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Cigarette butts near building entrances: what is the impact of smoke-free college campus policies?
  1. Joseph G L Lee,
  2. Leah M Ranney,
  3. Adam O Goldstein
  1. Tobacco Prevention and Evaluation Program, Department of Family Medicine, School of Medicine, The University of North Carolina, Chapel Hill, North Carolina, USA
  1. Correspondence to Joseph Lee, Tobacco Prevention and Evaluation Program, Department of Family Medicine, School of Medicine, The University of North Carolina at Chapel Hill, 590 Manning Drive, CB 7595, Chapel Hill, NC 27599, USA; jose.lee{at}


Background Indoor and outdoor tobacco-free campus policies for schools, hospitals and universities are increasingly being adopted. Yet, little direct evidence exists on the impact of tobacco-free campuses on tobacco outcomes.

Objectives To identify differences in cigarettes smoked at main campus building entrances by campus policy strength.

Methods Researchers collected cigarette butts (n=3427) at main building entrances (n=67) at baseline and follow-up on 19 community college campuses stratified by strength of campus outdoor tobacco policy (none, perimeter/designated area, 100% tobacco free). Outcome measures included the number of butts per day at building entrances averaged to create a campus score. Analysis of variance techniques examined differences in scores by the strength of campuses' outdoor tobacco policy.

Results One hundred per cent tobacco-free community college campuses had significantly fewer cigarette butts at doors than campuses with no outdoor restrictions. Butts on community college campuses with partial policies were not statistically different from campuses with no policy or campuses with a 100% tobacco-free policy but indicated that a dose–response relationship may exist.

Conclusions This study provides some of the first evidence on the impact of 100% tobacco-free outdoor policies on college campuses using an objective and reproducible measure. Such policies likely provide a more healthful environment for students, staff, faculty and visitors.

  • Smoking
  • social environment
  • organisational policy
  • universities
  • disparities
  • priority/special populations
  • public policy
  • prevention
  • health services
  • taxation and price
  • environmental tobacco smoke
  • advertising and promotion
  • advocacy

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  • Funding This work received funding from the North Carolina Health and Wellness Trust Fund Commission. Any opinions, findings, conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views and policies of the North Carolina Health and Wellness Trust Fund Commission.

  • Competing interests The UNC Tobacco Prevention and Evaluation Program's clinical Nicotine Dependence Program (AOG) receives unrestricted educational funding from Pfizer Pharmaceuticals to support dissemination of comprehensive tobacco cessation programmes.

  • Ethics approval University of North Carolina Biomedical Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.