Abstract
Background: This study aimed to evaluate students’ knowledge, attitudes, and behaviours regarding the Smoke-Free University policy, focusing on cigarette use. The main objectives were to determine smoking prevalence, assess cessation status, evaluate policy awareness, examine compliance, and explore attitudes toward tobacco control policy.
Method: This is a cross-sectional study conducted at University of Health Sciences a total of 315 students participated in the study. Data were collected through a questionnaire, which included questions on demographic information, smoking habits, compliance with anti-smoking policies, and students’ attitudes toward these policies.
Results: Among the participants, 73.7% were female, and 26.3% male. 16.2% of participants were current smokers, 5.7% were ex-smokers. Among males, 16.9% were smokers, while 15.9% of females reported smoking, (p= 0.437). The most commonly reported reason for quitting smoking was health concerns (66.7%). Additionally, 87.6% of participants reported being aware of the university’s smoke-free policy. Smokers generally showed moderate compliance, with 54% adhering to the smoking ban. Attitudes toward the smoking ban varied according to smoking status, while smokers had a negative attitude toward the policy, non-smokers expressed more positive attitude (p< 0.001).
Conclusion: Although the overall smoking prevalence in our study was lower than the national average, the unexpected gender difference highlights an important trend, raising questions about underlying factors and highlights the need for further research. In addition, policies alone, without proper implementation and awareness campaigns, are unlikely to achieve the desired outcomes, future efforts should focus on enhancing policy enforcement and increasing educational initiatives to drive behavioural change.
Keywords: university student, tobacco-free policy, smoking, Türkiye
Introduction
The prevalence of tobacco use among adults remains a major global public health concern. In 2006, the World Health Organization (WHO) identified it as the leading cause of preventable deaths worldwide.1,2 Evidence indicates that most smokers begin smoking during adolescence, underscoring the importance of prioritizing this age group in tobacco control strategies.1 Moreover, studies have shown that quitting smoking before the age of 30 can markedly reduce the risk of smoking-related mortality.3
In 2008, the WHO introduced the MPOWER strategies a practical policy package designed to facilitate the implementation of the Framework Convention on Tobacco Control (FCTC). Aligning with this global effort, Türkiye strengthened its tobacco control initiatives by revising its first anti-tobacco legislation (Law No. 4702, originally from 1996).4 A key provision of this 2008 revision was the extension of the indoor smoking ban to all public service buildings and a specific prohibition on tobacco use in all educational institutions, both indoor and outdoor.5,6
In 2021, based on the National Tobacco Control Law the University of Health Sciences Türkiye officially launched the “Smoke-Free University Initiative”. Under this policy, smoking is prohibited in all indoor areas, university buildings, official vehicles, and private vehicles within campus boundaries.7
Despite the implementation of numerous anti-tobacco measures in Türkiye, data from the Turkish Statistical Institute show that tobacco use among young adults has continued to rise from 16.4% in 2012 to 19.3% in 2022.8,9 This trend has raised concerns about the effectiveness of current policies and highlights the need for more effective strategies. Additionally, due to their lifestyle, university students are at risk of exposure to secondhand smoke, which poses a distinct public health challenge.10 National and international organizations have therefore recommended the adoption of stricter tobacco control policies in universities.11
In this context, it is important to note that research examining the tobacco control policies among university students in Türkiye remains limited.12 This underscores the need for more comprehensive studies within the Turkish setting.
The objective of this research is to assess students’ knowledge, attitudes, and behaviors regarding the Smoke-Free University policy in relation to smoking. The study further aims to investigate the prevalence of smoking, cessation status, awareness of the policy, compliance with tobacco control regulations, and attitudes toward tobacco control measures among students.
Materials and Methods
Study setting, design and population
This cross-sectional study was conducted at the University of Health Sciences, Türkiye, in 2024. The study population consisted of 7,934 students enrolled in seven faculties of the University. Inclusion criterion was being a registered undergraduate student at the university, at the time of study. All volunteering students were invited to participate in the study. Students who were in their internship period were excluded as they were placed outside the campus.
