Understanding Environmental Tobacco Exposure: An Exploratory Analysis of College Students’ Literacy and Perceptions

Background Despite increasing recognition of the health risks of secondhand smoke (SHS) and emerging evidence on thirdhand smoke (THS), tobacco use among college students remains prevalent in the U.S.Purpose Assess SHS and THS literacy among college students.Methods A convergent parallel mixed-methods design was used to assess college students’ understanding of health outcomes associated with SHS and THS exposure and tobacco-control policies. Quantitative data were analyzed using descriptive and bivariate methods, while qualitative responses were thematically analyzed. Data were collected beginning in March 2022.Results Among 194 responses, most participants were knowledgeable about common health risks associated with tobacco use and SHS exposure, whereas knowledge of THS was limited. Most participants reported that neither SHS nor THS receives enough public attention. While a majority felt familiar with tobacco-control policies at the institutional and state levels, perceived enforcement was limited. Although most expressed a willingness to learn more about SHS and THS, willingness to advocate against tobacco exposure was inconsistent, with females reporting greater agreement and risk perception.Discussion These findings suggest that tobacco literacy regarding THS remains limited among at-risk population.Translation to Health Education Practice Public health initiatives that engage students are needed to address these gaps.