Non-smokers’ responses when smokers light up: A population-based study

Abstract

Objective

This study examines the extent to which the ‘common courtesy approach’ is adopted by non-smokers when in the presence of smokers, in the state of Victoria, Australia, where restrictions on smoking in public places are relatively comprehensive.

Method

4,765 non-smokers aged 18 years and over were surveyed over two representative population telephone-administered surveys of randomly sampled Victorians conducted in 2004 and 2005.

Results

Only 5.5% of non-smokers said they would ask a person to stop smoking if they lit up a cigarette nearby. The majority of non-smokers (74.7%) reported they would move away and 16.4% said they would do nothing.

When asked what they would do if, in a public place, someone next to them asked if they minded whether they smoked, 48.8% of non-smokers reported they would say they would prefer it if they didn’t smoke, while 28.0% reported that they would tell the person they don’t mind when they would prefer that person not smoke. Overall, 46.7% of non-smokers indicated they would consent to be exposed to second-hand smoke if someone asked them this question.

Conclusions

Our findings underline the importance of smoke-free policies in protecting a significant proportion of the non-smoker population, who remain unlikely to protect themselves individually.

Introduction

A recent report by the US Surgeon General confirmed that there is no risk-free level of exposure to second hand smoke (SHS); and that separating smokers from non-smokers, cleaning the air, and ventilating buildings cannot eliminate exposure of non-smokers to SHS (USDHHS, 2006).

Tobacco companies have lagged well behind medical and public health groups in their acknowledgment of evidence linking SHS to serious disease and have long been advocates of a “common courtesy” approach as an alternative to policies restricting or banning smoking in public places. In this approach, non-smokers are encouraged to politely communicate their preferences or any annoyance that smoke may cause to non-smokers (Davis et al., 1990). In 2006, British American Tobacco Australia (BATA) maintained that “We believe that through practical solutions, common sense and courtesy, it is possible to accommodate all groups without the necessity of government intervention and outright bans” (BATA, 2006).

Surveys of American adults between 1974 and 1986 when restrictions on smoking were uncommon, indicated a small proportion of non-smokers would adopt the common courtesy approach, with only 4–6% saying they would ask a smoker to stop smoking (Davis et al., 1990). A population survey conducted in South Australia in 1993 found a comparable proportion of non-smokers (6%) would use this approach (Wakefield et al., 1995), even though the dangers of smoking were better known and smoke-free environments were more common than in 1974 when the original study was conducted. With several decades of progress in understanding the risks of SHS exposure and communicating them to the public, as well as increased restrictions on smoking in public places, it might be expected that non-smokers would be prepared to assert their preferences, especially if SHS exposure was a concern to them.

Research has shown that with increases in smokefree environments, support for total smoking bans in public areas also strengthens (McAllister, 1995). A cross-national comparative study conducted in 2002 found that in Australia, following implementation of total smoking bans at indoor restaurants, there was strong public support (71%) for bans at these venues, while in the UK, Canada and the US - where smoking bans in restaurants were uncommon at that time - support for bans at indoor restaurants was below 30% (Borland et al., 2006).

In the state of Victoria, Australia, restrictions on smoking in public places are relatively comprehensive; smoking is banned in restaurants and shopping malls (since 2001), restricted in licensed bars and gambling venues (since 2002), 68% of indoor workers reported total smoking bans at work in 2003 (Germain and Findley, 2004), and public support for smokefree bars was 80% in 2005 (Germain, 2006). The aims of the present study were to assess the extent Victorian non-smokers would adopt the common courtesy approach and whether this behavior is higher among never smokers and/or those more concerned about exposure to SHS.