Questionnaire
The questionnaire was developed based on the tools from earlier similar surveys, carried out in the United Kingdom and Lebanon.13,14 The questionnaire was revised in line with the objectives of the current study. The final version consisted of 39 items organized into four main sections: participants’ demographic characteristics, smoking-related habits, level of compliance with tobacco control policies, and attitudes toward these policies.
Data collection
Data collection was carried out over a six-week period between February and March 2024. Prior to distribution, the questionnaire was piloted with five students to evaluate feasibility, identify potential issues. Based on feedback from the pilot group, minor adjustments were made to the wording to improve clarity and response accuracy.
Data were collected electronically via Google Forms and distributed through classes official WhatsApp groups. Informed consent was obtained from all participants. The questionnaire was distributed twice across all classes to maximize reach, and all students had an equal opportunity to participate, as a sample was not selected—all eligible students were invited to take part in the study. At the end of the data collection process, a total of 325 students completed the questionnaire. After reviewing the responses, 10 participants were excluded for not meeting the inclusion criteria, resulting in 315 valid cases for analysis.
Statistical analysis
The sample size was calculated using data from the study by Chaaya et al.13, which examined compliance with smoking-related policies. Based on this calculation, a minimum of 305 participants was required (P = 0.727; Q = 0.273; α = 0.05; d = 0.05).
Descriptive statistics were used to summarize demographic characteristics of participants and to report smoking prevalence, policy compliance, and attitudes toward tobacco control policies. Frequencies and percentages were calculated for categorical variables. Categorical variables were compared using Pearson’s Chi-square test. When the assumptions of the Chi-square test were not met because of small expected cell counts, exact p-values were calculated using the Fisher–Freeman–Halton extension of Fisher’s Exact Test available in the SPSS Exact Tests module. A significance level of p < 0.05 was set for all statistical tests. All analyses were performed using IBM SPSS Statistics version 26.
The original five-point Likert scale for attitude questions was reduced to three categories (Agree, Undecided, Disagree) before analysis to help meet Chi-square assumptions. However, due to small subgroup sizes and expected cell counts below 5 even after merging, Fisher’s exact test was used for most comparisons, except where Chi-square assumptions were fully met.
Ethical approval
Ethical approval for the study was obtained from the Ethics Committee of Hamidiye Scientific Research Ethics Committee at the University of Health Sciences Decision No. 21/26, Document No. 24145, dated 22.12.2023).
Results
Among the participants, 73.7% (n = 232) were female and 26.3% (n = 83) were male. Distribution by faculty showed that 43.5% (n = 137) were enrolled in the Faculty of Health Sciences, 12.4% (n = 39) in the Faculty of Medicine, and 12.1% (n = 38) in the International Faculty of Medicine. Additionally, 9.2% (n = 29) were in the Faculty of Nursing, 8.6% (n = 27) in the Faculty of Life Sciences, 7.6% (n = 24) in the Faculty of Dentistry, and 6.7% (n = 21) in the Faculty of Pharmacy.
Overall, 16.2% of participants were current smokers, and 5.7% were former smokers. Smoking prevalence did not differ significantly between males (16.9%) and females (15.9%) (p = 0.437). However, when analyzed by nationality, students from Türkiye had a higher rate of current smoking (18.5%) compared to students from other countries (5.5%), and this difference was statistically significant (p = 0.025) (Table 1).
