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Description
Objective: To determine the association between perceived smoking among peers and smoking status among US College attending youth. Methods: we analyzed data from the American College Health Association's National College Health Assessment II survey administered to college students throughout the United States. We performed bivariate and multivariate analyses to determine if higher smoking prevalence was associated with higher levels of perceived smoking among subjects' peers. We controlled for gender, age, risk behaviors such as types of substance abuse, and various other demographic factors. Results: Students who reported higher perceived smoking status among their peers are 2.11 times more likely (CI 1.92- 2.21) to be smokers. In addition, behaviors such as being an alcohol user, illicit drug user, marijuana user, hookah user, or user of other tobacco products were associated with smoking among subjects. Males had a higher rate of self-reported smoking than females (13.78% to 9.89%), as did Whites and American Natives (12.21% & 13.26%), those aged 22-24 (14.37% compared to 10.57% for ages 18-21), and being diagnosed with depression in the last year (18.86% compared to no diagnosis 9.69%). Discussion: Smoking prevalence among college students may be associated with perception of peer behavior. Adolescents in general often overestimate the smoking prevalence of their peers, and this could be affecting the social norm among the non-smoking population entering college. Various national surveys of college-age populations show that smoking prevalence is no longer in a steady decline. This is of concern due to the college experience being an important period for the establishment of lifelong health behaviors. Many studies focus on high school years, but college students experience multiple life changing events that take place in a short period of time that could make them susceptible to smoking initiation. National smoking rates among adults continue to decline overall, but the college-aged population does not seem to be following suit. Additional interventions to alter perceptions of peer smoking should be explored as part of college health programs. One of these is to establish smoke-free college campuses. This could potentially reduce peer perceptions of smoking and also eliminate the environmental contamination of campuses with discarded butts.