Utilizing the Nicotine Products Policy Index to Assess [Tobacco/Smoking] Policies of Higher Education Institutions in Tennessee

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Objective: Tennessee’s tobacco use prevalence rate is 20.7%, compared to 16.1% nationally. This is associated with over 11,000 premature deaths and $5 billion annual costs. Over a third of young adults attend colleges/universities, and the use of electronic nicotine products is highest among this age group. This study created a Tennessee-specific best practices policy rating instrument to assist Higher Education Institutions (HEIs) in crafting comprehensive nicotine product policies. Methods: Between August 2017 and October 2018, a Tobacco-Free Generation Campus Initiative-funded team developed the Nicotine Product Policy Index (NPPI) rating instrument, with 50 items within four sections: 1) environment, 2) enforcement, 3) prevention and treatment services, and 4) policy organization. The policies of 84 Tennessee HEIs were scored using the NPPI, and total scores were transformed to ratings from 0-5 for a comprehensive policy. Results: Of Tennessee’s 34 independent colleges/universities, 11.76% were rated at 0 for lack of policy accessible to investigators. Ratings of 1 were given to 44%, 2 to 8.82%, 3 to 14.71%, and 4 to 17.64%. A rating of 4 was given to 17.64% of independent colleges/universities,15.38% of Tennessee’s 13 Community Colleges and 33.33% of Tennessee’s six Locally Governed Institutions. All four University of Tennessee-affiliated institutions earned a 4 rating. Only one institutional tobacco/smoking policy rated a 5: Tusculum College, an independent college/university. Conclusion: The NPPI could guide development of comprehensive nicotine product policies designed to address the high prevalence of tobacco use.

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