Social Smoking among College Students in the U.S

Introduction

Since the beginning of the twenty-first century, the age-standardized prevalence of tobacco smoking has continuously fallen. In 2015, WHO estimated that 20.2 percent of the world’s population aged 15 years and older were current smokers, showing that global smoking rates have declined by 6.7 percent since 2000 and by 4.1 percent since the WHO FCTC went into effect in 2005 (p. 11) [1]. Even though the health effects of cigarette smoking have been widely documented since the Surgeon General reported on the negative effects of smoking in 1964, people continue to commence smoking. In the United States, 440,000 deaths per year on average occur due to the effects of smoking; cigarette smoking in particular. Lung cancer, cardiovascular disease, and chronic airway obstruction account for the vast majority of these deaths. Besides, emphysema, diabetes, upper respiratory infections, and bronchitis are starting to be seen because of smoking which is a jeopardy factor for each of these health concerns. On the other hand, the economic charge is a significant subject that cannot be denied because of the high costs of this problem. Smoking is predicted to cost the economy $157 billion per year in health-related costs, and this figure is expected to rise (p. 133) [2].

In the United States, cigarette smoking kills more people than AIDS, alcoholism, drug addiction, car accidents, homicide, and suicide combined. When compared to nonsmokers, cigarette smoking in adolescents reduces the amount of maximum lung function reached, resulting in a higher incidence of asthma and acute respiratory infections (p. 246) [3]. Self-injury-based problems have risen among college students, and smoking is a kind of self-injury-based behavior. According to various studies, there is a link between nicotine addiction and mental issues. It gives rise to anxiety, stress, and miscellaneous disorders. Despite the paucity of literature in this area, a new study suggests that self-injurers have a greater prevalence of smoking than their non-injuring peers. These findings give us the idea of how smoking has importance in the life of young adults (p. 120) [4].

During the 1990s, the proportion of tobacco use among young adults was lower than in other age groups. This lower proportion pushed tobacco companies to focus on young adults more than before to create a market with young adults. Furthermore, the tobacco industry believed that the transition from adolescence to adulthood had an important role to bring a smoking habit to individuals. In this case, The industry saw this transition as a milestone to form a broad tobacco market, so it tried to integrate smoking into young adults’ social environments such as schools, pubs, and clubs with various marketing strategies (p. 1028) [5]. As a result of these policies, although smoking is declining among most adult groups in the United States, it has climbed dramatically among young adults aged 18 to 25, rising from 34.6 percent in 1994 to 41.6 percent in 1998. Despite the fact that university students are less likely to smoke than non- college students, the smoking rate among college students has increased dramatically, from 22% in 1990 to 28% in 1997. Students enrolled in public universities experienced the greatest growth, with a 33 percent increase from 1993 (22%) to 1997 (29%). In the United States, about 8 million students between the ages of 18 and 24 are enrolled in colleges and universities, and more than 2 million of them smoke. Smoking is becoming more of an issue among college students (p. 69) [6].

Smoking habits among young adults, including college students, vary greatly, ranging from daily heavy smokers to infrequent puffers. Those who smoke only once in a while are the most common group of young smokers. For example, 65 percent of college students who use tobacco do so on a sporadic basis. Moreover, the dependency proportion of smoking is lower for college students who smoke occasionally. Students only smoke in a limited number of situations, such as on weekends, while consuming alcohol, and socially with fellow smokers (p. 1199) [7]. Several studies point out the phenomenon of‘ social smoking’ which can be explained as another type of term for occasional smoking. According to debates in tobacco and health conferences, social smoking among young adult cigarette users is a relatively new phenomenon. Based on the observation of college health professionals, students identify themselves as social smokers instead of active smokers because of the conditions and density of their smoking activities (p. 133) [2]. However, it does not mean that this kind of smoking is not a danger to human health and living conditions. According to some studies, more than half of college students who smoke at low levels in their freshman year will continue to smoke in their senior year, and 30% will convert to daily smoking. More than 40 percent to more than 50 percent of regular adult smoking begins in young adulthood, depending on ethnicity. Furthermore, long-term smoking raises cardiovascular risks, and early cigarette usage is linked to respiratory problems, worsening health conditions, and mental health issues (p. 845) [8].

