Attitudes, perceptions, and smoking behavior of university faculty and staff following the introduction of a comprehensive tobacco-free policy: a repeated cross-sectional survey in Lebanon

Abstract

Background A growing body of research have evaluated the effect of university tobacco-free policies on faculty and staff, however, none of these studies has been carried out in the Eastern Mediterranean region. This study evaluates changes in faculty and staff attitudes, perceptions and smoking behavior, one year post-adoption of a tobacco-free policy in a medium-sized university in Lebanon and the region. Methods Two cross-sectional surveys were conducted in 2017 and 2018: pre-and one year post-policy implementation. A random sample of 625 and 624 participants took part in the 2017 and 2018 studies respectively.Results Faculty and staff had a positive attitude towards the policy at the two time points. The belief that there should be exceptions to the policy significantly decreased from 79% to 59% (p=0.002) among all smokers, particularly those with lower educational attainment (81% to 57%, p=0.007).Perception of compliance among peer smokers increased from 73% to 87% (p= 0.009). The proportion of smokers did not significantly change one year post-policy implementation, however, 44% of smokers with lower educational attainment, compared to only 7% of those with higher educational attainment (p< 0.001), reported a decrease in their smoking behavior outside campus.Conclusion The policy had a positive effect on the attitude, behavior and perception of policy benefits among smokers with lower educational attainment, who constitute the majority of smokers. Studies tackling the effectiveness of university or workplace smoke-free policies are scarce in the Middle East.Findings from this study inform and support future efforts to develop university and workplace tobacco free policies.