Prior studies indicate a link between poor academic performance and e-cigarette use in high school students (18 years and below). However, the effect of post high school education on e-cigarette use is poorly summarized in literature. The objective of the current study was to determine if there was a difference in prevalence of past 30-day e-cigarette use in a national sample of young adults due to different educational levels. Four groups of young adults were studied based on their level of education: High School Dropouts, High School Graduates/GED, Current College Students, and College Graduates. Data from the Population Assessment of Tobacco and Health (PATH) study was used to assess the association between educational attainment and e-cigarette use in young adults (ages 18-24). Relative e-cigarette use was measured via a survey, along with other control variables, across the four groups. Common factors affecting use across each educational attainment group were also analyzed. It was found that e-cigarette use tended to decrease as educational attainment increased among young adults. That is, higher levels of education seemed to be a protective factor against e-cigarette use when controlled for other factors. This study expands past research on this topic to include young adults as they transition from adolescents to adults. Prior studies established a link between academic performance at the same educational level (high school). This study indicates a difference in e-cigarette use between different educational levels. This study also differentiates between e-cigarette use among High School Dropouts and High School Graduates/GED.

Indiana University-Purdue University Indianapolis (IUPUI) / The smoking rate of low-income pregnant women is almost 4 times the rate for higher-income women. A better understanding of smoking within the low-income population is needed. The purpose of this dissertation was to study smoking and related factors for pregnant and postpartum women living in poverty. The first component used Rodger’s evolutionary concept analysis method and uncovered three attributes, four antecedents, and three consequences for smoking cessation. The second (N = 1,554) and third (N = 71,944) components were a secondary data analysis of first-pregnancy Medicaid-eligible women enrolled in the Nurse-Family Partnership program from 2011-2016. The second component explored patterns of smoking and depression and their associations. Eight distinct patterns of smoking and depression were found. Smokers were more likely than nonsmokers to have depressive symptoms at the end of pregnancy (OR = 1.37 [1.04, 1.81] and 12 months post-delivery (OR = 1.93 [1.47, 2.51]. The third component investigated covariates present during early pregnancy and their relationships with smoking status and sought to find best fitting predictive models. Multivariable logistic regression showed cigarette use in the 3 months prior to pregnancy and at program intake were significant predictors for smoking status at the end of pregnancy and 12 months post-delivery. Interactive Matrix Language, Structured Query Language, and iterations of logistic regression identified 5 covariates (high school education, cigarette use prior to pregnancy, smoking status at pregnancy baseline, depression, and self-mastery) for the best fitting model at the end of pregnancy and three additional covariates (post-secondary education, marital status, and race) for the 12 months post-delivery model. The area under the receiver operator characteristic curve was 0.9681 for the end of pregnancy model and 0.9269 for 12 months post-delivery model, indicating excellent prediction ability of the models. Results can be integrated in smoking prevention education, screening, and cessation intervention programs.

Background: Substance use can have lifelong consequences for adolescents and the rates of substance use in Canadian adolescents are increasing. This is a serious public health issue which needs to be addressed. The purpose of this study is to determine the impact of public health unit (PHU) engagement in school-based substance use prevention programs on student substance use. Methods: Data was collected from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour (COMPASS) study over the 2018/19 data collection year. A multi-level logistic regression was used to analyze the associations between PHU engagement and student substance use. Results: The analyses found that 70% of schools had PHU engagement in substance use prevention programs. Overall, PHU engagement made no difference on student substance use. However, when PHU engagement was divided into five levels of engagement (with zero being no engagement and five being the highest level of engagement) it was found that students from schools where PHUs solved problems jointly (level two) had statistically significantly greater odds of binge drinking, alcohol use and cannabis use. Schools were also divided into low and high-use schools for each substance. It was found that students in low-use schools had statistically significantly greater odds of binge drinking, alcohol and cannabis use with some levels of PHU engagement and students from high-use schools had statistically significantly lower odds of cannabis and cigarette use with some levels of PHU engagement compared to a similar student from a school without PHU engagement. Conclusions: Our findings show that there is opportunity for greater PHU engagement with schools in substance use prevention programming. Furthermore, it is important that PHUs are working with schools to ensure school-based substance use prevention programs are evidence-based and tailored to the specific needs and risk-levels of the students. / Thesis / Master of Science in Nursing (MSN) / The purpose of this study is to determine the impact of public health unit (PHU) engagement in school-based substance use prevention programs on student substance use. Data for this study was collected from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour (COMPASS) study. The results show that 70% of schools had PHU engagement in substance use prevention programs. Across all schools, when PHUs and schools solved problems jointly an increase in student binge drinking, alcohol and cannabis use was found. When schools were divided into low and high-use schools, similar results were found when PHUs engaged with low-use schools whereas when PHUs engaged in high-use schools a reduced odds of student cannabis and cigarette use was found in some situations. These findings highlight the importance for PHUs to consider the specific needs and risk-levels of the students and schools they are engaging with.

