Submitted by Anonymous on February 17, 2012 - 3:00am
Some 10 years ago, Ozarks Technical Community College became the first higher education establishment to ban smoking even outdoors. Since then, several hundred more universities and community colleges, especially in the South and Midwest, have followed suit. In a sense, the outdoor bans seem like a logical extension of 30 years of efforts to reduce tobacco use, given the harmful effects of smoking.
The majority of the most elite schools, especially Ivy Leaguers like Harvard and Princeton, have yet to jump on the bandwagon, however. I can’t help but think that this is because they have more common sense than the rest of us: it’s only a matter of time before this “smoke-free campus” movement gets a student assaulted, raped or killed.
Does this sound alarmist? I shouldn’t think so, given that the sequence of events is perfectly foreseeable, and quite likely, in the aggregate. Here's why:
Some 20 percent of university students smoke. On big campuses like mine (over 20,000 students), many of these make the university residences their home. At some late-night hour after my university implements its intended ban, a student will want to go out for a smoke. To avoid or comply with the new rules, she’ll end up on the far periphery of the campus, in one of the dark places of the university, or on a street off campus.
The university’s “walk safe” escort program will have informed her that they don’t have the resources to escort her, especially for an activity that university administrators want to stigmatize further. Later, the statistic in the newspaper may or may not mention why she was out there in the first place. Her bereaved parents may or may not have sufficient grounds to sue the university (but if other parents even suspect that one of their children smoke, they would do well to send them to study somewhere without a draconian outdoor ban).
I find this, along with other aspects of the latest temperance movement, intensely depressing. I respect the new president at my university and think he does a good job in general (rare praise from a faculty member, I know), so I sent him a letter outlining some of my concerns with a complete outdoor ban on smoking. Besides the safety issue, I listed some of the following concerns:
Taking a conservative estimate of 20 percent of students who smoke out of a university body of 20,000 gives us the figure of 4000 smoking students. Consequences of an outdoor ban on campus would include:
1 – Increased vehicle traffic. If just half of these 4000 students who smoke have access to a car and use it to leave campus just once more a week for lunch or a break (as a result of the ban), this equals two thousand extra car trips a week around the university. Unlike tobacco outdoors, vehicle exhaust does pose a significant health risk to others, and the extra traffic (some 60,000 extra car trips an academic year as a conservative estimate) will increase the university’s carbon footprint accordingly.
2 – Increased risk of harm to students and other members of the university community. If students are forced off campus when they want to smoke, this will lead them to negotiate traffic on foot or by car. In the case of differently abled students and those with reduced mobility, pushing them off campus seems a particularly hard to justify and even cruel approach.
3 – Avoidance strategies. If avoidance strategies of people addicted to tobacco are half as strong as tobacco researchers say they are, student enrollment will suffer as a result of the complete outdoor smoking ban. Particularly students in the arts and international students from countries such as China, which have higher smoking rates, have many choices and may look elsewhere for their education. Additionally, students who smoke will likely spend less time on campus and avail themselves less frequently of campus dining options – leading to a reduction in university revenues and a less vigorous student presence on campus. All these factors remain extremely difficult to measure, and anti-smoking activists who claim to have measured no impact from smoke-free campus policies elsewhere misrepresent the situation.
4 – Morale. Judging from student comments many of us have already heard around campus, the complete outdoor smoking ban alienates many and breeds resentment toward an administration seen as having gone too far. Faculty in particular may find it frustrating to work so hard for student retention and morale only to see their efforts hampered in this regard.
5 – Honesty. The implication that tobacco smoke poses a significant health risk to others outdoors is disingenuous. A university’s first mission centers around truthful discourse, and we should be teaching our students to differentiate between significant risks (such as smoking) and totally insignificant risks (such as secon hand smoke outdoors). We should be teaching our students to deconstruct misleading government and advocacy group statements, such as the claim that “these is no safe level of exposure to secondhand smoke.” By such criteria, there is no safe level of exposure to sunlight either.