Among the 18 participants who quitted smoking, a total of 24 responses were reported, as multiple responses were allowed. The most commonly cited reason for quitting was personal health (50%, n = 12) (Table 2).
| Table 2. Distribution of students who quit smoking according to their reasons for quitting (n=18) | |||
| Reason |
|
|
|
| Because it is better for my health |
|
|
|
| Because it is better for my family's health |
|
|
|
| At my doctor's request |
|
|
|
| At the suggestion of my relatives/friends/neighbours |
|
|
|
| For economic reasons |
|
|
|
| No particular reason |
|
|
|
Among smokers, 54.9% (n = 28) reported complying with the Smoke-Free University rules, with no significant gender difference (p = 0.28). Nearly half (47.1%, n = 24) admitted to smoking in prohibited areas, while only 9.8% (n = 5) reported receiving a warning, again with no gender difference (p = 0.120). Overall, 87.6% (n = 276) of all participants were aware of the policy, most commonly through banners (67%, n = 185) (Table 3).
A total of 68.9% of participants (n = 217) reported having observed a student smoking in prohibited areas, while 19% (n = 60) stated that they had not made such an observation. These findings indicate that smoking in restricted areas is common and that the majority of participants have witnessed it.
Non-smoking students showed significantly more positive attitudes toward the smoking ban than smokers (p < 0.001). Overall, 63.5% of participants (n = 200) strongly supported the policy, with support highest among non-smokers (76.8%, n = 189) and lowest among smokers (7.8%, n = 4). Similarly, 67.1% of non-smokers (n = 165) perceived the ban as highly effective in creating a healthy environment, compared to only 5.9% of smokers (n = 3) (Table 4).
| **Fisher's exact test was used due to expected cell counts <5. | |||||||||
| Table 4. Distribution of students’ attitudes toward the Smoke-Free University policy according to their smoking status | |||||||||
| Attitude |
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
||
| Level of support for the policy | |||||||||
| Large Extent |
|
|
|
|
|
|
|
|
|
| Some Extent |
|
|
|
|
|
|
|
|
|
| Not At All |
|
|
|
|
|
|
|
|
|
| Not Sure |
|
|
|
|
|
|
|
|
|
| Effect of the ban on creating a healthy environment | |||||||||
| Large Extent |
|
|
|
|
|
|
|
|
|
| Some Extent |
|
|
|
|
|
|
|
|
|
| Not At All |
|
|
|
|
|
|
|
|
|
| Not Sure |
|
|
|
|
|
|
|
|
|
| Effect of the ban on avoiding smoking | |||||||||
| Large Extent |
|
|
|
|
|
|
|
|
|
| Some Extent |
|
|
|
|
|
|
|
|
|
| Not At All |
|
|
|
|
|
|
|
|
|
| Not Sure |
|
|
|
|
|
|
|
|
|
| Degree to which the policy encourages quitting tobacco | |||||||||
| Large Extent |
|
|
|
|
|
|
|
|
|
| Some Extent |
|
|
|
|
|
|
|
|
|
| Not At All |
|
|
|
|
|
|
|
|
|
| Not Sure |
|
|
|
|
|
|
|
|
|
| Degree of compliance with the Smoke-Free Campus policy | |||||||||
| Large Extent |
|
|
|
|
|
|
|
|
|
| Some Extent |
|
|
|
|
|
|
|
|
|
| Not At All |
|
|
|
|
|
|
|
|
|
| Not Sure |
|
|
|
|
|
|
|
|
|
A large majority of smokers (88.2%, n=45) stated that campus policies violate the personal freedoms of smokers, while this rate was 26.4% (n=65) among non-smoking students. Non-smoking students largely evaluated the degree of protection offered to non-smokers by the smoke-free policy positively (88.6%, n=218). These findings indicate that students’ attitudes towards the smoking ban differ significantly based on their smoking status (Table 5).
Discussion
The study found that the prevalence of smoking among participants was lower than the national average, although it was higher among women. Health concerns were identified as the most common reason for former smokers to quit. While most participants were aware of the smoke-free campus policy, compliance with the regulation was moderate. Non-smokers generally supported the policies, whereas smokers showed relatively less support.
