Smoker self-identification versus recent smoking among college students.

Background: College students who engage in occasional or social cigarette smoking are less likely to identify themselves as smokers and to attempt to quit. This analysis aimed to determine: (1) the correlates of denying being a smoker among students reporting smoking in the past 30 days and (2) if denying this label was related to not attempting to quit smoking in the past 12 months.
Methods: A total of 9931 students at 14 colleges completed a random sample survey in 2007.
Results: Of 2255 students reporting having smoked a cigarette in the past 30 days, 50.7% responded No to Do you consider yourself a smoker. Logistic regression indicated that, after controlling for the number of smoking days in the past 30, being younger (OR=0.94, p<0.001); being male (OR=1.59, p=0.009); attending a 4-year (versus 2-year) college (OR=1.73, p=0.004); and consuming alcohol in the previous 30 days (OR=2.14, p=0.03) were correlates of denying being a smoker. Logistic regression indicated that denial was related to not attempting to quit in the past 12 months (OR=1.72, p<0.001), after controlling for the number of smoking days, age, gender, type of school, and other health factors.
Conclusions: Half of college smokers deny being smokers, particularly those who are younger, male, attending 4-year colleges, and alcohol consumers. Denying being a smoker was associated with not attempting to quit smoking. Therefore, traditional methods of ascertaining smoking status may not be valid in this population. Healthcare providers should more specifically ask students about recent smoking behavior. Further research is needed to develop interventions targeting smoking among this population.