<strong>Background. </strong> Post-secondary institutions account for more smokers than any other occupational setting in Canada (Hammond, 2005). Unfortunately, little is known about tobacco use among this distinct population of students. The purpose of this study was to identify the prevalence of smoking and patterns of cigarette use among undergraduates at the University of Waterloo. The current study also sought to investigate the role of school connectedness in predicting students? smoking behaviours, and to explore the relation of student smoking status as determined by a behavoural measure and self-reported smoking status. <br /><br /> <strong>Methods. </strong> A secondary analysis of data collected using the University of Waterloo Tobacco Use Survey (2004) was employed for this research. Data were analyzed using descriptive statistics (frequencies, means, and percentages), non-parametric statistics (chi-square and Cohen?s kappa), principle components factor analysis and logistic regression in order to serve the exploratory purposes of the study. <br /><br /> <strong>Results. </strong> Overall, 17. 55% of the respondents reported current cigarette use (3. 37% daily; 14. 18% non-daily). Although most (85. 5%) students? self-perceptions remained as ?nonsmokers who never smoke? from university entrance to the study date, a greater proportion of students made a negative change in their self-perceived smoking status over this time period than a positive change (10. 13% vs. 4. 38%, respectively). Among students who perceived themselves as ?nonsmokers who never smoke? or ?ex-smokers? at university entrance, being more academically engaged predicted making a negative change in ones? self-perceived smoking status (OR= 1. 924, CI₉₅= 1. 064-3. 480). Finally, the proportion of non-daily smokers differed between the two measures of smoking status. Many students classified as ?occasional smokers? using the behavioural measure actually perceived themselves as ?nonsmokers who smoke sometimes?. <br /><br /> <strong>Discussion. </strong> The results of this study provide valuable new insights into smoking among Canadian university students. Students who are more academically engaged may be at risk of initiating smoking, perhaps as a means of stress reduction. Furthermore, the adult measure of occasional smoking typically used in tobacco research may be insufficient to inform tobacco control efforts for this population as it results in different proportions of non-daily smokers when compared against students? self-perceived smoking status. The findings of this exploratory research await replication with larger samples and different measures. Implications of the results for practice and further research are discussed. <br /><br /> <strong>Conclusions. </strong> This strategy of assessing connectedness to school shows promise in predicting post-secondary students? cigarette smoking behaviours. The results also provide support for continued investigation into the best ways to measure and assess current cigarette use in this unique population.

This study examined factors that may protect African-American young adults in college from early onset of cigarette smoking, and factors that may place them at risk for cigarette smoking, using the framework of the Social Cognitive Theory. It was hypothesized that existing regulation of smoking, positive attitude toward academics and school connectedness would be related to low cigarette-smoking rates, while exposure to pro-tobacco promotions would be related to high cigarette smoking rates. A convenience sample of 576 undergraduates at Dillard University of New Orleans completed a Harvard College Alcohol Study survey. Forty six percent (n=269) completed the survey. Ninetyone percent were African American, and 13% of them were ever-smokers. Chi Square analysis was used to test for a statistically significant difference in response rates between eversmokers and non-smokers. Results indicated no significant differences between respondents for any outcome measures. The Social Cognitive Theory constructs were not supported by the findings.The results of this study do not support any of the hypotheses. The Social Cognitive Theory constructs used to examine the hypotheses are not supported by the findings. Future studies should address the limitations of this research by using a random sampling technique, sampling across all academic classification levels, and assessing the validity and reliability of the Harvard College Alcohol Study survey measures for cigarette smoking.

<strong>Background. </strong> Post-secondary institutions account for more smokers than any other occupational setting in Canada (Hammond, 2005). Unfortunately, little is known about tobacco use among this distinct population of students. The purpose of this study was to identify the prevalence of smoking and patterns of cigarette use among undergraduates at the University of Waterloo. The current study also sought to investigate the role of school connectedness in predicting students? smoking behaviours, and to explore the relation of student smoking status as determined by a behavoural measure and self-reported smoking status. <br /><br /> <strong>Methods. </strong> A secondary analysis of data collected using the University of Waterloo Tobacco Use Survey (2004) was employed for this research. Data were analyzed using descriptive statistics (frequencies, means, and percentages), non-parametric statistics (chi-square and Cohen?s kappa), principle components factor analysis and logistic regression in order to serve the exploratory purposes of the study. <br /><br /> <strong>Results. </strong> Overall, 17. 55% of the respondents reported current cigarette use (3. 37% daily; 14. 18% non-daily). Although most (85. 5%) students? self-perceptions remained as ?nonsmokers who never smoke? from university entrance to the study date, a greater proportion of students made a negative change in their self-perceived smoking status over this time period than a positive change (10. 13% vs. 4. 38%, respectively). Among students who perceived themselves as ?nonsmokers who never smoke? or ?ex-smokers? at university entrance, being more academically engaged predicted making a negative change in ones? self-perceived smoking status (OR= 1. 924, CI₉₅= 1. 064-3. 480). Finally, the proportion of non-daily smokers differed between the two measures of smoking status. Many students classified as ?occasional smokers? using the behavioural measure actually perceived themselves as ?nonsmokers who smoke sometimes?. <br /><br /> <strong>Discussion. </strong> The results of this study provide valuable new insights into smoking among Canadian university students. Students who are more academically engaged may be at risk of initiating smoking, perhaps as a means of stress reduction. Furthermore, the adult measure of occasional smoking typically used in tobacco research may be insufficient to inform tobacco control efforts for this population as it results in different proportions of non-daily smokers when compared against students? self-perceived smoking status. The findings of this exploratory research await replication with larger samples and different measures. Implications of the results for practice and further research are discussed. <br /><br /> <strong>Conclusions. </strong> This strategy of assessing connectedness to school shows promise in predicting post-secondary students? cigarette smoking behaviours. The results also provide support for continued investigation into the best ways to measure and assess current cigarette use in this unique population.

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