Examining the trends, norms, and underlying reasons for tobacco use in this age group is of great importance for designing effective prevention and control strategies.15,16 In the other hand attitudes, stress, and lifestyle changes associated with university life contribute to the high smoking rates in this population, highlighting the role of campus policies in reducing these habits.17
According to national data from 2022, the rate of tobacco uses among individuals aged 15-24 in Türkiye was reported as 19.3%8, whereas our study determined a slightly lower prevalence of 16.1%. In comparisons with studies from other Turkish universities similar results have been obtained. A 2017 study at Artvin Çoruh University found a smoking prevalence of 27.9% and noted that anti-smoking policies were not implemented at that university.17 Conversely, a 2020 study at Üsküdar University reported a smoking prevalence as high as 57%.12
Internationally, our study’s results were also lower when compared with neighboring countries. A 2020 study conducted in Syria during the Syrian crisis found a smoking prevalence of 24.7%.18 Similarly, a study carried out at Yarmouk University in Jordan in 2005 reported a smoking rate of 35%.19 When examined by gender, our study revealed a higher smoking rate among women (15.9%) compared to the national prevalence of 9% among women aged 15–24 reported by Turkish Statistical Institute for 2022.8 Moreover, the narrowing gap between male (16.9%) and female smoking rates in our findings contrasts with the commonly observed trend of higher smoking prevalence among men. Notably, this pattern is consistent with findings from other Turkish universities, including Artvin Çoruh university (15.3%) 17 and Ahi Evran university (15.1%)20, indicating that this is not an isolated phenomenon. This increase may be associated with factors such as urbanization, higher educational attainment, and increased economic independence among young women in Türkiye.21,22
In our study, the most frequently reported reason for quitting smoking was health concerns, cited by 66.7% of participants. This was followed by economic reasons (16%) and advice from relatives or friends (16%). This finding is consistent with an Italian study, which similarly identified health concerns as the most commonly reported reason for smoking cessation.23 These results underscore the importance of raising awareness about the health effects of smoking, which may in turn motivate more students to quit smoking.24 Although our study did not directly assess whether smoking bans influenced participants’ decisions to quit, 16% of former smokers cited economic factors as a reason for cessation. Increasing tobacco taxes is one of the key strategies commonly implemented to reinforce smoking bans.25 This finding underscores the importance and effectiveness of such economic measures in reducing tobacco use and supporting compliance with smoke-free policies.
Our study revealed a mixed level of compliance with the university’s anti-smoking policies. Among smoking students, 45% reported smoking outside designated areas, indicating that a substantial proportion disregarded the policy. Moreover, only 9.8% of smokers stated that they had received a warning or penalty from the university, suggesting that the policy is not adequately enforced despite high rates of non-compliance. To reduce response bias and gain further insight into policy compliance, both smokers and non-smokers were asked whether they had observed other students smoking in prohibited areas. A total of 68.9% of participants reported witnessing peers violating the policy. This high observation rate indicates that, although the anti-smoking policy is formally in effect, there may be insufficient monitoring or effective enforcement by university authorities.
A similar study at American University of Beirut reported a higher compliance rate (72.7%) compared to our study (54.9%), the authors suggested that this lower level of compliance might be attributable to the fact that smoking bans in public areas across the country have not been sufficiently reinforced as a national policy, leading students to revert to their usual habits when off campus.13 Another study conducted in California in 2014 compared four universities with different policies, the results showed that universities implementing more comprehensive policies had higher levels of student compliance, in the same contrast students were found to have lower rates of smoking and exposure to second-hand smoke, as well as a markedly reduced intention to smoke on campus.26 Another study conducted in 2014 at the University of Montana in the United States examined compliance with an outdoor tobacco ban and an educational program before, during, and after implementation. The results showed that compliance rates increased significantly from 33% before implementation to 74% during the intervention week, which included active enforcement and educational initiatives. This demonstrates that monitoring and education play a critical role in increasing compliance with smoking policies.27
In our study, 87.6% of participants stated that they were aware of the smoke-free campus policy, reflecting a generally high level of awareness among students. The most common source of information about the policy was campus banners, reported by 67% of participants. These findings indicate that visual materials such as banners remain a widespread and effective means of disseminating policies. However, despite this high level of awareness, compliance with the policy did not align with expectations. This suggests that awareness alone may not be sufficient for the adoption of policies.
