Qualitative community study

A longitudinal, ethnographic study to explore the social context and impact of the legislation on attitudes, behaviour and experiences at various levels in four socio-economically contrasting localities in Scotland.

A collaboration between the Scottish Centre for Social Research, Edinburgh, and the Division of Community Health Sciences at the University of Edinburgh.

Principal Investigator: Dr Claudia Martin

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Study aims

• Explore the social context and impact of the Scottish smoke-free legislation on attitudes, behaviour and experiences, at individual, family and community levels, in four socio-economically contrasting localities in Scotland.
• Acquire a detailed ethnography of the four localities and to reflect the perspectives of, and impact of the legislation on, individuals, families, employees, employers, and other target groups within the population, and on communities, pre- and post-legislation.
• Examine the behavioural, social and cultural impact of the legislation to prohibit smoking in enclosed public places in different communities.
• Explore any change in use of community facilities and the relationship between smoking and alcohol consumption.
• Explore the extent to which the legislation was enforced locally and the impact this has on attitudes towards smoking and the legislation.

Study design

• Longitudinal ethnographic study involving mixed qualitative methods (individual in-depth interviews, focus groups, observations, key informant/stakeholder interviews) in four contrasting communities in Scotland.
• The study employed a nested case study approach within two local authority areas in Scotland (one urban and one semi-rural area, with two socio-economically contrasting communities within each).
• Repeat in-depth interviews pre- and post-legislation were conducted with a panel of 32 current and eight recent former smokers; together with 14 semi-structured interviews with formal and informal "enforcers" within each community; and 12 focus group discussions with populations of interest.
• Discreet, systematic direct observations were made in public places (enclosed and outdoor) to observe social practices within different social contexts of smoking and non-smoking (sampled at various points in time across the study period to capture time-of-day and seasonal effects).
• Data were collected over four waves: in the six month period prior to the introduction of the legislation, 1-3 months (immediately post-implementation), 6-9 months and, finally, 9-12 months post-legislation, to acquire a detailed ethnography of the four localities and to reflect the perspectives on, and impact of, the legislation pre- and post-legislation.

Research instruments and protocols

• Pre-legislation Panel Topic Guides Wave 1 (including friendship, non-smoking panel)
• Post-legislation Panel Topic Guides Waves 2 & 3 (including parents and teenagers)

Main outcomes

• Changes in smoking behaviour (reduction in consumption of tobacco, including quitting) were noted in all localities, but were most marked within the disadvantaged communities.
• Following the legislation smoking became more of a conscious decision than a routine or habitual behaviour.
• There was a better informed understanding, and increased awareness, of the effects of SHS.
• Feelings of stigma, especially among women, were associated with being a more visible smoker even in communities with high smoking prevalence.
• There was a high level of compliance with the law post-implementation. In more deprived communities, this was in spite of pre-legislation hostility and bravado about intention to flout the law. However, there was some evidence of continuing resentment.
• Some people were enthusiastic about the aesthetic changes to public places and impact of the legislation on smoking.
• Some groups, especially older men whose lives centred round bars, experienced a sense of loss as their companions stayed at home.
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Updated 17th July 2014