Publication
Workplace Smoking Policies in Scotland
2. Views about smoking and the risks of passive smoking
- The quantitative study investigated the perceived risks of passive smoking. The qualitative study examined these risks further as well as exploring attitudes towards smoking in general and how these underpinned views about smoking policies and behaviour at work.
- The qualitative research demonstrated that both smokers and non-smokers viewed smoking very negatively. Comfort, particularly the smell of smoke, was often top of mind.
- The quantitative survey found that the majority of those responsible for smoking policies were aware of the health risks of passive smoking (88%). Likewise, in the qualitative research, concerns about the health risks of passive smoking were also raised.
- There was, however, an underlying uncertainty and scepticism about the real level of danger for individuals from either smoking or passive smoking. Smoking was seen as a way to relax and unwind and to deal with a stressful job. Non-smokers were very aware of smoking as an addiction and therefore often tolerant of the perceived needs and rights of smokers.
2.1 Quantitative Study
2.1.1 Attitudes towards passive smokingOne possible facilitator or barrier to implementing smoking policies was the policy-maker or policy-implementer's attitude towards passive smoking and ventilation. If people did not believe that there were any health risks associated with passive smoking, then they were unlikely to see the need for a smoking policy.
Without prompting, the majority of respondents (60%) believed that a complete smoking ban in the workplace would benefit the health of non-smokers. In order to understand why this might be the case, all respondents were asked to say, in their own words, what they believed to be the health risks associated with passive smoking. The vast majority (88%) were able to list at least one health risk associated with passive smoking. Respondents who smoked were less likely to cite any risks (71% compared with 92% of non-smokers). The specific health risks cited are included in Table 2.1.
Around half of respondents (54%) said inhaling other people's smoke was generally dangerous to health. Almost a third (32%) mentioned cancer generally and a quarter (25%) mentioned damaged lungs or lung cancer specifically. Only 6% said that inhaling others' smoke had no health risks associated with it, with 6% unsure. Respondents who smoked were more likely than any other group to believe that there were no health risks (17%).
Table 2.1: Percentage of respondents who believed passive smoking had the following health risks (%)
Risks associated with passive smoking |
% of respondents |
Generally dangerous to health |
54% |
Cancer (general) |
32% |
Damaged lungs/lung cancer |
25% |
Respiratory problems |
15% |
Asthma |
9% |
Heart disease/heart attack |
8% |
Smelly clothes/hair |
4% |
Laryngitis and other throat problems |
1% |
Coughs/colds/influenza |
1% |
Irritated eyes |
1% |
Circulatory problems |
1% |
No health risks |
6% |
Don't know |
6% |
Base: All respondents (1604) |
|
The fact that only 6% did not see any health risks indicates that a lack of knowledge about (or belief in) the health risks associated with passive smoking should not be a barrier to the implementation of smoking policies. However, it should be noted that the qualitative study revealed that this widespread knowledge of the health risks associated with smoking might be undermined by uncertainty and scepticism regarding the real level of danger for individuals as discussed below in Section 2.2.
2.2 Qualitative Study
Smoking was generally viewed very negatively by smokers, non-smokers and ex-smokers. As was the case in the surveys, respondents generally mentioned the health risks associated with smoking and passive smoking as well as issues relating to comfort. However, it was clear that, underlying this acceptance of the health risks of smoking, there was a wide range of beliefs about the real level of danger for both smokers and those inhaling others' smoke. There was also strong awareness of the addictive nature of smoking. This contributed to non-smokers' tolerance of other people smoking and smokers' belief in their own right to do so.
Smokers and non-smokers described smoking as a 'dirty' or 'filthy' habit.
"It's a horrible habit, especially when people are eating." (Non-smoker, 50-250 employees, leisure and hospitality).
Comfort was generally the issue which was raised first and which seemed to generate the strongest emotions. The smell of smoke, in particular, was greatly disliked, both in itself and because it became embedded in clothes, furniture and rooms.
"What gets to me is the smell. I love smoking, it's the best thing in the world, but... when you go outside you can smell it." (Smoker, 5-9 employees, construction).
Smokers tended to be very aware of the discomfort caused to non-smokers by the smell of smoke and were keen not to impose this on them.
"I feel very strongly about that, I feel that if someone doesn't smoke, I've got no right whatsoever to contaminate their clothes, affect their health, I think I've got no right at all." (Smoker, 5-9 employees, construction).
