College Students’ Attitudes and Perceptions Towards Smoking

Abstract

The purpose of this study was to examine the differences in participant’s attitudes towards smokers of different genders as well as the use of different cigarette types (traditional and electronic). We used a paper survey with a short, twelve item attitudes scale, The Santa Clara Religiosity Measure (Plante & Boccaccini, 1997), and the Duke University Religion Index (Koenig & Bussing, 2010), as well as standard demographic questions. The participant pool consisted of students in an introductory psychology class at a small southeastern college aged 18 years old or older (N=126). No special requirements were needed to complete the survey. We hypothesized that participants would show more negative attitudes towards female smokers and towards traditional tobacco cigarettes. However, no support was found for either hypothesis. There were two significant interactions discovered with regards to religiosity and perceptions of smokers. Participants with higher religiosity scores viewed electronic cigarette smokers more negatively than traditional cigarette smokers. Future directions for this study should include larger, more diverse participant pools, more accurate measures of attitudes and religiosity, as well as more locations than just a southeastern college.

College Students’ Attitudes and Perceptions Towards Smoking

Tobacco has been a staple in the United States economy since the days of the colonies. Today, big tobacco companies sell over fifty two billion dollars of traditional tobacco cigarettes a year (Tobacco Product Dollar Sales, 2014). Since the 1964 report from the Surgeon General, tobacco companies have been pressured to market products labeled “safer” than traditional cigarettes (Trumbo & Harper, 2013). This increased motivation for safer tobacco products has led to low-tar and light cigarettes. As of 2012, twenty two percent of young adults currently smoke traditional cigarettes in the United States (A Third of Students Smoke, n.d.). As a growing social norm among college students, smoking habits vary from traditional cigarettes to electronic nicotine dispersal systems, or electronic cigarettes, and other nontraditional tobacco products (Richter, Pederson, & O’Hegarty, 2006).

In a study conducted by Richter, Pederson, and O’Hegarty (2006) risk perceptions of traditional cigarettes and non-traditional tobacco products among college aged young adults were analyzed. Results showed that perceptions varied among different racial/ethnic groups. African American participants were more likely to rate all products as equally harmful and Hispanic participants were most likely to indicate that they did not know which product was more harmful than another product. The same study also indicated that a participant classified as an occasional smoker was less likely to perceive harmful effects from his or her smoking habits. However, the sample of participants (N=137) is relatively small compared to other studies.

The use and perception among college students of electronic cigarettes was examined in a study by Trumbo and Harper (2013). In this study, 244 participants were surveyed over perceptions of public use, personal intentions of use, awareness of electronic cigarettes, and smoking status, which was classified as ever smokers and never smokers. In general, the results showed that students were more likely to perceive electronic cigarettes as more appropriately allowed in public and that traditional tobacco products should never be allowed in public. The same study also found that students had a more negative attitude towards electronic cigarettes, and that it may be somewhat socially acceptable to use electronic cigarettes.

Being a current or former smoker was positively associated with alternate product use, awareness of electronic cigarettes, and that there were stronger social norms against smoking. Awareness of electronic cigarette smoking was associated with greater tobacco smoking acceptance, positive attitudes towards electronic cigarettes, and a stronger attitude towards electronic cigarettes as a favored innovation. The study by Trumbo and Harper (2013) concluded that the initial use of electronic cigarettes would most likely be restricted to individuals who already use some manner of tobacco product whether it be traditional or nontraditional.

More and more research shows electronic cigarette use is growing in popularity and use perceptions accompanying this growing popularity varies. Rass, Pacek, Johnson, and Johnson (2015) found that users of both electronic and traditional cigarettes believed electronic cigarettes to be less addictive and harmful than traditional tobacco cigarettes. Further evidence of increased popularity of electronic cigarettes is seen in a study conducted by Zhu, Gamst, Lee, Cummins, Yin, and Zoref (2013), which found that national tobacco use surveys report e-cigarette use and/or experimentation among youth and adult smokers over a 1-year period has increased to twice what it was, as well as a three time increase among youth never-smokers of tobacco cigarettes. The increasing popularity has begun to spark debate on potential health impacts of these products over long term and short term use (Kosmider et al., 2014). Other potential health impacts include potential return to nicotine dependence from former smokers, delayed cessation among current smokers, and avoidance of smoking restrictions (Pearson, Richardson, Niaura, Vallone, & Abrams, 2012).