This study also assessed students’ attitudes toward the university’s smoke-free campus policy. As expected, the majority of non-smoking students (76.8%) viewed the policy positively. This strong support is thought to stem largely from concerns about exposure to second-hand smoke. As evidence of this, 67% of non-smokers stated that smoking creates an unhealthy environment, while 88.6% emphasized that the policy is important for protecting their health. In contrast, smokers showed far less support for the policy (7.8%). Smokers’ resistance to the policy may stem from perceiving it as a restriction on their personal freedom. Indeed, 88.2% of smokers reported viewing the policy as an intrusion on their personal freedom. Our findings are consistent with those of a study conducted in the United Kingdom, as the majority of participants supported tobacco bans but also acknowledged their impact on personal freedoms. Such attitudes highlight the challenges of implementing policies that may be perceived as intrusive, particularly among smokers who feel targeted.14 Similarly, a 2009 study at the American University of Beirut found that non-smokers were more satisfied and more supportive of the policy compared to smokers, who displayed greater resistance.13
In terms of generalizability, participation in the study was voluntary, and not all invited students responded to the survey. Therefore, the respondents may not fully represent the entire student population. To evaluate the potential impact of this bias, we compared the demographic composition of our sample to the official university registry data. The sample closely mirrored the university population; for example, 73% of participants were female versus 68% in the university, and 43% were from Health Sciences versus 47%. This alignment on observable characteristics suggests that, on these key demographics, our sample did not substantially deviate from the target population, thereby partially mitigating concerns about the impact of selection bias. While this demographic match is encouraging, it does not guarantee representativeness of the population on the primary study variables.
This study has several key limitations. Its cross-sectional design prevents establishing causal relationships and fully explaining the reasons for student noncompliance. The lack of similar prior research at the university limits the ability to compare these findings. Finally, since the study was conducted at a single university with a focus on health sciences students, the results cannot be broadly generalized to other institutions or populations.
Conclusion
Although the overall smoking prevalence in our study was lower than the national average and findings from other universities, the unexpected gender difference highlights an important trend. The higher smoking rate among young women raises questions about the underlying factors contributing to this increase and underscores the need for further research. In term of compliance Our study suggests that relying solely on the existence of policies could be insufficient; instead, comprehensive monitoring programs should be implemented. Moreover, educational campaigns play a crucial role in raising awareness among smokers about the harmful effects of second-hand and thirdhand smoke. These initiatives should emphasize that smoke-free policies are not intended to restrict personal freedoms but rather to protect the health and well-being of non-smokers.
Ethical approval
This study has been approved by the of Hamidiye Scientific Research Ethics Committee at the University of Health Sciences (approval date: 22.12.2023, number: 24145). Electronic informed consent was obtained from all participants online prior to their participation in the survey.
Source of funding
The authors declare the study received no funding.
Conflict of interest
The authors declare that there is no conflict of interest.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Generative AI Statement
Generative AI tools were used solely for language editing, grammar correction, and translation support. All final revisions, interpretations, and scientific decisions were made by the authors.
Etik kurul onayı
Bu çalışma Hamidiye Sağlık Bilimleri Üniversitesi Hamidiye Bilimsel Araştırmalar Etik Kurulu tarafından onaylanmıştır (onay tarihi: 22.12.2023, numarası: 24145). Ankete katılım öncesinde tüm katılımcılardan çevrimiçi olarak elektronik bilgilendirilmiş onam alınmıştır.
