Funding: TRDRP Pilot Community-Partnered Participatory Research Award
Study Team
Kimberlee Homer Vagadori (community Co-PI: CYAN a program of Heluna Health)
Camillia Lui (academic Co-PI: Alcohol Research Group at Public Health Institute (ARG/PHI))
Sang Leng Trieu and Becky Perelli (Co-I: Ohlone College)
Elisa Tong and Melanie Dove (Co-I: University of California, Davis (UCD)),
Joshua Yang (Co-I: California State University, Fullerton (CSUF))
Project Overview
Nationally, over the past five years, young adult tobacco use has increased within a context of emerging electronic products, dual and polysubstance use with alcohol and cannabis, and rising mental health conditions worsened by the COVID-19 pandemic. Serving more than 1.8 million students, the California (CA) community college (CC) system is a prime setting to deliver comprehensive tobacco screening, intervention and treatment to young adults, and especially to groups experiencing tobacco-related health disparities such as racial and ethnic minorities, sexual and gender minorities, those from lower socioeconomic status, and rural areas. A better understanding of tobacco use and co-use with alcohol and cannabis among CC students and how to implement interventions to meet their needs are warranted.
Inequities in tobacco control from policy, screening, and cessation are evident with CA CCs. As of June 2023, only 66% of CA CCs have 100% tobacco-free policies, while all four-year public universities have been 100% tobacco-free since 2017. Also, the extent of tobacco treatment interventions vary given that only 92 of the 115 CCs have a student health center. A 2021 survey of 30 CA CC student health centers showed that while 93% screened for tobacco use, only 43% provided any interventions. Currently there are no standard practices across CA CCs to deliver tobacco screening and intervention within student health or mental health visits.
Building off the CYAN’s College Tobacco Program (community Co-PI) and a TRDRP New Investigator Award on CC’s tobacco-free policy adoption (academic Co-PI ), this pilot CPPRA study will (1) Examine CC students’ tobacco use and co-use with alcohol and cannabis, and identify help-seeking facilitators and barriers to reduce or quit tobacco use and co-use; (2) Investigate the extent of student screening and intervention services for tobacco, alcohol and cannabis use and co-use in a sample of 8-10 CA CCs; and (3) Integrating Aims 1 and 2, identify student-centered strategies that are feasible, acceptable, and appropriate for screening and intervention of tobacco use and co-use with alcohol and cannabis at CCs and to increase utilization of these services. This pilot study has potential for significant impact by understanding tobacco use and co-use patterns among CA CC students for a future implementation study of student-centered screening and intervention services of tobacco use and co-use with alcohol and cannabis at CCs.
Project Aims
Aim 1: Examine CC students’ tobacco use and co-use with alcohol and cannabis, and identify help-seeking facilitators and barriers to reduce or quit tobacco use and co-use
1.1 Through Healthy Minds Survey (HMS) data, identify and understand CC students’ tobacco use and co-use with alcohol and cannabis, and factors associated with use and co-use
1.2 Through qualitative listening sessions, identify CC students’ readiness to seek care, knowledge of services, and help-seeking experiences for tobacco use and co-use
Aim 2: Investigate the extent of student screening and intervention services for tobacco, alcohol and cannabis use and co-use in a sample of 10 CA CCs; specifically:
2.1 Through key informant interviews with student health and mental health service providers, HSACCC annual benchmark survey (HABS) data, and clinical flow charts, examine the extent of tobacco screening and intervention services on-campus, and whether co-use or polyuse of alcohol or cannabis is incorporated into screening
2.2 Through key informant interviews with student health and mental health service providers, examine facilitators and barriers for implementing screening and intervention services for tobacco use and polysubstance use in CCs
Aim 3: Integrating Aims 1 and 2, identify student-centered strategies that are feasible, acceptable, and appropriate to improve screening and intervention of tobacco use and its co-use with alcohol and cannabis and to increase utilization of these services
3.1. Identify student-centered strategies that address key barriers to student engagement/utilization of tobacco screening and intervention services and facilitate CC’s capacity to implement these services [Figure 1. Ability to engage and Appropriateness]
3.2. Examine the feasibility, acceptability, and appropriateness of these strategies among CC students and CC service providers in the sample of 10 CA CCs.
