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a Department of
Public Health Sciences, University of Toronto, and Ontario Tobacco
Research Unit, Centre for Health Promotion, University of Toronto,
Toronto, Ontario, Canada, b Centre for Addiction and Mental Health,
Toronto, c Ontario Tobacco Research
Unit, Centre for Health Promotion, University of Toronto, and Centre
for Addiction and Mental Health, Toronto, d Department
of Community Health and Preventive Medicine, Moorehouse School of
Medicine, Atlanta, Georgia, USA, e Ontario Tobacco Research Unit, Centre for Health
Promotion, University of Toronto, and Samuel Lunenfeld Research
Institute, Mount Sinai Hospital, Toronto, f Department of Public Health Sciences, University
of Toronto
Correspondence to: Professor Blake Poland, Department of Public Health Sciences, Faculty of Medicine, University of Toronto, McMurrich Building, 12 Queen's Park Crescent West, Toronto, Ontario M5S 1A8, Canada; blake.poland{at}utoronto.ca
Received 8 October
1999; Revision received 19 May 2000;
Accepted 1 June 2000
OBJECTIVE
To determine
if smokers and non-smokers cluster into meaningful, discrete subgroups
with distinguishable attitudes and behaviours regarding smoking and
smoking restrictions.
DESIGNQualitative
research with 45 smokers guided development of questionnaire items
applied in a population based telephone survey of 432 current smokers
and 1332 non-smokers in Ontario, Canada.
METHODSCluster
analysis of questionnaire items used to categorise adult smokers and
non-smokers; comparison of clusters on sociodemographic characteristics
and composite knowledge and attitude scores.
RESULTSSmokers
clustered in three groups. "Reluctant" smokers (16%) show more
concern about other people discovering that they smoke, but parallel
"easygoing" smokers (42%) in supporting restrictions on smoking
and not smoking around others. "Adamant" smokers (42%) feel
restrictions have gone too far, and are less likely to accommodate non-smokers. Significant gradients across categories in the expected direction were observed with respect to smoking status, stage of
change, knowledge, and attitude scores, and predicted compliance with
restrictions, validating the proposed typology. Non-smokers also
clustered into three groups, of which the "adamant" non-smokers (45%) are the least favourably disposed to smoking. "Unempowered" non-smokers (34%) also oppose smoking, but tend not to act on it.
"Laissez-faire" non-smokers (21%) are less opposed to smoking in
both attitude and behaviour. A significant gradient across categories
in the expected direction was observed with respect to composite scores
regarding knowledge of the health effects of active and passive smoking
and a composite score on support for restrictions on smoking in public places.
CONCLUSIONRecognition
and consideration of the types of smokers and non-smokers in the
population and their distinguishing characteristics could inform the
development of tobacco control policies and programmes and suggest
strategies to assist implementation.
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