Objective: This study examined the extent to which US campuses identified as “100% tobacco-free” by the American Lung Association of Oregon adhered to the American College Health Association's the most recent guidelines and recommendations promoting tobacco-free environments in colleges and universities.

Participants: A key informant from 162 of 175 institutions (92.6% response rate) completed an online survey between January 2010 and February 2010.

Methods: The variables under study were assessed via a cross-sectional research design. Participants completed a 35-item survey regarding their school's tobacco policies, procedures, and enforcement practices.

Results: Although the vast majority of schools had written policies and procedures in place, schools with current policies were the most compliant. Numerous opportunities for improved adherence were identified in the results.

Conclusions: Findings from this study may help institutions in the development and implementation of a new tobacco policy, as well as strengthen policies among existing tobacco-free schools.