6 – Liberalism. With the notable exception of some “Bible colleges,” which also ban alcohol, dating and other practices, most universities in this country value tolerance of people’s lifestyles and individual preferences. We enshrine this policy when our university handbook advises the following: “Don't attempt to impose your values -- whether political, religious or cultural -- on others.”
My university president actually agreed with most of the points I made. He replied, however, that he couldn’t rescind the coming ban because other universities in our state were also implementing similar policies, and the state legislature in neighboring Arkansas just legislated complete outdoor smoking bans at all universities there.
“Besides,” he said, “I would have all the true believers on this campus banging on my door in outrage.”
How misguided. Instead of respecting our students and offering them a safe, liberal environment on campus, our university administrators feel cowed by the new political correctness of the latest temperance movement. How distressing that the groups pushing these policies, from the “true believers” to Anheuser-Busch funded organizations like the Bacchus Network (which would divert universities’ attention from alcohol to tobacco) or pharmaceutical company groups (who often get universities to buy their smoking cessation products and distribute them for free or at a subsidized price), couldn’t care less about the fallout.
Call me old fashioned, but I think I actually prefer the image of a university with pipe-wielding, pontificating professors and arts students smoking and arguing politics by the campus fountain. In any case, the proportion of the campus community and population in general that smokes has been steadily declining since the 1970s, without these draconian "smoke-free campus" bans.
The author is an associate professor of political science at a university in the Midwest.
Graduation is seven months away. For a 22-year-old undergrad whose post-baccalaureate plans are nebulous, this might seem like forever. Not for me. In January 2000, at the age of 42, I returned to college after a long academic hibernation. I've been a part-time college student ever since, creeping up on a long-delayed graduation.
There is no single, overriding reason why I returned to college after so long away, but I felt trapped between a spouse wrapping up work on her M.A. in journalism and a son in high school who demanded to know why his college dropout father was pushing him into higher education. Unless I returned to college immediately, I would soon be the least-educated person in the house. Baylor's then-generous tuition remission program for employee family members -- my wife is managing editor of an academic journal -- eased my concerns about the financial burden of returning to school and ensured that Baylor was the only university to which I applied.
Since returning, I have been challenged in unexpected ways. Baylor does little to accommodate nontraditional undergraduate students, offering no weekend classes and few evening classes. Some offices close during the lunch hour, and entire buildings are sealed tighter than Tupperware promptly at 5:00.
Initially, I held a traditional full-time job, and I often flew across town with minimal regard for traffic signals, hoping to beat the English department's noon lock-down. Each time I arrived to find the office door handle still warm from the hand of the person who locked it, I taught new and imaginative curse words to Baylor's abundant squirrel population.
Back then, registration and payment of tuition and fees required a day off work, a beach ball-sized bladder, and the endurance of a sequoia as lines moved slower than frozen molasses. While Baylor's adoption of electronic solutions reduced my frustration by allowing me to register and pay fees online, the university's constant upgrading of hardware and software soon outpaced my personal budget. Now I must travel to campus just to find a computer powerful enough to complete these tasks.
Even though I successfully overcame real and imagined obstacles, I had no specific plan when I returned to school. At first, I enrolled in one course each semester. I soon realized that I would qualify for AARP membership while I was still receiving student discounts, so I began doubling and tripling my class load.
When presented with the opportunity to move from conventional employment to self-employment, I embraced it. Rather than forcing my class schedule fit my work schedule, I could adjust my workload to fit my class schedule. This becomes increasingly important as I approach the end of undergraduate life, when only single sections of required courses may be offered each semester.
Hardest to adjust to was the realization that I am no longer young. Desks are too small for someone who gained his "freshman 15" and then spent nearly 30 years developing middle-aged spread, and what's left of my hair is now more salt than pepper.