Friend and family history of electronic and traditional cigarette use was found to be positively associated with lifetime use of traditional and nontraditional tobacco products among participants in a study conducted by Pokhrel, Fagan, Kehl, and Herzog (2015). The same study also showed participants felt that electronic cigarettes cut down on negative health effects of smoking such as cancer risks and second hand smoke, as well as a positive attitude towards using electronic cigarettes as a stepping stone on the road to quitting tobacco use.

Religiosity, defined as a collection of attitudes and beliefs in the search for the divine, is negatively correlated with the quantity, frequency, and age of initiation to smoking (Klassen, Smith, & Grekin, 2013). Also, religiosity decreases the chance of smoking with the presence of established risk factors such as cancer and emphysema (Klassin, Smith, & Grekin, 2013). These findings have led to attempts to incorporate religion in smoking prevention and cessation programs. The majority of literature on religiosity and its relationship with smoking has focused on traditional cigarettes. However, the study by Klassen et al. (2013) includes the effects of religiosity on use perceptions of electronic cigarettes as well. The results of this study indicate that, although religiosity was negatively associated with cigarette use as found in previous studies, this negative correlation did not extend to the use of electronic cigarettes, and religiosity did not have a significant impact on electronic cigarette use.

Another factor that influences the likelihood of smoking habits is socioeconomic status. Businelle et al. (2010) found tobacco related illnesses and negative health impacts and perceptions of tobacco products are more profoundly experienced by individuals with a low socioeconomic status as defined by education, income, and occupational status. Lower socioeconomic status is positively correlated not only with negative health impacts and perceptions, but also with frequency of tobacco product use and earlier initial age of first use.

Demographic factors such as socioeconomic status, race/ethnicity, age, and religiosity affect use and perceptions of traditional cigarettes and electronic cigarettes (Businelle et al, 2010; Klassen, Smith, & Grekin, 2013). The popularity of electronic cigarettes and the differences in harm perceptions of traditional and electronic cigarettes are important factors in the market for both traditional and electronic cigarettes.

The purpose of this study was to see if there were more negative attitudes associated with female smokers as well as if there were more negative attitudes associated with smokers of traditional tobacco cigarettes. We hypothesized that participant’s attitudes on smoking would show more negative attitudes towards female smokers and traditional cigarettes.

Method

A survey was given to students in an introductory psychology class. Participants were informed of the basic purpose of the study and informed consent was obtained from those old enough to participate. Four different surveys containing differences in the scenario were distributed evenly and randomly among the participants.

Participants answered some demographic questions about themselves related to smoking habits, socioeconomic status, age, race, and gender. The participants were then directed to answer the Santa Clara Religiosity measure and the Duke University Religion Index to measure the participants’ level of religiosity (Koenig & Bussing, 2010; Plante & Boccaccini, 1997). The participants then read a brief scenario involving an individual that was either male or female and smoking behavior involving either an electronic cigarette or a traditional cigarette.

Participants

129 participants were recruited from an introductory psychology class from a small southeastern college. Three potential participants were under eighteen years of age and so data collected from these participants was excluded from analysis with data from 126 participants meeting eligibility to be included in analysis. No special circumstance criteria needed to be met to complete the survey. Exclusion criteria included the vulnerable population of under age students. Participants were volunteers and were not forced in any way to answer any questions they did not feel comfortable doing so. Of the 63 participants whose data was analyzed, 46 percent were male and 54 percent were female. 54 percent of the participants were traditional freshman with 38 percent being sophomores, 6 percent being juniors, and just under 2 percent being move on when ready students.

Participants’ racial/ethnic background was broken down as a potential demographic factor. 69.8 percent of participants were white, 15.2 percent were black, 3.2 percent were Hispanic, 1.6 percent were Native American, 1.6 percent were Asian/ Pacific Islander and 7.2 percent identified themselves as other. Perceived socioeconomic status was also analyzed. A large percentage of 85.7 percent identified as middle class, 9.5 percent identified as upper class, and 4.8 percent identified as lower class.

Design

An experimental two by two design was used. The first independent variable was the sex of the smoker in the survey taken by the participants. We used both male and female values. The second independent variable was the type of cigarette used by the smoker in the scenario in the survey taken by the participants. We used both traditional tobacco cigarettes and electronic cigarettes as the values. Our dependent variable is a participant’s attitudes and perceptions of smoking.

