Georgia State University ScholarWorks @ Georgia State University Public Health Capstone Projects School of Public Health Spring 5-15-2015 Evaluating the Implementation of a Tobacco-Free Policy across the 30 Institutions of the University System of Georgia Elif Alyanak Follow this and additional works at: https://scholarworks.edu/iph_capstone Recommended Citation Alyanak, Elif, "Evaluating the Implementation of a Tobacco-Free Policy across the 30 Institutions of the University System of Georgia." , Georgia State University, 2015.edu/iph_capstone/4 This Capstone Project is brought to you for free and open access by the School of Public Health at ScholarWorks @ Georgia State University. It has been accepted for inclusion in Public Health Capstone Projects by an authorized administrator of ScholarWorks @ Georgia State University. For more information, please contact scholarworks@gsu. ABSTRACT ELIF ALYANAK Evaluating the Implementation of a Tobacco-Free Policy across the 30 institutions of the University System of Georgia (Under the direction of Michael Eriksen, Dean and Faculty Member) Abstract: Background: Tobacco use continues to be the leading cause of preventable death, not only within the United States but now globally.
Research shows that health promotion has helped to educate individuals of the harms and risks associated with usage, but tobacco control policies help to prevent individuals from initiating use and assist others with cessation, and especially help protect nonsmokers from the adverse effects of secondhand smoke. These types of policies are particularly increasing on college and university campuses, as seen with the October 2014 adoption of a 100% tobacco and smoke-free policy on the campuses of the 30 institutions that constitute the University System of Georgia (USG). This evaluation studied the development and implementation of a system-wide tobacco and smoke-free policy, examining the effectiveness of multiple intervention components adopted to prevent and control tobacco use by students, faculty, and staff. Methodology for Proposed Plan and Products: The USG worked to develop an education campaign prior to the official implementation of the tobacco-free policy, creating signage, communications, promotional student and faculty videos, and two websites to provide policy information as well as implementation resources and cessation material.
The USG also organized a Tobacco-Free Kick-Off Meeting, providing institutional leadership with a forum to address any questions or concerns. One individual from each institution (n= 30 individuals) then participated in a survey addressing the strategies used throughout implementation, for the purpose of collecting information on support and success six months post-policy adoption. Results indicated that the majority of institutions actively communicated the new policy (n=29; 96. Employees positively supported the policy (n=28; 93.3%), reporting substantial compliance on campus (n= 22; 73.3%) and sufficient support from the USG (n=24; 80%).
Discussion: It appears that the system-wide implementation of the tobacco-free policy was supported and successful on campuses. Further evaluation research is necessary to assess more long- term impacts of the policy, specifically health-related outcomes for faculty, staff, and students as well as methods customized to the growing concern of e-cigarettes on campus. This implementation analysis and evaluation provides further support to the national tobacco-free campus initiative with a unique system-wide perspective. INDEX WORDS: tobacco, smoking prevention, worksite health, college students, college campuses i EVALUATING THE IMPLEMENTATION OF A TOBACCO-FREE POLICY ACROSS THE 30 INSTITUTIONS OF THE UNIVERSITY SYSTEM OF GEORGIA By ELIF ALYANAK B., APPLIED BIOLOGY GEORGIA INSTITUTE OF TECHNOLOGY A Capstone Submitted to the Graduate Faculty of Georgia State University in Partial Fulfillment of the Requirements for the Degree MASTER OF PUBLIC HEALTH ATLANTA, GEORGIA 30303 2015 ii EVALUATION THE IMPLEMENTATION OF A TOBACCO-FREE POLICY ACROSS THE 30 INSTITUTIONS OF THE UNIVERSITY SYSTEM OF GEORGIA By ELIF ALYANAK Approved: Michael Eriksen.________ Committee Chair Jessica Howell Pratt.