Despite raising one of my own, members of the wired generation confound me. While my family didn't own a television until I reached third grade, my classmates came out of the womb clutching a computer mouse and a cell phone. A once-peaceful walk across campus is now interrupted at every step by the nonstop chatter of the connected, and the beep, chirp and moan of student cell phones regularly disturb classes.
When I was born, there were only 49 states, and I soon learned that most important events in the constitutional history of the United States have happened during my lifetime. This means that my fellow students study history, while I study current events.
In many classes, I've been the oldest person in the room, leading to an awkward sorting out of social convention. Will the instructor treat me with the respect due my age, or with the disdain appropriate for an undergrad?
At the beginning of each semester, professors often question students' about their future plans, and my classmates mention doctor, lawyer and engineer. Me? I want to be a Social Security recipient because there isn't enough time between graduation and retirement to actually have a career.
When I tell my wife about some of my class discussions -- discussions where life experience clearly colors my opinions -- she says, "Don't frighten the children." And it's difficult not to think of my classmates as children, even though many of them are in early adulthood, because my 21-year-old son is among them, and I often find myself enrolled in courses with members of his high school graduating class.
In a university where students of my generation can probably be counted in single digits, there's little opportunity to develop friendships. Even sincere attempts make me feel like the creepy neighbor my mother always warned me about.
But I have tried to experience college life the way a traditional undergrad might.
I've eaten cafeteria food, quickly realizing that the cast-iron stomach I had as a teenager is now one of the seven largest methane producers in Texas, and I must monitor my diet.
My wardrobe slowly devolved, and T-shirts emblazoned with one of Baylor's many logos are now my apparel of choice.
I joined three academic fraternities, but soon decided that my days as a chaperone ended with my son's high school graduation party.
Although I've yet to pull an all-nighter, I've certainly had my share of late-nighters, not opening my textbooks until my family finally retires for the night.
Along with other Baylor students, I've sat in the stands through losing season after losing season of football, and sat glued to the television as our women's basketball team advanced through the NCAA tournament to take the title.
While my son speeds through college without stopping for marriage, children and career, I relish the few advantages of being a college student at my age. I especially enjoy the reaction at the local multiplex when I request the "student discount," and my wife takes great pleasure in telling people that she sleeps with a college student.
I'll be 48 when I finally receive my B.A. in professional writing, having spent six years finishing half of my undergraduate requirements. At this glacial pace, dare I even consider grad school?
Michael Bracken is a 47-year-old senior at Baylor University. His latest book is Yesterday in Blood and Bone, a collection of short stories published by Wildside Press.
Given tightened state budgets stemming from a deteriorating economy, public colleges and universities face unprecedented financial challenges. The phrases “hiring freeze” and “no spending increases” are dominating headlines of campus newspapers (and this Web site). On the consumer side, declining 401(k) and 529 college savings plans are contributing to greater financial demands on students and their families.
Will colleges and universities continue to push this economic burden to families at this difficult time, in the form of higher tuition, room and board, and various fees? Or will the institutions find alternative solutions?
Here at the Center for Student Health and Life, our concerns relate specifically to how this new, harsh reality affects student health and wellness on campus. Exacerbating the problem, health care costs generally have been increasing about 10 percent a year since 2000.
Despite these realities, we believe that every college student deserves access to high quality health and wellness services. Given rising costs, more creative solutions must be found to improve the quality of health care. While reducing the financial burdens placed on students and their families may not be in the realm of the possible, rising costs must end.
Unfortunately, many schools are increasing the fees that all students are required to contribute toward a student health center (which further increases financial aid demands). For example, the health fee at North Carolina State University is now slated to increase to $247 from $196 three short years ago. At the University of Maryland at College Park, budget cuts have translated into a hiring freeze, causing a position for a staff psychologist to become vacant in January. The University of Nevada at Las Vegas student newspaper recently printed an article titled “Hiring Freeze Hurts Health Center.”
But hiring freezes and/or fee increases at student health centers can be averted at many medium and large-sized schools by dealing with some cultural obstacles and following the lead of some of their peer schools.
