Health Communication Solutions for Campus Tobacco Control: Case Study of the Eliminate Tobacco Use initiative in Texas

Background: Despite declining cigarette smoking rates in the U.S., there is a continued need for tobacco prevention efforts to reach young adults. Tobacco initiation occurs prior to age 21 in 95% of smokers, and 99% of life-long tobacco users start before age 26. Use of alternative tobacco products, such as e-cigarettes and hookah, remain high among young adults. Therefore, post-secondary educational settings offer a unique opportunity in which to promote tobacco control actions.

Program background: Beginning in 2016, the University of Texas MD Anderson Cancer Center and the University of Texas System designed and implemented a comprehensive tobacco control program (Eliminate Tobacco Use) involving three domains of action – campus policies, prevention/education programs, and cessation services – to promote a progressive tobacco-free culture on university campuses. Cross cutting these action areas is evidence-based health communication strategies, including development of a brand and visual identity for tobacco control for all 14 system institutions, providing schools the tools to use the new brand effectively, and communication consultation from experts.

Evaluation Methods and Results: As of 2017, all UT institutions adopted tobacco-free campus policies. Progress continues to be captured in a web-based dashboard, communicated in annual impact reports, and reported out in the annual statewide summit. Based on initial success and shared interests in university-based tobacco control, other states have begun implementing this same model for their campus community. Traffic to the ETU website and downloaded resources are tracked. Technical assistance is provided on-demand to campuses seeking communication consultation.

Conclusions: Identifying effective appeals to prevent initiation or encourage cessation is critical for tobacco control efforts. Communication strategies that reach young adults can have notable influences on health knowledge and behavior. Despite ongoing policy and communication efforts to eliminate tobacco use, work remains to be done. Young adults typically display high psychological reactance to anti-smoking messages that attach negative labels to smokers, and their lifestyle makes them prime targets for tobacco advertising. Taking in these considerations alongside additional evidence on effective health communication practices, the ETU initiative developed health communication resources to be used by campuses System-wide. The communication toolkit contains guidance on brand implementation, suggested creative materials, tailoring best practices, social media graphics and content, physical signage guidance, and accompanying communication guidelines.

Implications for research and/or practice: The ETU initiative forged new interdisciplinary connections across academic institutions and offers a model for other systems of higher education interested in pursuing similar initiatives. The health communication strategies used in our program highlight how tailoring and targeting messages are essential to effective health behavior change; a skill that is useful across health topics and audiences. Each campus is very different from one another, and each audience (students, faculty, and staff) within a single campus varies greatly as well. Health communication practitioners will learn how a single campaign can be tailored to different geographic areas and how targeting is essential to varied audiences in a customized but unified fashion.