Yazarlık katkısı
Çalışma konsepti ve tasarımı: MMA, PT; veri toplama: MMA; sonuçların analizi ve yorumlanması: MMA; makaleyi hazırlama: MMA, PT. Yazar(lar) sonuçları gözden geçirmiş ve makalenin son halini onaylamıştır.
Finansman
Yazar(lar), çalışmanın herhangi bir finansal destek almadığını beyan etmiştir.
Çıkar çatışması
Yazar(lar) herhangi bir çıkar çatışması olmadığını beyan etmiştir.
Veri Kullanılabilirliği Beyanı
Bu çalışmanın bulgularını destekleyen veriler, makul bir talep üzerine sorumlu yazardan temin edilebilir.
Üretken Yapay Zeka Beyanı
Üretken yapay zekâ araçları yalnızca dil düzenleme, dilbilgisi düzeltme ve çeviri desteği amacıyla kullanılmıştır. Tüm nihai revizyonlar, yorumlar ve bilimsel kararlar yazarlar tarafından yapılmıştır.
References
- Sabiston CM, Lovato CY, Ahmed R, et al. School smoking policy characteristics and individual perceptions of the school tobacco context: are they linked to students’ smoking status? J Youth Adolesc 2009; 38: 1374-1387. https://doi.org/10.1007/s10964-009-9422-z
- World Health Organization (WHO). The fact about smoking and health. WHO; 2006. Available at: http://www.wpro.who.int/media_centre/fact_sheets/fs_20060530.htm (Accessed on May 15, 2025).
- Peto R, Darby S, Deo H, Silcocks P, Whitley E, Doll R. Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies. BMJ 2000; 321: 323-329. https://doi.org/10.1136/bmj.321.7257.323
- Saraçoğlu S, Öztürk F. Türkiye’de tütün kontrol politikaları ve tütün tüketimi üzerine bir değerlendirme. Politik Ekonomik Kuram 2020; 4: 20-44. https://doi.org/10.30586/pek.730271
- Bilir N, Özcebe H. Tobacco control activities in Turkey. TJPH 2013;11(2):96-103. https://doi.org/10.20518/tjph.173019
- Erdöl C, Ergüder T. Tütün ve tütün ürünlerinin kullanımının önlenmesi, kontrolü ve tedavisi. Ankara: Sağlık Bilimleri Üniversitesi Yayınları; 2021.
- Sağlık Bilimleri Üniversitesi. Dumansız Üniversite Uygulama Talimatnamesi. 2023. Available at: https://sbu.edu.tr/uploads/7c8ef55f-a774-7277-092e-3a0814c9d6d1/33_02_senato_karari_dumansiz_universite_uygulama_talimatnamesi.pdf (Accessed on Dec 27, 2024).
- Republic of Türkiye Ministry of Health. Report on public health in Türkiye. Republic of Türkiye Ministry of Health; 2022. Available at: https://dosyamerkez.saglik.gov.tr/Eklenti/48055/0/siy2022eng050420241pdf.pdf (Accessed on Dec 28, 2024).
- Türkiye İstatistik Kurumu (TÜİK). Percentage of individuals’ status of smoking tobacco products by sex and age groups, 2010-2019. TÜİK; 2019. Available at: https://data.tuik.gov.tr/Bulten/Index?p=Turkiye-Saglik-Arastirmasi-2019-33661 (Accessed on Dec 28, 2024).