Procedure

A physical paper survey was given during the regular class time of the introductory psychology course. The survey was used to determine if correlations exist between certain demographic factors such as age, race, and perceived socioeconomic status as well as religiosity and a college student’s attitudes and perceptions on smoking either electronic or traditional cigarettes and whether there are differences between the perceptions of the two types of cigarettes.

Before the survey was given, informed consent was obtained from all participants old enough to do so. All questions about the survey were answered before, during, or after the survey was completed. It was explained that all data was confidential and the survey was completely voluntary, and that any participant could withdraw at any time. When the participants completed the survey the survey packets were collected. All participants were debriefed and the purpose and goals of the data collection were explained to all participants.

Materials

A paper survey was distributed to students in an introductory psychology class. The survey contained several demographic questions about age, race, student classification and perceived socioeconomic status growing up. The 5 item DUREL (Koenig & Bussing, 2010) was included to measure the basic religiosity of a participant and the Santa Clara Religiosity Measure (Plante & Boccaccini, 1997) was included for a more precise measure of religiosity. On both religion scales, the higher the score of a participant the more religious that participant is.

An attitudes scale was also included. Twelve items on a scale of 1-not at all to 7-very measured levels of positive and negative attitudes towards smoking habits of a smoker in a scenario on the survey. The attitudes portion of the survey had a Cronbach’s Alpha value of .625 with a total scale standard deviation of 7.73177.

Results

Using data collected from 63 participants old enough to give informed consent, we ran a one way ANOVA comparing the attitudes scale and both independent variables of gender of the smoker in each scenario and type of cigarette in each scenario.

With regard to hypothesis 1, we expected results to show more negative attitudes towards traditional tobacco cigarettes, however, no support was found. Item 2 on the attitudes scale “How likely are you to continue to sit on the bench for any length of time” (see Appendix C, Item Reverse 5) was found to have marginal significance between traditional cigarettes (M=4.09, sd=1.97) and electronic cigarettes (M=3.22, sd=1.55), F(1,61)=3.228, p=.077.

With regard to hypothesis 2, we expected participants to have more negative views of female smokers than male smokers. However, we did not find significant differences overall between females and males. One item “To what extent did you think this person is rude” (see Appendix B, Item ATT5) was significantly different with Males (M=3.10, sd=1.20), and Females (M=3.90, sd=1.56), F(1,61)=5.34, p=.024. Meaning that participants found that female smokers were actually being ruder than male smokers when smoking in public.

Discussion

The purpose of this study was to see if there were any differences in the attitudes of participants on male and female smokers of both electronic and traditional cigarettes. We hypothesized that traditional cigarettes would have more negative attitudes attached to them than electronic cigarettes and that female smokers would have more negative attitudes attached to them then male smokers.

However, the results from our ANOVA tests showed no support for either of our hypothesis. One item for hypothesis 1 did show marginal significance between traditional and electronic cigarettes and one item for hypothesis 2 showed significant differences between male and female smokers.

A research study conducted by Trumbo and Harper (2013) did show that there were less negative attitudes associated with electronic cigarette and alternative product use than with traditional tobacco cigarettes. Compared with our study, more significant results were found in their study compared to ours. A possible explanation of this difference is the number of participants in each study. Trumbo and Harper had 244 participants to draw data from while our study only had 63 participants whose data was usable in analysis. More participants means more accurate results and the discrepancy in participant numbers could account for the insignificant findings.

Major limitations of our finding include the small number of participants but is not limited to just this one aspect. Other limitations include the location that the survey was given, and the age demographic of the participant pool. The survey was given out in an introductory psychology class in a small southeastern college which limits the age group to mostly between 18 and 20 years old and most of these participants were raised in the south meaning most were raised by traditional grandparents and parents.

Another limitation is that the majority of participants were Caucasian American students. According to the study by Richter, Pederson, and O’Hegarty (2006), there are noticeable racial differences in attitudes towards traditional and nontraditional tobacco products. Differences in perceptions of harm and positive and negative attitudes towards stigma.

There are many future possibilities for our study. One major thing that should be done in the future, is that the study should be expanded to a larger, more representative participant pool to increase accuracy of results from data analysis. Another major direction for the future is that the study should be expanded to more inclusive racial participant pools as well as different locations with different cultural backgrounds such as the southwest, northeast, or northwest. Future studies should also expand to a more definite scale of attitudes and religiosity as more comprehensive measures with more generalizable results.

References

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