Assessing Smoking Habits, Attitudes, Knowledge, and Needs among University Students at the University of Milan, Italy

Background: College campuses and universities are valuable settings for smoking prevention programs targeting young adults. Aim: To investigate smoking habits, electronic cigarette (e-cig) and heated tobacco product (HTP) use, exposure to passive smoke, compliance with smoking bans on campus, attitudes toward the anti-smoking policies, and educational needs among students at the University of Milan, Italy. Methods: A validated questionnaire was web-submitted to 64,801 students in the period May-July 2021. For each item, the frequency was calculated and chi(2) test with Bonferroni correction was used to compare differences among the 10 faculties of the University. Results: 7162 students participated in the survey, while 6605 questionnaires were included in this report (62% female, 84% aged 18-25 years). Sixty-four percent of participants were never smokers, 19% were smokers, 2.8% were e-cig or HTP users, 3.7% were dual smokers, 10% were former smokers, and 66% reported routinely spending free time with smokers. Almost all students were aware of the dangers of active and passive smoking of cigarettes, while about 20% did not have an opinion on the dangers of e-cigs/HTPs. Only 49% were aware of the smoking ban in the outdoor areas of the university. Students from the faculties of Law and Political, Economic, and Social Sciences smoked more frequently and were more frequently exposed to passive smoke than other students. Medicine students were the most aware of the dangers of passive smoking and using e-cigs/HTPs. Conclusions: This is the first study in Italy involving the entire student population of a university and highlighting differences among faculties in terms of active and passive smoking and opinions. The results suggest that prevention campaigns addressed to students should consider their specific study curricula and give information tailored to the different educational needs to efficiently support health promotion.