Smoking behavior causes many different issues for individuals in physiological, psychological, social, or economic aspects. Social smoking is a term that is not examined adequately even though many social smokers are common in colleges. This phenomenon needs more focus to create correct strategies for solving the problem of tobacco use among young adults. Several definitions of social smoking and the lack of identity of social smokers compose a complicated process and a barrier to overcoming the concerns of smoking and reducing the negative effects of tobacco use among young adults, and college students in particular. In this context, this paper aims to examine the term social smoking and its characteristics, and identities of social smokers which are poorly understood. The sample of the paper is college students in the US. Furthermore, currently available solutions ways, and strategies to overcome the effects of social smoking among college students will be handled.

Definition of Social Smoking and Characteristics of Social Smokers

Nondaily smoking is a prevalent term of smoking among young adults. According to research, Smoking was reported to be less than 30 days per month by 19.9% of young adults. Furthermore, another form of nondaily smoking, which shows an occasional smoking habit, is called social smoking (p. 1291) [9]. The term social smoking is a kind of pattern that was not defined in the literature, so the lack of the definition creates an obstacle to comprehending this term. In some ways, social smoking means smoking together mostly instead of smoking alone (p. 134) [2]. There are also several definitions of social smoking based on the context of smoking. For example, smoking is seen in social places such as nightclubs, bars, and restaurants, or nondaily smoking by young adults that occurs only in the presence of other smokers (p. 845) [8]. The above-mentioned definitions of social smoking raise theoretical and methodological issues. People who identify themselves as social smokers, do not accept themselves as a smoker, but they behave as daily smokers. For instance, limiting social smokers to those who “smoking that occurs only in the presence of other smokers” is a rigorous behavioral definition that only encompasses a fraction of those who consider themselves to be social smokers or daily smokers may be included in the “to smoke together mostly instead of smoking alone” category, which includes self-identification as a social smoker. Thus, these indefinite may cause various problems to examine the pattern of social smoking (p. 1291) [9].

Before handling the identity of social smokers, it is significant to understand how this behavior occurs among students and young adults. Although the initiation of cigarette use typically occurs before age 18; longitudinal research suggests that smoking is often initiated and escalates rapidly after age 18. Several long-term surveys, including Monitoring the Future (MTF) and Teenage Attitudes and Practices Survey (TAPS), tracked smoking habits from high school to college. According to age trend statistics, the amount of students who smoke a half-pack or more per day increases with age, causing researchers to speculate that light smokers in high school either become heavy smokers or quit college (p. 69) [6]. Early smokers were identified in puberty by a lack of exposure to smoking models, low levels of deviance, negative attitudes toward smoking, and college attendance. Late-onset smokers may be more inclined to comply with smoking regulations during puberty, but when they move from adolescence to emerging adulthood, they may no longer see smoking as an aberrant activity. Furthermore, once adolescents leave home, possibly to attend college, they are no longer subject to parental regulations and supervision (p. 2213) [10]. In this case, the time interval from high school to college is a crucial period. Students who never smoked in high school or only smoked infrequently before college may be enticed to try cigarettes or increase their use frequency throughout their college years. Approximately 40% of college smokers report an increase in their smoking behaviors during college, and approximately 20% of college smokers become daily smokers (p. 346) [11].