MPH_____ Committee Member __________________________ Committee Member Date iii TABLE OF CONTENTS ACKNOWLEDGEMENTS………………………………………………………………………. v LIST OF TABLES………………………………………………………………………………… xx LIST OF FIGURES……………………………………………………………………………….2 Purpose of Study…………………………………………………………………. 5 REVIEW OF THE LITERATURE……………………………………………………………….1 Characteristics of Adolescent Tobacco Usage………………………………………………… 7 2.2 Health Consequences Associated with Tobacco Usage on College Campuses……………….3 Tobacco-Free Policy Campus History………………………………………………………… 14 2.4 Policy Review of Similar Organizations………………………………………….5 Evaluations of Policy Adoption and Implementation…………………………………………. 25 PRORPOSED PLAN AND METHODOLGY…………………………………………………….1 The University System of Georgia…………………………………………………………….2 The Creation and Timeline of the USG Tobacco-Free Policy………………………………… 26 3.3 Components of Policy Implementation…………………………………………….4 Evaluation and Survey Creation………………………………………………….……………… 41 DISCUSSION AND RECOMMENDATIONS…………………………………………………… 53 4.1 Discussion of Research Questions…………………………………………………………….2 Recommendations Concerning Communications…………………………….3 Recommendations Concerning Enforcement and Compliance……………………………….1 Study Strengths and Limitation……………………………………………………………….2 Implications of Findings……………………………………………………………………….
81 iv ACKNOWLEDGEMENTS I would like to formally thank all of the faculty and staff that I have had the pleasure of working with at Georgia State University’s School of Public Health for their constant enthusiasm for public health, inciting the same kind of passion in students like myself daily. I also would like to thank my brother for encouraging me to consider GSU and my parents for their unwavering support and their magical ability to make food appear in front of me when I could not stop writing. Special thanks to my committee members, Dr. Eriksen and Mrs.
Jessica Howell Pratt for not only leading me to this project but also for their presence, feedback, and motivation throughout the entire process. Prior to its official adoption by the Board of Regents, while the policy was still in planning stages, Marion Fedrick and Karin Elliott of the University System of Georgia approached Dr. Eriksen about recruiting a student to take on this project. I am immensely grateful that he and Jessica recommended me as a candidate for this project, as it gave me the opportunity gain first-hand experience, while working with the wonderful members of Human Resources Office at the University System Office.
For their support and assistance throughout the policy implementation and evaluation process, I would like to formally thank Marion Fedrick, Karin Elliott, Lydia Lanier, Monica Fenton, and Kenasia Brown. v List of Tables Table 1. Survey Respondent General Characteristics 41 Table 2. Usage of Communications throughout Implementation 42 Table 3.
Awareness of Tobacco-Related Resources 44 Table 4. Opinions/Perception of Policy Compliance 48 Table 5. Opinions/Perception of Support from USG 49 Table 6. Relationship between Kick-Off Attendance and Attitude of USG Support 49 Table 7.
Calculated Associations between Population Size and Policy Compliance 50 vi List of Figures Figure 1. USG Tobacco-Free Logo and Stickers 30 Figure 2. USG Tobacco-Free Signage 30 Figure 3. USG Tobacco-Free Student-Related Videos 32 Figure 4.
USG Tobacco-Free Faculty and Staff Video 32 Figure 5. USG Tobacco-Free Resource Webpage 35 Figure 6. Viewership of the USG Tobacco-Free Page, Oct. Viewership of the USG Tobacco-Free Resource Page, Oct.
Methods of Policy Communication 42 Figure 9. Knowledge of Health Insurance Coverage for OTC NRTs 45 Figure 10. Knowledge of Health Insurance Coverage for Prescription NRTs 45 Figure 11. Methods of Policy Enforcement on Campuses 47 vii ABSTRACT ELIF ALYANAK Evaluating the Implementation of a Tobacco-Free Policy across the 30 institutions of the University System of Georgia (Under the direction of Michael Eriksen, Dean and Faculty Member) Abstract: Background: Tobacco use continues to be the leading cause of preventable death, not only within the United States but now globally.
