Place and re-normalising smoking: Tobacco, alcohol and social pressures for young people. Janet Hoek ASPIRE2025, University of Otago

Transcription

1 Place and re-normalising smoking: Tobacco, alcohol and social pressures for young people Janet Hoek ASPIRE2025, University of Otago

2 Overview Social environments How context supports behaviour What we know about tobacco and alcohol? How are these behaviours paired? Why does this pairing matter? What measures should we look to put in place? How can we use policy to denormalise smoking?

3 Context and behaviour Introduction of smoke-free spaces a crucial measure in denormalising smoking (Thomson et al., 2009) Measures make several points: Recognise harm of smoking State exposing others to harm not acceptable Re-position being smoke-free as a norm

4 Context and behaviour Denormalising measures work: Smoke-free playgrounds Smoke-free stadia Smoke-free sports grounds Make explicit statements about smoking Doesn t fit with: Protecting children Enjoying sport Participating in physical activity

5 Context and behaviour Similar logic now being extended to other settings: Smokefree streets Key setting where children are likely to see smoking Exposure to smoking much greater in general settings than child-specific settings

6 Why is it important to reduce exposure NZ (15+) mean estimate of smoking prevalence 2012: 36% (cf to daily smoking 17% - NZHS 2011/12) Young people who over-estimate smoking prevalence are more likely to experiment with smoking (Gilpin et al., 1994; Unger et al., 2002) Smoking cues increase relapses (Hoek, et al., 2010) Important for quitters to be able to avoid these Smokefree places reduce cue exposure

7 Looks like a success story? Important to recognise the progress made Reductions in children s exposure Will help sustain rapid reductions in adolescent smoking BUT Smoking prevalence highest among young adults Protective factors do not endure SO Important to examine settings where YAs smoke

8 Tobacco and alcohol Many young adults begin as social smokers when drinking (Hoek et al., 2013) Walking the tightrope: I am not a smoker, but sometimes I smoke Non-smoking identity with superior social status Smoking behaviour attracts stigma

9 Tobacco and alcohol Differentiation from smokers At the start it s like oh I m a social smoker and I only smoke when I drink. Evolving definitions: Part 1 And then, it s like I m a social smoker and like I only smoke when I m round 4 pints, Evolving definitions: Part 2 and now it s like I m a social smoker because I ve never had one by myself (laughs) for me it s changed to always include me.

10 Alcohol as facilitator and excuse Alcohol and smoking go hand in hand Removes constraints: you re more relaxed so you don t really mind smoking Excuse: When I m drunk, I guess because the care factor goes down

11 Smoking a norm in drinking environment Unity and cohesion: well everyone else will be out smoking. You don t want to sit inside on your own and just drink... Social pressure: Well, no one wants to smoke on their own, do they, and they ll be like, come have one with me...

12 Smoking a norm in drinking environment Enables conversation: it s not that I can t talk without a cigarette, it s just that something else to do all the time. It kind of makes the conversation flow a little bit more easily

13 Policy options: Smokefree settings If outdoor areas strongly associated with smoking Run mass media campaigns Important, but may not apply after drinking Change ease of smoking Alter environments Access to the product Availability of product

14 Altering environments: Extend SF perimeter Welcomed by respondents Eliminate pressure: then I wouldn t have to smoke. Like, well not have to, but none of my mates would offer me them Inconvenience would assert smokefree identity: Oh, I probably wouldn t do it if there was nobody to get cigarettes off... I m willing to go outside but I m not willing to completely leave a club to go and find someone standing somewhere on the street down the road.

15 Altering environments: Extend SF perimeter External bar areas currently the hip zones

16 Decrease product availability Require retailer registration (Licensing) Conditions include: Cannot also sell alcohol No one allowed under age of 21 permitted in-store Fewer outlets registered and permitted to sell tobacco Outcomes Product harder to access and consume alongside alcohol

17 Where to from here? Crucial to continue with smokefree outside environments Decouple smoking from popular settings Important to focus on CBD areas and around bars Alcohol plays a pivotal role in social smoking Maintain focus on supply Make product more difficult to access and use

18 Kia ora, thank you See work on smokefree settings by George Thomson: ago html