Tobacco-Free Policy

This policy was approved by the President's Coordinating Council (PCC) on May 7, 2015 and will go into effect on July 1, 2016.

INTRODUCTION
Saint Louis University (SLU) is committed to providing a safe and healthy environment for learning and working for its students, staff, and faculty members. The risks of tobacco products, including the risk of involuntary smoking to non-smokers’ health, are well established. A national program to promote tobacco-free university campuses has been promoted by the U.S. Department of Health and Human Services, the American College Health Association1, the American Cancer Society, the American Lung Association, the Association of Schools and Programs in Public Health, and many other public health organizations.

As of January 2, 2014 approximately 811 college and university campuses in the U.S. were tobacco-free. Local tobacco-free universities include Washington University in St. Louis, University of Missouri-St. Louis, and campuses of St. Louis Community College. National universities with tobacco-free policies include all campuses of the City University of New York, the University of Kentucky, the University of Texas, Emory University, University of Michigan, the University of California campuses, and Creighton University. Information on the Tobacco-Free College Campus Initiative, a list of tobacco-free university campuses, and links to individual university tobacco-free policies can be found at tobaccofreecampus.org.2

BACKGROUND
In the fifty years since the first Surgeon General’s report on tobacco, the Office of the Surgeon General, the Centers for Disease Control and Prevention (CDC) and other agencies have documented that tobacco use is the leading preventable cause of illness and premature death in the United States. Smokeless tobacco and cigarettes each cause cancer, other diseases, disability and premature death. Numerous studies have found that breathing secondhand smoke (involuntary smoking) is a cause of disease and premature death, including death from heart disease, stroke, respiratory disease, and cancer in otherwise healthy nonsmokers. In 1993 the Environmental Protection Agency classified environmental tobacco smoke as a carcinogen. In utero exposure of unborn babies to tobacco products also increases their risks of low birth weight, sudden death, impaired lung function throughout childhood, and increases the risk of several types of birth defects, including congenital heart defects.3, 4

Over 440,000 deaths occur every year in the U.S. attributable to tobacco, about 46,000 of which are due to involuntary exposure to tobacco smoke. To put tobacco-attributable deaths in perspective, every year in the U.S. there are more deaths due to tobacco than are due to HIV/AIDS, car crashes, heroin, homicide, alcohol, fires, cocaine, and suicide combined. Ninety-nine percent of smokers and a similar percentage of people who use smokeless tobacco start tobacco use before age 26 years; most of these people start tobacco use before age 22 years. Among occasional recreational users of tobacco, daily smoking and addiction typically occur by age 26 years. College age students, and college campuses in particular, are a focus of tobacco company marketing. The Office of the U.S. Surgeon General estimates that over $27 million per day is spent by the tobacco industry on messaging targeting college age people (HHS, 2013).5, 6

Tobacco use is highly addictive. Working and learning in an environment where people smoke cigarettes and use other tobacco products increases the likelihood of people initiating a life-long addictive habit of tobacco use. Likewise, people who wish to stop using tobacco products are less likely to successfully stop tobacco use when working and learning in an environment where tobacco use is allowed.6, 7

Published data demonstrate the effectiveness of tobacco-free university policies.6, 7 Sixteen months after initiating a tobacco-free policy at University of Michigan, 89% of faculty and staff, and 83% of students supported the policy. About 70% of faculty and students noticed decreased smoking on campus. Smoking rates by faculty and students decreased, and a large percentage of faculty and students who used tobacco indicated that the policy influenced them to stop, or attempt to stop, using tobacco.8

A published study in 2011 compared two Big-Ten universities - Purdue University (no policy) and Indiana University (policy implemented in 2008). Between 2007 and 2009, rates of tobacco use increased at Purdue University while at Indiana University tobacco use decreased. Between 2007 and 2009, smokers at Indiana University decreased their cigarette consumption, while smokers at Purdue University increased their cigarette consumption. The study showed a significant favorable change in attitudes among Indiana University students regarding elimination of tobacco use on university property.9

E-cigarettes (electronic cigarettes), heavily marketed by tobacco companies, are an effective mechanism for nicotine delivery that produces nicotine addiction as effectively as typical cigarettes. A recent CDC study reported a dramatic increase in e-cigarette use among adolescents, and concluded that e-cigarette use increased the risk of nicotine addiction, and that many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes.10 No e-cigarette product has been approved by the Food and Drug Administration (FDA) as a safe and effective way to quit cigarette smoking. The FDA has warned that little is know about the amount of nicotine or other harmful chemicals (e.g., propylene glycol) that are actually inhaled by users of e-cigarettes or inhaled by those in proximity to those using e-cigarettes. Citing the risks of e-cigarettes, the FDA has announced its intent to expand its tobacco product authority to include the regulation of e-cigarettes.11

For several years university health and public health organizations and experts have favored tobacco-free campus policies. Smoke-free campus policies only limit smoke-producing tobacco, with the primary intent being to prevent involuntary tobacco smoke exposure. An increase in smokeless tobacco rates have been reported on smoke-free university campuses, as tobacco companies increase marketing of smokeless tobacco (e.g., chew, snuff) around smoke-free campuses. Smokeless tobacco causes nicotine addiction and cancer. Tobacco-free campus policies prevent the use of any tobacco product, including e-cigarettes; the primary intent of tobacco-free policies is to improve the overall health of the campus community. Cessation programs are emphasized as components of tobacco-free policies. Tobacco-free policies are more effective in changing societal norms about tobacco use, and send a message that the university values health promotion. 1-3, 5-7

