DOES STARTING COLLEGE AFFECT THE PROBABILITY OF INITIATION OF TOBACCO PRODUCTS? EVIDENCE FROM TURKIYE
Abstract - Tobacco use is costly due to consumption costs, lost production, and health costs. Little is known about how college students initiate tobacco products and whether they have higher risks relative to their non-college peers. In this context, comparing freshmen college students to their non-college starting counterparts, this study investigates whether starting college is associated with higher risks of initiation of tobacco products. The study is centered around the idea that the first year of college life comes with locational, social, environmental, and emotional changes that non-college individuals do not experience. By starting college, many students leave their family environments, move to another city, go into new relationships, and face with new opportunities and challenges. Whether these new life changes pose additional risks for tobacco initiation is a crucial higher education, health and economic policy question. In this regard, this study analyzes significant differences in tobacco initiation between freshmen college students and their non-college counterparts in Türkiye utilizing propensity score matching (PSM) and treatment effects (TE) estimation. The study utilized primary data collected from 213 freshmen students at Ankara Yildirim Beyazit University, Ankara, Türkiye and 1,423 non-college peers (a total of 1,643 observations) through face-to-face online surveys. Through treatment effects estimations that controlled for age, sex, health status, family income, and residential place and used nearest neighboring match at maximum 5, the study found that freshmen college students were 10% higher probability (P>|z| 0.00) to initiate tobacco products relative to their non-college peers. The study also found that curiosity, admiration, close friends, and emotional regulation were the top self-declared reasons for tobacco initiation among college freshmen. Also, among the high tobacco-initiation-risk campus locations, main entrance of school buildings and café exits came atop. These findings bear crucial policy implications for higher education systems in Türkiye and elsewhere that there must special tobacco control measures in place for first year college students for long-term desired health and economic outcomes, as tobacco control is being one of the most cost-effective interventions.
Keywords - Tobacco Control, Tobacco Initiation Behavior, College Students, Propensity Score Matching