The characteristics of social smokers are essential factors for identifying smokers and examining the social smoking term. In the literature, several types of research handle social smokers in college students in the US. Based on the results of these researches, it can be possible to observe social smokers’ characteristics, identities, and attitudes towards smoking. To exemplify, according to the research conducted by Brown, et al., students who smoke occasionally did not describe themselves as a smoker. The participants of the research also mentioned that they were not addicted owing to their quantity of smoke. If a person smokes plenty of cigarettes, it shows that he is a smoker (p. 1201) [7]. Considering their smoking habits, not all smokers identify themselves as such. Approximately half of the smokers deny smoking, with half of these “deniers” identifying as social smokers alternatively (p. 346) [11]. Nondaily tobacco users are those who use any tobacco product, at any level, for less than 30 days per month. Heavy smokers are those who smoke a maximum of five cigarettes per day on at least four days per week (p.192) [12].

Moran et al. found that social smoking is extensive among students who have more social conditions. The reason is that they could find more chances to smoke socially. It is mentioned that social smokers’ tobacco use is related to alcohol use, binge drinking, and party activities. Besides, social smokers do not identify themselves as addicted smokers, however, they have a strong attitude toward quitting smoking. College students believe that they quit occasional smoking after graduation. On the other hand, their attitude in the dimension of health shows that cigarette use on a low scale is not harmful, and it does not cause the diseases which are associated with smoking (p. 1032) [5]. Social smokers do not identify themselves as a smoker, and use smoking as a tool to create a social environment, and make themselves socially acceptable to others. However, the attitude of social smokers in the health context creates a barrier to public health strategies. For this reason, the prevention and solution ways on smoking may not be shown to social smokers. The tendency levels of social smokers are low in the case of psychological and physical addiction. Because of that, the strategies for social smokers to quit should focus on the social profits of smoking. Strategies can emphasize that smoking is not important for social smokers to quit smoking habits. Banning smoking in environments where students spend most of their time is also an important step to prevent social smoking (p. 137) [2].

Besides being more social, and creating an environment with others, college students also emphasize different kinds of reasons that give them a start to smoke. From the perspective of college students, alcohol or binge drinking is one of the most effective factors for their smoking attitude. It is normal for them to smoke while drinking, however, if someone smokes in daily life, it is seen as a dependence by the students. The psychological condition of college students is another factor that triggers smoking. Smoking generally occurs when they do not feel happy. Stress, anxiety, anger, and other negative psychological aspects cause smoking. In research, it is claimed by a participant that smoking only occurs during negative feelings, and if he feels happy, he does not need to smoke (p. 1201-1202) [7]. Risk-taking and irreverence are rarely considered factors of smoking. The biggest predictors of cigarette smoking in college students were high-risk behaviors like marijuana usage, binge drinking, and many sex partners. High-sensation seekers smoke more in social contexts, such as at a party or with a partner, than poor seekers in a sample of college students. In the literature on smoking initiation, depression is a significant factor. Although there has been evidence of a link between depression and social comparison or peer smoking, it is unclear whether depression causes one to smoke or whether starting to smoke causes depression (p. 248) [3].

It is necessary to examine quitting intentions of social smokers for understanding the approach of college students against smoking. As it is mentioned in this paper, social smokers do not identify themselves as addicted smokers. In this case, their purpose for quitting smoke can be seen as weak. Some groups of college students believe that if you are not a daily smoker, it is not a danger whether you quit smoking or not. However, some groups intend to quit as well. Several times, quitting smoke comes to mind for these students, such as after graduation or after getting married (p. 1201) [7]. There are several quitting motivations of smokers in social, economic, and physical contexts. The cost of smoking or a desire to save money, health reasons, improving fitness levels to participate in sports, and social causes, such as the hate of their smoking by family, friends, partners, or roommates, or the smell, the poor taste, the effect of smoking on one’s appearance, labeling, and growing hooked to cigarettes are all factors that taken into account as quitting motivations by the college students (p. 965) [13]. Labeling by other people about smoking is a significant factor to see how social smokers are affected by social stigmas, and considering this factor has an important role in quitting period. That is, the people around social smokers such as family members, or schoolmates, can shape social smokers’ smoking frequencies. Students take care of where they smoke, when they smoke, and with whom they smoked. To give an illustration, some social smokers do not want to inform their parents about their smoking because they think that their parents may negatively label them, and parents may implement several punishments to stop their children. Moreover, the role in college that social smokers draw is also important for them. Although social smoking creates a social zone for the students, it makes them think about their identities in the college area. Female students claim that it is not seen as a right behavior from the perspective of some others, and if you smoke, they do not see you as a girl. Thus, stigmas as a prior factor for social smokers, affect smoking behaviors, and social smokers try to protect their identities from their smoking behavior (p. 2202) [7].

