The experiences of college students regarding new nicotine-tobacco product usage on a Northeastern university campus: A qualitative study

Diana Sireci, Lila Olman, Cassie Anzalone, Brittany Bungert, Nicole Sala, Taylor Winby, Ashley GuerraMentors: Joyce Rhodes-Keefe, RN-C, MS, Lori Sprague, MS, RN, Rosemary Collier, MS, RN, Geraldine R. Britton, RN, PhD

Background

Incidence of new nicotine-tobacco products (such as electronic cigarettes, vapor products, and hookah) is increasing among the college-aged population. Students are less likely to smoke cigarettes, are more likely to smoke hookah, and are unaware of new products’ potentially harmful effects. Research has found that motivating factors for these products include social activity, peer influence, and relaxation. However, current data and knowledge on college campuses is limited. Our previous quantitative analyses of distributed student surveys found that participants have limited knowledge of the ingredients in these products. The majority of these students proclaimed using these products for social purposes. This qualitative study adds to the body of knowledge regarding nicotine-tobacco product usage and awareness in this population.

Questions

Results: Themes I. Social Purposes• E-cigarettes used individually; hookah used socially. • Hookah & e-cigarettes are new or “trendy” (ex. “smoke tricks”).• E-cigarette/hookah users are not considered “smokers.”

II. Misinformation/Knowledge Gap• Unlike cigarettes, vapor product information is not easily accessible.• Hookah has less secondhand smoke than regular cigarettes. • Vapor products are safer alternatives to cigarettes.

III. Individualization• Smoking vapor products is an individual choice and does not affect non-smokers. • Similar to alcohol, use may or may not be deterred by knowledge of negative effects or legality.• Younger generation uses vapor products for social purposes; older generation uses vapor products for smoking cessation purposes.

Recommendations/ConclusionsFrom this analysis, there is an obvious knowledge deficit of hookah and e-cigarettes. Thus, we propose an educational intervention with the use of interactive online module programs. The material would be research-based, presented in an interactive format to help students relate to the material in their college settings and social environments.

Purpose❖ The purpose of this study is to conduct three focus groups to

explore the health beliefs, attitudes, perceptions and knowledge of university students regarding nicotine-tobacco products.

Objectives:❖ To determine usage and knowledge of cigarettes, e-cigarettes,

and hookah within the campus community.❖ To assess attitudes and perceptions of the media’s portrayal of

nicotine-tobacco products.

AcknowledgmentsSupported by the Binghamton University Academic and Faculty

Development Fund.Statement of Disclosure: The author reports no actual or potential

conflicts of interest.

ReferencesRockcellar Magazine Store (2016). Retrieved from http://www.rockcellarmagazine.com/shop/index.php?main_page=product_info&products_id=503Sharma, E., Clark, P. I., & Sharp, K. E. (2014). Understanding psychosocial aspects of waterpipe smoking among college students. American Journal of Health Behavior, 38(3), 440-447. doi: 10.5993/AJHB.38.3.13Sutfin, E. L., McCoy, T. P., Morrell, H. E. R., Hoeppner, B. B., & Wolfson, M. (2013, Aug 1). Electronic cigarette use by college students. Drug and Alcohol Dependence, 131(3), 214-221. doi: 10.1016/j.drugalcdep.2013.05.00

MethodologyDesign:❖ A qualitative study conducted via 3 focus groups on a medium-

sized university campus.❖ Multiple questions were asked to facilitate discussion.❖ Two recorders were utilized. Field notes were taken by two

researchers.❖ One focus group was transcribed by student researchers. Two

focus groups were outsourced for transcription.❖ 25 total participants.❖ Incentive to participate was provision of pizza and water.

Procedure:❖ Recordings of focus groups were listened to and analyzed for key

themes individually and collectively.❖ Common themes were identified among all focus groups.

“...my dad. He used to smoke, and then just converted to an e-cig...and it’s been helping. He’s not smoking an actual cigarette...to my knowledge, e-cigarettes are just much more better than actual cigarettes

“I feel like hookah seems more for recreation and cigarettes seem more out of a habit and a need to do it.” 5. Do you think that e-cigarettes and hookah have any effect on

health? If so, do you think they are similar to cigarette health effects?

“I think with e-cigarettes and hookah there’s this misconception that they’re less harmful because there [is] not the classic lighting of a typical cigarette…”

4. What does “being a smoker” mean to you?

“...as long as it doesn’t affect me personally I don’t really mind other people doing it or...have too much of a say... its them and if they want to do it that’s fine...it doesn’t hurt me...I don’t think it really matters too much”

3. Do you feel there are differences between smoking hookah and cigarettes? What are the differences? How about e-cigarettes?

2. Describe in what situations, you use or would use e-cigarettes or hookah? What about the situations makes smoking appealing?

1. What kind of messages/information are you receiving about hookah and e-cigarettes? From what sources?