A tobacco-free policy at SLU would give students, faculty, and staff the opportunity to study and work in an environment without involuntary exposure to tobacco products proven to reduce life expectancy. Tobacco-free universities reduce risk of death and disease from passive involuntary smoking, reduce the odds of young people starting a life-time tobacco habit, and make it easier for those who wish to stop using tobacco to quit. Economic benefits of tobacco-free campuses include reduced employee health care costs, reduced absenteeism, cost savings in grounds and building maintenance, and reduced risk of fires. People who are addicted to tobacco must be treated with respect as a tobacco-free policy is implemented and sustained. Student and employee access to tobacco-cessation programs are an essential component of a successful tobacco-free policy.1-3, 5-9

The SLU Tobacco-Free Policy Proposal below is modeled after tobacco-free policies that have been implemented at other large, complex universities in urban settings, including the University of Texas, Washington University in St. Louis, City University of New York, University of Michigan, University of Kentucky, and Creighton University,1 and in consultation with experts in tobacco-free policies at the Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services. This final proposal has been drafted with input from three university-wide town hall meetings, input from meetings with the Faculty Senate, SGA, and SAC, and with input from individual faculty, staff, and students from across the university. Likewise, additional input has been obtained from health providers at SLU Student Health Services.

SLU Tobacco-Free Policy Proposal
Effective at the beginning of the 2015 Fall semester, or another date determined by the SLU leadership in consultation with the SLU Faculty Senate, Student Governmental Association, and Staff Advisory Committee, SLU will be 100% tobacco-free. This policy applies to all members of the SLU community, including students, faculty, staff, patients, contractors, and visitors to campus.

For the purpose of this policy, “tobacco” is defined to include, but not be limited to, any lit cigarette, cigar, pipe, bidis, clove cigarette, e-cigarettes, any other smoking product; smokeless or spit tobacco, also known as dip, chew, snuff, or snus in any form; and any other tobacco product or device not approved by the FDA for the strict purpose of tobacco cessation.

The use, distribution, or sale of tobacco, including any smoking device, or carrying any lit smoking instrument, in University owned, leased, or occupied facilities or on University leased, owned, or occupied property, at events on University Properties, or in University-owned, rented or leased vehicles, is prohibited. This includes:

  • All campuses,
  • Parking facilities and lots (including in personal vehicles);
  • SLU buildings located near city/municipality owned sidewalks, within 25 feet of entryways or exits, near air intakes, or near fire/explosion hazards;
  • Off-campus housing managed by SLU;
  • All university housing managed by SLU; and
  • Hotels and other establishments operated by SLU.

Tobacco Cessation Programs
SLU recognizes that tobacco use is addictive, and that quitting tobacco use can be difficult. To assist those students, faculty members and staff who wish to quit smoking, SLU and other organizations offer free or reduced-cost smoking-cessation programs. This Tobacco Policy will not be fully implemented until the establishment, publication, and effective start of these programs and services. A summary of available programs will be posted on the SLU website.

Implementation and Enforcement
The proposed SLU tobacco-free policy is a health initiative for the SLU community. Data from other colleges and universities suggest that over time there is a reduction in tobacco use and a reduction in involuntary exposure to tobacco smoke regardless of the method of enforcement. It is important that the university community, especially student leaders, faculty leaders and staff leaders promote good health and support an environment free of tobacco.

The SLU administration, with input and recommendations from the Faculty Senate, the Student Government Association, and the Staff Advisory Committee will develop plans for implementation and enforcement of the tobacco-free policy. The Tobacco-Free College Campus Initiative (tobaccofreecampus.org), the Office of the Surgeon General, the Office on Smoking and Health at CDC, and other organizations have experience launching tobacco-free campus policies and are available to assist with implementation and enforcement policies and procedures.

References

1. American College Health Association Guidelines. Position statement on tobacco on college and university campuses. November, 2011. www.acha.org.

2. Tobacco-Free College Campus Initiative. http://tobaccofreecampus.org

3. U.S. Department of Health and Human Services. Ending the Tobacco Epidemic: Progress Towards a Healthier Nation. Washington, D.C.: U.S. Department of Health and Human Services, Office of the Assistant Secretary of Health, August, 2012. http://www.hhs.gov/ash/initiatives/tobacco/.

4. Best D, Committee on Environmental Health, Committee on Native American Child Health, Committee on Adolescence. Technical Report - Secondhand and prenatal tobacco smoke exposure. Pediatrics 2009:124(5):e1017-e1044.

5. U.S. Department of Health and Human Services. The Health Consequences of Smoking – 50 years of progress: A Report of the Surgeon General. Office of the Surgeon General, Public Health Service, U.S. Department of Health and Human Services, Rockville, MD. 2014. Download at www.cdc.gov/tobacco

6. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Office of the Surgeon General, Office of the Assistant Secretary for Health, Public Health Service. U.S. Department of Health and Human Services, 2012.

7. Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs - 2014. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014, Atlanta, Georgia. Download at www.cdc.gov/tobacco

8. Michigan News, University of Michigan. Smoking Declines After U-M Campus Ban, May 9, 2013. University of Michigan Regents, Ann Arbor, Michigan, 2013. Accessed at http://www.ns.umich.edu/new/releases/21454-smoking-declines-after-u-m-campus-ban

9. Seo DC, Macy JT, Torabi MR, Middlestadt SE. The effect of smoke-free campus policy on students’ smoking behaviors and attitudes. Preventive Medicine 2011;53(4-5):347-52.

10. Centers for Disease Control and Prevention. Notes from the field: Electronic cigarette use among middle and high-school students in the United States, 2011-2012. MMWR September 6, 2013, Vol. 62(35);729-730.

11. US Food and Drug Administration. Electronic Cigarettes and FDA Regulation of e-cigarettes. http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm, accessed 2-13-2014.

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