Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Elizabeth Prom-Wormley, MPH PhD

Second Advisor

Steven Cohen, DrPH

Third Advisor

Thomas Eissenberg, PhD

Fourth Advisor

Alison Breland, PhD

Fifth Advisor

Linda Hancock, PhD, CFNP, RN


Background: Although cigarette smoking is decreasing in the US and among college students, tobacco use remains a major public health problem. Specific socioecological gaps in the literature related to college tobacco use exist including: trends of tobacco use, combinations of polysubstance use, and availability of tobacco products around college campuses.

Objectives: The main goal of this research was the understand interrelationships that exist within a socioecological framework of college tobacco use. Specifically, this project aims to: 1) examine trends of tobacco and polytobacco use by gender and associations of polytobacco use and perceived peer tobacco use, 2) examine specific combinations of polysubstance use and how the resulting profiles of use differ by gender, and 3) evaluate tobacco retailer density around college campuses and in neighborhoods of Richmond, VA.

Methods: Two chapters of this project use data from the National College Health Assessment II from 2008-2015. The third chapter uses data collected from electronic cigarette brand websites to geospatially examine tobacco retailers in the Richmond Virginia Metropolitan Statistical Area. Various statistical analyses were utilized to complete each project including linear, logistic, and negative binomial regression, latent class and confirmatory factor analysis, and spatial analysis.

Results: Trends of some tobacco products among US college students declined while others remained stable from 2008-2015. Nearly 1 in 4 college students used a tobacco product and nearly 1 in 10 were polytobacco users. Alcohol and marijuana use remained stable. Specific classes of polysubstance users were found to exist between males and females, in addition to sociodemographic and institutional associations with polysubstance use by gender. College campuses in the Richmond area were found to have a substantial number of tobacco retailers and retailer density was higher in low socioeconomic status neighborhoods.

Conclusions: The findings from the three different studies fill extensive gaps in the literature related to trends of college tobacco use, differences in classes of polyuse by gender, and availability of tobacco around college campuses. Overall, while tobacco use is declining, there are still a substantial proportion of college students who use tobacco and other substances and products appear to be readily available.


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