Date of Award


Document Type


Degree Name

Master of Public Health


Health Science and Human Ecology

First Reader/Committee Chair

Monideepa B. Becerra, DrPH, MPH, CHES


Background: The tobacco epidemic has been a constant since the popularization of tobacco products. However, with the introduction of non-combustible products that include e-cigarettes and vapes, the usage of tobacco products has continued to increase. Tobacco exposure can stem from first-hand (FHS), second-hand (SHS), and third-hand smoke (THS), with the last two impacting even non-smokers. The health effects from all types of tobacco exposure can be detrimental. These effects include the risk of cancer in any organ of the body, cardiovascular disease, and respiratory diseases.

Methods: The study utilized a cross-sectional design through an anonymous web-based survey given to students in a public college institution. Their knowledge, attitude, and practices regarding first-hand, second-hand, and third-hand smoke were assessed. The data collected was analyzed using SPSS version 28.

Results: A total of 197 survey responses regarding student knowledge, attitudes, and behaviors were collected and analyzed. Key results indicated most students believed SHS (78.2%) and THS (92.9%) smoke are not receiving enough attention. Students stated they believed the general population is somewhat informed (69.0%) regarding secondhand smoke, but about 58% agreed the general population is not at all informed about thirdhand smoke. The study also found 70.4% of surveyed students were highly likely/likely to discuss SHS and THS with their family, while 61.7% agreed they were highly likely/likely to discuss the topics with their peers as well. However, 23% of students stated they were highly unlikely/unlikely to research more about SHS and almost 19% of students agreed they were highly unlikely/unlikely to research more about THS. Another key finding was assessment of student behavior regarding tobacco products. Only 4.6% of survey respondents confirmed they do currently use tobacco products, while the majority (95.4%) stated they do not.

Conclusion: The results of the study showed a clear knowledge gap regarding the different tobacco exposures, specifically THS. The study suggested students believed this gap in knowledge was prevalent with other individuals in their social environment, including family and friends. Despite this, most students were willing to discuss potentially sensitive topics with their social circles. A call to action for college institutions to close the gap of knowledge on second-hand and third-hand smoke to educate students on the harmful effects of tobacco use is recommended. This study suggests if students obtain education on these topics and feel confident in their knowledge, conversation and advocacy onto their social environments may be encouraged.