Social norms regarding smoking

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Oral presentation by Lars Ramström at the 51st International ICAA Conference on Dependencies Limassol, Cyprus, 2 to 6 November 2008

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Social norms regarding smoking

  1. 1. Social norms regarding smoking Lars M. Ramström Institute for Tobacco studies, Stockholm, Sweden WEDNESDAY 5.11.2008 at 14.00 hours Major session on Social and Cultural Norms and Acceptability of Certain Behaviours 51st International ICAA Conference on Dependencies Limassol, Cyprus, 2 to 6 November 2008
  2. 2. SOCIAL NORMS have been described as values, beliefs, attitudes and behaviors that are generally approved in a certain social environment. <ul><li>SOCIAL NORMS REGARDING SMOKING are affected by various phenomena in the social environment (such as tobacco advertising) and influences from opinion leaders (such as celebrities and experts). </li></ul><ul><li>These conditions can differ a lot from time to time and between different groups/countries. </li></ul>
  3. 5. According to a recent Nationwide survey: M ore D octors smoke Camels than any other cigarette Quoted from the text:     &quot;Doctors in every branch of medicine - 113,597 in all - were queried in this nationwide study of cigarette preference” US advertisement in 1951 US advertisement in 1951 US advertisement in 1951
  4. 6. Smoking by physicians vs men at large Examples of patterns in different countries according to the stage of the smoking epidemic Source: Tobacco Control Country Profiles, Second Edition 2003 (American Cancer Society Inc, World Health Organization, International Union Against Cancer) 4 % 21 % Falling Australia 12 % 39 % Falling Luxembourg 52 % 38 % Rising Bulgaria 61 % 53 % Rising China Physicians Men at large Smoking prevalence Trend for smoking Country
  5. 8. One of 14 pictorial health warnings on cigarette packs in Australia. To cover 90% of the back side. To cover 30 % of the front side.
  6. 9. 50 years ago… <ul><li>Smoking was accepted as a ”normal” behaviour in most Western communities </li></ul><ul><li>Later… </li></ul><ul><li>Denormalization of smoking has increasingly been recognized as a key komponent of tobacco control programmes </li></ul>
  7. 10. Denormalization beliefs among ITC Four-Country * Survey respondents (n = 8991) Source: Hammond D et al. Tobacco Denormalization and Industry Beliefs Among Smokers from Four Countries. Am J Prev Med 2006;31(3) * Canada, United States, United Kingdom, Australia 9% 3% 88% People who are important to me believe I should not smoke 16% 3% 81% There are fewer and fewer places I feel comfortable smoking 12% 7% 81% Society disapproves of smoking Disagree Neutral Agree Statement
  8. 11. Perception of acceptability of smoking and of snus use. Swedish men, age 18 – 79. Source: Ramström L, Wikmans T. Changing tobacco habits in Sweden: Influence of environmental and psycohological factors related to smoking and use or smokeless tobacco (”snus”). Poster presentation at the SRNT 14th Annual meeting, Portland 2008.
  9. 12. Perception of acceptability of smoking Swedish men, age 18 – 79. Source: Ramström L, Wikmans T. Changing tobacco habits in Sweden: Influence of environmental and psycohological factors related to smoking and use or smokeless tobacco (”snus”). Poster presentation at the SRNT 14th Annual meeting, Portland 2008.
  10. 13. “ Does it occur that you feel uncomfortable in your role as smoker/snus user?” Swedish men, age 18 – 79. Source: Ramström L, Wikmans T. Changing tobacco habits in Sweden: Influence of environmental and psycohological factors related to smoking and use or smokeless tobacco (”snus”). Poster presentation at the SRNT 14th Annual meeting, Portland 2008.
  11. 14. Desire to quit smoking vs. Feeling uncomfortable as smoker. Swedish men, age 18 – 79. Source: Ramström L, Wikmans T. Changing tobacco habits in Sweden: Influence of environmental and psycohological factors related to smoking and use or smokeless tobacco (”snus”). Poster presentation at the SRNT 14th Annual meeting, Portland 2008.
  12. 15. How do most adults that you know feel about other adults smoking? <ul><li>Strength of smoke-free Proportions answering regulations ”disapprove a lot” Weak 15% </li></ul><ul><li>Medium 16% </li></ul><ul><li>Strong 20% Source: Hamilton W. et al. Do local tobacco regulations influence perceived smoking norms? Health Education Research Advance, Accessed October 18, 2007 . </li></ul>
  13. 16. Making workplaces totally smoke-free <ul><li>Reduction of smoking prevalence 4% </li></ul><ul><li>Reduction of number of cigarettes per day per continuing smoker 25% </li></ul><ul><li>Total reduction of cigarette consumption 29% </li></ul>Derived from: Fichtenberg C, Glanz S, Effect of smoke-free workplaces on smoking behaviour. Systematic review. British Medical Journal Vol. 325, 27 July 2002.
  14. 17. Health Effects of Smoke-Free Workplaces ( Examples from Scottish Bar Staff, two months after introduction of smoking ban ) <ul><li>- Number of those showing smoke-related symptoms fell from 80% to 50%. </li></ul><ul><li>- Improvement in lung function by as much as 10%. </li></ul>Source: BBC News 2006.10.11
  15. 18. Summary and conclusions <ul><li>Acceptability of smoking is now substantially lower than in the mid-1950s. </li></ul><ul><li>Decreasing acceptability of smoking is strongly linked to decreasing cigarette consumption. </li></ul><ul><li>Non-smoking environments favour smoking cessation and improve health. </li></ul><ul><li>Continued denormalization of smoking should be an integral part of tobacco-control policies. </li></ul>

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