, 2009; Levinson et al., 2007; Moran, Wechsler, & Rigotti, 2004) and believe that they will not become addicted, will be able to quit on their own when they want to, and don��t smoke enough to present a risk to their health (Morley, Hall, Hausdorf, & Owen, 2006; Murphy-Hoefer, hepatocellular carcinoma Alder, & Higbee, 2004; Thompson, Thompson, et al., 2007). Contrary to these beliefs, there is growing evidence that even occasional smokers experience greater health risks when compared with nonsmokers (An et al., 2009; Bjerregaard et al., 2006; Husten, 2009; Okuyemi et al., 2002), and they are less successful at quitting when they try (Everett et al., 1999). Additionally, nicotine dependence, which can develop within a month of initiation even after smoking only a few cigarettes per week (DiFranza, 2008), is found among college students across the spectrum of smoking frequency (Dierker et al.

, 2007). A number of studies have also demonstrated relationships between tobacco use and other behavioral health risks among college smokers, including alcohol and other drug use (Dierker et al., 2006; Reed, Wang, Shillington, Clapp, & Lange, 2007; Rigotti, Lee, & Wechsler, 2000) and depression (Kenney & Holahan, 2008), but there is limited information about how these or other risky behaviors are associated with different levels of smoking or how to address these multiple morbidities in the college health setting. From a public health perspective, college students should be considered an important target group for cessation programs (Koontz et al.

, 2004), but, in practice, LITS are less likely than regular smokers to be advised to quit (Reed & Burns, 2008), only half (55%) of college health services offer tobacco treatment for students (Wechsler, Kelley, Seibring, Kuo, & Rigotti, 2001), and existing programs tend to be underutilized (Halperin & Rigotti, 2003). Clinicians may hold beliefs similar to those of many students in assuming that low levels of tobacco use do not present significant risk for nicotine dependence or other health problems (Halperin, Thompson, Hymer, Peterson, & Thompson, 2006) despite the recommendation that interventions be directed at smokers subsequent to their earliest exposures, but before daily smoking patterns are formed (Okuyemi et al., 2002). The current study investigates potential correlates of smoking with a focus on health and behavioral risks associated with different levels of tobacco use and dependence in a sample of students accessing Dacomitinib health education or medical care at five public university health centers. This study goes beyond previous studies by examining a constellation of risky behaviors and mental health issues that accompany smoking in this population, stratified by level of tobacco use and emerging nicotine dependence.