Although there are various quitting motivations, the attitude of smokers toward quitting is not serious. The researches that were written on social smoking about college students have nearly the same results about the quitting attitude of social smokers. The results show that college students’ social smoking habit is underestimated by themselves. Because of the lower smoking scale, they think that they will quit smoking easily. However, social smoking can transform into permanent smoking. Based on the research on the participation of college students, among the percentage between 33 and 50% of students, it is seen that students had a daily smoking habit after a while when they started to smoke occasionally (p. 137) [2].

Discussion

As it is understood from the several data and results of research that are given above, social smoking among college students occurs based on various reasons in social, environmental, and emotional contexts. The term ‘social smoking’ is tried to be explained, but there is not an exact definition. The literature shows that a few pieces of research have a social smoking definition, and the researchers see this point as a limitation for producing obvious approaches (p. 137) [2]. The lack of a concrete definition may be associated with the differences in social smokers’ understanding of social smoking. Between young adults, social smoking phenomena differ due to their approaches and attitudes. It is possible to say that creating a clear definition of social smoking depends on understanding the social smokers because it can be estimated that social smokers attend smoking with different aims, and show this behavior with different conditions and contexts when we look at the results of the research which are conducted with the participation of college students. The identity of social smokers was evaluated based on college students’ answers, and due to not seeing themselves as real smokers, it is hard to change their attitude. However, the fear of labeling is a kind of punishment for them to think that they should not smoke even if they are not dependent. Moving from this point, this situation can be used as a quitting step for smokers. At the same time, banning smoking can be an effective punishment for overcoming the smoking problem because it is being used by a group as a socializing tool.

Conclusion and Recommendations

Smoking behavior is a kind of pattern that occurs as a result of several factors, and it can affect individuals in different ways such as psychologically, socially, and financially. After the selling strategies of tobacco industries, the proportion of tobacco use among college students increased and this context became a critical case in the literature to examine smoking practices and to obstruct disadvantages for college students. In this context, social smoking is one of the patterns that are related to tobacco use. The insufficiency of the definition of this term, and the unclarity of social smokers need to be explained to create correct strategies in health, psychological, financial, and social dimensions. As a general idea of researching social smoking, it can be said that social smoking is a smoking practice in social smokers who do not see this practice as a smoking habit. This practice is not a serious problem for them in terms of their physical and psychological health. In this case, the normalization of social smoking among college students may be a barrier to implementing health-related strategies. In addition to this, the attitude of students towards occasional smoking causes their quitting process. They think that it will be easy to quit this kind of smoking habit in the future. Because of that, the strategies that help the quitting process may be ineffective in the stage of quitting.

For future research, several implementations, new strategies, and solutions ways need to be developed. Although there are certain definitions of social smoking, researchers should focus on exploring more clear definitions for the understanding of social smoking. Furthermore, completed studies are not enough and they are limited to making a general idea about social smoking. In this case, in academic literature, social smoking and social smokers should be examined more. The tobacco industry has an important role in the increase of smokers because of its sales strategies. For this reason, the selling strategies of tobacco companies should be controlled by health ministries, organizations, or associations. With this aim, the things which encourage young adults can be obstructed in protecting them from wrong consciousness. Particularly, interventions and punishments in social places where smoking behavior mostly occurred should be disseminated by focusing on analyses on social smoking and the identity of social smokers. Thus, smoking as a socializing tool will be seen negatively. Finally, health care services can give individualized support to college students to quit smoking regularly.