Context Adults aged 18 to 24 years, many of whom are in college, represent the
youngest legal targets for tobacco industry marketing. Cigarette smoking has
been described among college students, but little is known about noncigarette
tobacco use by college students or cigar use by adults of any age.
Objectives To assess the prevalence of all forms of tobacco use (cigarettes, cigars,
pipes, and smokeless tobacco) among US college students and to identify student-
and college-level factors associated with use of each product.
Design The Harvard College Alcohol Survey, a self-administered survey conducted
Setting One hundred nineteen nationally representative US 4-year colleges.
Subjects A total of 14,138 randomly selected students (60% response rate).
Main Outcome Measures Self-report of current (in the past 30 days), past-year, and lifetime
use of cigarettes, cigars, pipes, smokeless tobacco, and all tobacco products.
Results Nearly half (45.7%) of respondents had used a tobacco product in the
past year and one third (32.9%) currently used tobacco. Cigarettes accounted
for most of the tobacco use (28.5% current prevalence), but cigar use was
also substantial (37.1% lifetime prevalence, 23.0% past-year prevalence, and
8.5% current prevalence) and combinations of the 2 were common. Total tobacco
use was higher in men than in women (37.9% vs 29.7%; P<.001),
despite nearly identical current cigarette smoking rates between the sexes
(28.5% for women vs 28.4% for men), because of greater use of cigars (current
prevalence, 15.7% vs 3.9%; P<.001) and smokeless
tobacco (current prevalence, 8.7% vs 0.4%; P<.001)
by men. Tobacco use was significantly higher among white students (P<.001), users of other substances (alcohol and marijuana) (P<.001), and students whose priorities were social rather
than educational or athletic (P<.05). Among students
who had used both cigars and cigarettes, only 8.9% smoked cigars at an earlier
age than they had smoked cigarettes.
Conclusion Our study indicates that tobacco use is common among college students
and is not limited to cigarettes. College appears to be a time when many students
are trying a range of tobacco products and are in danger of developing lifelong
nicotine dependence. National efforts to monitor and reduce tobacco use of
all types should expand to focus on college students and other young adults.