However, views varied as to how considerate they needed to be. Some felt that they should not smoke anywhere inside, where there were non-smokers, whilst others believed that standing next to an open door and blowing their smoke outwards was sufficient. Non-smokers also expressed a range of attitudes to the level of consideration that they expected or wanted from smokers.
"I don't begrudge people smoking, that's their choice... I think the older I've got, the more intolerant I've become of smoking... people are selfish when they smoke." (Non-smoker, 10-49 employees, retail).
Not all non-smokers believed that smokers should not smoke near them, even if they disliked the smell or other effects of smoking. Health risks associated with smoking were raised spontaneously a great deal, but there were debates as to the true extent of the risk for both smokers and those inhaling other people's smoke. Smokers and non-smokers usually mentioned cancer, lung problems and heart disease as being possible dangers of smoking, with some also discussing respiratory problems, asthma and coughing. Some also raised more minor effects such as increased susceptibility to colds and coughs, general ill health, poor skin and a poor or unhealthy appearance.
"I know people who have lung cancer who don't smoke, so I wouldn't say that it's necessarily smoking that causes it... everybody's got cancer in them and sometimes it starts and sometimes it doesn't, no matter what... I know it doesn't help your health, because I know personally that since I stopped smoking... I can walk further without choking." (Non-smoker, 5-9 employees, construction).
However, beneath this surface awareness of the health risks, there was considerable uncertainty and some scepticism, as to how serious they really were. Respondents cited personal experience or anecdotal evidence as countering the statistics and other information they had seen in the media and on cigarette packets. For instance, one pregnant smoker remarked that she was not overly worried about the effect of smoking on her baby as she had heard of smoking mothers who had healthy babies and non-smokers who had experienced problems.
"I know there are risks associated with it [smoking when pregnant], but I don't know, my mother smoked with us and I smoked when I was expecting [her first child], obviously I've cut down significantly... you've known so many healthy babies from smoking mothers... you can see they're healthy and not asthmatic. My partner is asthmatic but neither his mother nor father smoked... " (Smoker, 250+ employees, leisure and hospitality).
Likewise, another smoker commented that she found the low-level effects of smoking (colds, bad skin and so on) easy to accept because she experienced them herself, but that she was more sceptical about the serious health risks as her mother had had both cancer and a heart attack but had never smoked. In the same way, other respondents sometimes wondered if the link between lung cancer and smoking was certain because they had known non-smokers who had experienced it and smokers who had not. Non-smokers did tend to view the health risks more straightforwardly, but even they were unsure as to how much damage they would really experience if they spent time with friends or colleagues while they smoked.
Despite the unpleasant effects of smoking, it was seen as a way to relax and unwind. Those with stressful jobs reported that it helped them to deal with this stress and that it was something they could do in breaks or when having a drink to help them unwind. Non-smokers also often cited smoking as a way in which colleagues coped with stress.
"It's a need they have to feel... enforced stopping of something usually agitates people. They can probably hold off for longer but if they come back more relaxed it's much more productive." (Non-smoker, 5-9 employees, social & personal services/voluntary sector).
The tolerance of smoking displayed by non-smokers tended to be linked to their view of smoking as an addiction. Smokers discussed the addictive nature of smoking and often despaired of being able to give up successfully (and not start again).
"I could be on track, focussing on something, and then the need for a cigarette comes in and I feel I have to meet that need. I'm driven by something else... I still feel a bit controlled by the addiction." (Smoker, 5-9 employees, social and personal services).
Non-smokers agreed that it was very hard to give up and cited the physical and psychological effects of a smoker being unable to smoke when they needed to. Both smokers and non-smokers also pointed out that, as smoking was legal as well as being addictive, it was unreasonable to expect all smokers to give up or not to smoke throughout a work day. This influenced their views of how smoking policies should operate, as is discussed below.
Cost was occasionally mentioned by smokers. However, non-smokers seemed to have more faith than smokers in the use of cost as an argument to give up. In relation to smoking at work, both smokers and non-smokers also discussed their dislike of seeing groups of people smoking outside doorways (and the butts which were then dropped). They also mentioned fire risks posed by smoking inside, the cleaning requirements for rooms where smoking was allowed and the issue of hygiene in relation to kitchen or serving staff smoking.