- Wolfson M, McCoy TP, Sutfin EL. College students’ exposure to secondhand smoke. Nicotine Tob Res 2009; 11: 977-984. https://doi.org/10.1093/ntr/ntp100
- Borders TF, Xu KT, Bacchi D, Cohen L, SoRelle-Miner D. College campus smoking policies and programs and students’ smoking behaviors. BMC Public Health 2005; 5: 74. https://doi.org/10.1186/1471-2458-5-74
- Kekliktepe B, Göğcegöz I. Assessment of university students’ perspectives on smokeless campus policy. Current Addiction Research 2020; 4 : 1-6. https://doi.org/10.5455/car.105-1588602884
- Chaaya M, Alameddine M, Nakkash R, Afifi RA, Khalil J, Nahhas G. Students’ attitude and smoking behaviour following the implementation of a university smoke-free policy: a cross-sectional study. BMJ Open 2013; 3: e002100. https://doi.org/10.1136/bmjopen-2012-002100
- Bloor RN, Meeson L, Crome IB. The effects of a non-smoking policy on nursing staff smoking behaviour and attitudes in a psychiatric hospital. J Psychiatr Ment Health Nurs 2006; 13: 188-196. https://doi.org/10.1111/j.1365-2850.2006.00940.x
- Bennett BL, Deiner M, Pokhrel P. College anti-smoking policies and student smoking behavior: a review of the literature. Tob Induc Dis 2017; 15: 11. https://doi.org/10.1186/s12971-017-0117-z
- Loukas A, Garcia MR, Gottlieb NH. Texas college students’ opinions of no-smoking policies, secondhand smoke, and smoking in public places. J Am Coll Health 2006; 55: 27-32. https://doi.org/10.3200/JACH.55.1.27-32
- Karadoğan D, Önal Ö, Kanbay Y. Prevalence and determinants of smoking status among university students: Artvin Çoruh University sample. PLoS One 2018; 13: e0200671. https://doi.org/10.1371/journal.pone.0200671
- Idris A, Al Saadi T, Turk T, et al. Smoking behaviour and patterns among university students during the Syrian crisis. East Mediterr Health J 2018; 24: 154-160.
- Khader YS, Alsadi AA. Smoking habits among university students in Jordan: prevalence and associated factors. East Mediterr Health J 2008; 14: 897-904.
- Babaoğlu ÜT, Şimşek Ş, Özdenk S, Demir G, Cevizci S. Prevalence of smoking and risk factors among students at a university in Turkey. J Clin Anal Med 2017; 8: 68-73. https://doi.org/10.4328/JCAM.4631
- Lillard DR, Christopoulou R, editors. Life-course smoking behavior: patterns and national context in ten countries. Oxford: Oxford University Press; 2015: 141-152. https://doi.org/10.1093/med/9780199389100.001.0001
- Başar D, Öztürk S, Ara-Aksoy S. Gender differences in smoking behaviour: analysing the changes for the 2008-2014 period in Türkiye. Sosyoekonomi 2021; 29: 107-126. https://doi.org/10.17233/sosyoekonomi.2021.02.06
- Gallus S, Muttarak R, Franchi M, et al. Why do smokers quit? Eur J Cancer Prev 2013; 22: 96-101. https://doi.org/10.1097/CEJ.0b013e3283552da8
- McCaul KD, Hockemeyer JR, Johnson RJ, Zetocha K, Quinlan K, Glasgow RE. Motivation to quit using cigarettes: a review. Addict Behav 2006; 31: 42-56. https://doi.org/10.1016/j.addbeh.2005.04.004
- Buczkowski K, Marcinowicz L, Czachowski S, Piszczek E. Motivations toward smoking cessation, reasons for relapse, and modes of quitting: results from a qualitative study among former and current smokers. Patient Prefer Adherence 2014; 8: 1353-1363. https://doi.org/10.2147/PPA.S67767
- Fallin A, Roditis M, Glantz SA. Association of campus tobacco policies with secondhand smoke exposure, intention to smoke on campus, and attitudes about outdoor smoking restrictions. Am J Public Health 2015; 105: 1098-1100. https://doi.org/10.2105/AJPH.2014.302251
- Harris KJ, Stearns JN, Kovach RG, Harrar SW. Enforcing an outdoor smoking ban on a college campus: effects of a multicomponent approach. J Am Coll Health 2009; 58: 121-126. https://doi.org/10.1080/07448480903221285
Copyright and license
Copyright © 2026 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
