An intervention to increase compliance with a tobacco-free university policy

Purpose. To test the effects of a population-based self-efficacy message card campaign on compliance with a tobacco-free campus policy. Setting. This study was conducted at a large public university in the South. Subjects. Three hundred twelve observational periods at 39 campus sites. Intervention. The message card campaign, based on the Theory of Planned Behavior, consisted of distributing approximately 6000 efficacy-enhancing cards over 3 days. The intent of the cards was to increase awareness of the policy and resources available to help individuals stop smoking or remain comfortable while on campus. Measures. Policy compliance was measured using the Tobacco-Free Compliance Assessment Tool. Field notes were used to assess campaign reaction. Analysis. Mann-Whitney U-test was conducted to compare number of cigarette butts in hot spot areas before and after the intervention. A rate ratio was also calculated using Geographic Information System (GIS) mapping software to compare cigarette butts collected per day before and after the intervention at each of the study sites. Results. The median number of cigarette butts per day after the intervention was significantly lower than before the intervention (1.9 vs. 4.7, χ²: 8.1, p = .004). Eighteen sites (66.6%) had a post-pre ratio of .11 to .75, indicating a decrease in cigarette butts per day. Conclusion. An efficacy-enhancing message card campaign shows promise in improving compliance with tobacco-free campus policies.