Unpacking the Transformations Activated by Smoke-Free Campuses: A Logic Model of France's First Initiative.

Smoke-free campuses (SFCs) are characterized by a ban on smoking and vaping on all higher education premises (indoor and outdoor spaces) and by the smoking cessation support they provide. Although literature has demonstrated the impact of SFCs on smoking among young adults, little is known about the sequences of transformations they activate, the assumptions on what it takes to work and on the motivations and constraints that inform their development. Drawing from the first SFC implemented in France, we report on an analysis of the expected transformations in smokers and their environment generated by the activities on campus. Guided by Mayne's logic model template and tapping into three sources of data (i.e., internal documents, semi-structured interviews with people involved in its implementation, and direct nonparticipant observations), we identified the causal model linking the SFC's activities to its impacts. Our results show that the SFC's activities aim to impose constraints to discourage tobacco use, reduce environmental triggers to smoking, denormalize smoking, and facilitate access to cessation aids through better information and accessibility. The SFC may also influence campus dynamics by fostering cohesion, the campus's appeal, and social interactions within the smoking shelters. The policy is also meant to stimulate similar initiatives in other campuses and institutions in the health sector notably through the training of a new generation of managers. The resulting logic model is an essential tool for the transferability of SFC to other environments and can facilitate the identification of indicators for assessing their impacts and effects.