There are several approaches that could work for many schools, including:
Making it easier for a family’s health plan to be accepted at student health centers; and
Negotiating more effectively with private insurance companies for those who are not covered under their family plans.
According to a recent Government Accountability Office study, 80 percent of college students have health insurance, with two-thirds of college students covered under a parent’s employer sponsored plan. More good news is that recently passed legislation which has now been signed into law ensures that a student’s family coverage continues even if the student takes a break from their studies due to illness (a tragic loophole that has now been fixed). And many states are increasing the age under which a child can remain on their parent’s plan, including New Jersey, which raised the age limit to 30.
But the reality is that only about 25 percent of the “out of network” costs are reimbursed when the health center is not “in network,” according to The History and Practice of College Health, by H. Spencer Turner and Janet L. Hurley (University Press of Kentucky, 2002).
Most parents with whom we’ve talked are surprised that most schools do not make it easy to use a family’s current health insurance coverage. And most students are pretty oblivious as well: in our survey earlier this year, most students did not know whether their health center accepted their family plan or not. To be sure, going “in network” does not necessarily work for all schools, particularly smaller schools with limited facilities for whom the administrative costs would be too high.
The reasons many medium- and large-schools do not make it easy to use family coverage involves historical and cultural obstacles to health centers doing coding, “credentialing” (also necessary to become “in network”) and the paperwork and additional administrative costs involved with filing insurance claims. On one hand, who can blame them? Who wants to deal with insurance companies when many of us rightly or wrongly feel that their goal in life is to “delay, deny and frustrate?” Many doctors and nurses are attracted to college health centers because they can avoid some of these “headaches” and focus exclusively on providing care.
However, budgets are too tight to allow the cultural barriers to continue to stand. Accepting a family's current health insurance policy can eliminate the need for fee increases and prevent staffing cuts. Ohio University and the University of South Florida are two recent examples of schools that recently moved to insurance billing to address financial challenges, keeping administrative costs down along the way.
Ohio University had been facing a $400,000 shortfall for its health center. Inside Higher Edcovered Ohio University’s change to become “in network” providers and accept family insurance policies to deal with its budget crunch. Inside Higher Ed states that "[w]ith the revenue [Ohio University] hopes to tap into, the university is considering a renovation and addition to its health facility, and is expanding its services this fall." The school plans to hire additional psychologists with the added resources, and increase evening and weekend hours.
The University of South Florida now accepts multiple insurance providers, and “this means that going to the clinic will be cheaper for students,” according to The Oracle, the college paper. To reduce administrative costs associated with processing claims, USF teamed up with its medical center, USF Health. Ohio University contracted with a third party billing company to minimize up-front expenditures and administrative costs associated with accepting a student’s family insurance.
Colleges must also do a better job of negotiating insurance policies for the one-third of students who are not covered under their family plan.
Under many insurance plans offered by schools, there’s a lot of fine-print. Just because the school has endorsed a plan on some level, doesn’t mean it has the “Good Housekeeping” seal of approval. Prescription drug coverage is often minimal; there are many exclusions, out-of-pocket maximums are generally high, and benefit ceilings are low. Lab work often has higher costs where the health center is paid for largely by student fees. Schools and students can and should expect more for their coverage, and colleges need to use their purchasing power to negotiate better deals.
The financial challenges facing public colleges and universities have been accentuated during this recent market meltdown. And while every college student deserves access to high quality health and wellness services at their school, these students should not bear such a heavy financial responsibility. Given the rising costs, more creative solutions -- like accepting a family’s current health insurance policy -- must be explored to protect the quality of care while keeping a lid on the rising fees. With schools like Ohio University and the University of South Florida proving the success of this approach, the bar has been set for others to follow.
Jon Englund is the executive director of the Center for Student Health and Life, a national not for profit organization dedicated to improving the health and wellness of college students. You can find more information on the organization on its Web site.