Research shows that health promotion has helped to educate individuals of the harms and risks associated with usage, but tobacco control policies help to prevent individuals from initiating use and assist others with cessation, and especially help protect nonsmokers from the adverse effects of secondhand smoke. These types of policies are particularly increasing on college and university campuses, as seen with the October 2014 adoption of a 100% tobacco and smoke-free policy on the campuses of the 30 institutions that constitute the University System of Georgia (USG). This evaluation studied the development and implementation of a system-wide tobacco and smoke-free policy, examining the effectiveness of multiple intervention components adopted to prevent and control tobacco use by students, faculty, and staff. Methodology for Proposed Plan and Products: The USG worked to develop an education campaign prior to the official implementation of the tobacco-free policy, creating signage, communications, promotional student and faculty videos, and two websites to provide policy information as well as implementation resources and cessation material.
The USG also organized a Tobacco-Free Kick-Off Meeting, providing institutional leadership with a forum to address any questions or concerns. One individual from each institution (n= 30 individuals) then participated in a survey addressing the strategies used throughout implementation, for the purpose of collecting information on support and success six months post-policy adoption. Results indicated that the majority of institutions actively communicated the new policy (n=29; 96. Employees positively supported the policy (n=28; 93.3%), reporting substantial compliance on campus (n= 22; 73.3%) and sufficient support from the USG (n=24; 80%).
Discussion: It appears that the system-wide implementation of the tobacco-free policy was supported and successful on campuses. Further evaluation research is necessary to assess more long- term impacts of the policy, specifically health-related outcomes for faculty, staff, and students as well as methods customized to the growing concern of e-cigarettes on campus. This implementation analysis and evaluation provides further support to the national tobacco-free campus initiative with a unique system-wide perspective. INDEX WORDS: tobacco, smoking prevention, worksite health, college students, college campuses viii Author’s Statement Page In presenting this capstone as a partial fulfillment of the requirements for an advanced degree from Georgia State University, I agree that the Library of the University shall make it available for inspection and circulation in accordance with its regulations governing materials of this type.
I agree that permission to quote from, to copy from, or to publish this capstone may be granted by the author or, in his/her absence, by the professor under whose direction it was written, or in his/her absence, by the Associate Dean, School of Public Health. Such quoting, copying, or publishing must be solely for scholarly purposes and will not involve potential financial gain. It is understood that any copying from or publication of this dissertation which involves potential financial gain will not be allowed without written permission of the author. Elif Alyanak________ Signature of Author ix Notice to Borrowers Page All capstones deposited in the Georgia State University Library must be used in accordance with the stipulations prescribed by the author in the preceding statement.
The author of this capstone is: Elif Alyanak 400 17th Street, NW Atlanta, GA 30363 The Chair of the committee for this capstone is: Michael Eriksen. School of Public Health Georgia State University P. Box 3995 Atlanta, Georgia 30302-3995 Users of this capstone who not regularly enrolled as students at Georgia State University are required to attest acceptance of the preceding stipulation by signing below. Libraries borrowing this capstone for the use of their patrons are required to see that each user records here the information requested.
NAME OF USER ADDRESS DATE TYPE OF USE (EXAMINATION ONLY OR COPY) x Evaluating the Implementation of a Tobacco-Free Policy across the 30 institutions of the University System of Georgia CHAPTER I: INTRODUCTION 1.1 Background Research consistently shows that there is an inverse relationship that occurs between education and tobacco use: the more educated an individual is, the less likely he is to use tobacco. Data from the 2013 National Health Interview Survey indicated that smoking prevalence was the greatest among individuals with a GED (41.4%), decreasing substantially with every supplementary higher education degree, to the extent that individuals with an undergraduate degree had a smoking prevalence of 9.1% and those with a graduate degree had a smoking prevalence of 5.6% (Jamal et al. Furthermore, individuals who have not received high school diplomas have an average smoking duration of 40 years compared to 18 years for individuals who have earned at least a bachelor’s degree (Siahpush et al. Considering this relationship between education and tobacco use, there is still a significant percentage of tobacco use among American adolescents, particularly those of college and university age.
As this population contains the first age group that tobacco companies can legally target with marketing, research shows that 18.7% of individuals between the ages of 18 and 24 years identified as current smokers in 2013 (Jamal et al.