as compared to those who continue to smoke (Novello, 1990).