Elsevier

Health & Place

Volume 6, Issue 2, 1 June 2000, Pages 117-123
Health & Place

Smokers at risk: implications of an institutionally bordered risk-reduced environment

https://doi.org/10.1016/S1353-8292(00)00003-4Get rights and content

Abstract

The paper draws on an evaluation of a workplace smoking policy implemented at Edinburgh University to examine some implications for smokers at work. While the objective of institutional risk-reduced environments is to diminish or control the level of risk behaviour within, they may have unanticipated implications for participants who are unwilling or unable to adapt. Data presented in the paper suggest that the University smoking policy carried its own risk. That is, the policy did not impact equally upon all members of the organisation but was experienced as divisive in contributing towards and sustaining social inequalities among staff.

Introduction

Just as risk is an endemic feature of the times in which we live (Giddens, 1991, Beck, 1992) so is the expectation that we will individually or collectively try to reduce or control risk (Beck, 1995). Hence, individuals are encouraged to take responsibility for their risk-related behaviour, and, where social responsibility is acknowledged, reduction and control of risk may also be attempted through regulatory means.

Smoking is widely accepted to be a health-related risk factor both for those who passively inhale environmental tobacco smoke as well as those who smoke (Wald et al., 1991, Ehrlich, 1992). One way of socially regulating or containing risk is through the construction of institutionally bordered risk-reduced environments which, founded on the principles of sequestration, banish particular aspects of experience from the regularities of everyday life (Giddens, 1991). Sequestration, which was encapsulated by the establishment of the asylum, reflected a preference for regulating behaviour through ‘social control’ which historically arose when it became accepted that a ‘deviant’ behaviour or condition was not an exogenous phenomenon but amenable to remedial treatment.

An example of an institutionally bordered risk-reduced environment is the workplace which is either smoke-free or where smoking is restricted to reserved areas. Policies to create smoke-free or smoking restricted workplaces have become increasing acceptable to both employers and employees (Amos et al., 1995, Brenner et al., 1997). The recent Government White Paper on tobacco (DOH, 1998) has established that smoking in the workplace will be regulated in future by an ‘Approved Code of Practice’ defining the type of smoking policies employers will need to operate in order to comply with health and safety legislation. The code is to be designed specifically to encourage the introduction of smoking policies which give priority to the needs of non-smokers at work.

In this paper we draw on an evaluation of a workplace smoking policy at Edinburgh University to examine some implications of institutionally defined risk-reduced environments for smokers at work. The account is underpinned by our understanding that the reasons for persistent smoking are complex and involve diverse contributory factors, including physiological dependency upon nicotine, psychological dependency and social circumstance, as well as the use of advertising and other social conditioning methods which encourage a substantial proportion of the population to take up and persist in smoking. Thus, despite moves to control risks associated with smoking, these risks must be understood in part as a function of the society in which they arise. This understanding is central to Beck’s (1992) thesis about risk society, that is, the spiral of risk creation and management in late modernity. Beck (1992, p. 183) argues that industrial development goes hand in hand with both its associated hazards and the attendant growth of risk management industries, and that “while all earlier cultures and phases of social development confronted threats in various ways, society today is confronted by itself, through its dealings with risks”. The impact of the ways in which society elects to deal with those risks, in which it has substantial investment, has received relatively little empirical attention. This is an oversight which should be addressed, not least because those involved in regulating risk, and well as those in the business of producing it, do not necessarily anticipate, and seldom experience first hand, the ultimate consequences of their actions (Bauman, 1991).

In the paper we explore how, given a cultural climate in which smoking is no longer tolerated, a smoking ban may fuel and widen social divisions between those who smoke and those who do not. Furthermore, social divisions between smokers and non-smokers are compounded by social class and occupational differentials in smoking behaviour, whereby smoking is already firmly established as a marker for social disadvantage (Amos and Ineson, 1989, Graham, 1987, Graham, 1993, Marsh and McKay, 1994, Jarvis, 1997).

In addressing the implications of this for smokers at work, we have found Bauman’s theory about ‘post modern strangers’ useful in understanding how individuals who are perceived to participate in behaviour which is risky or dangerous to others may come to see themselves, and be seen by others, as marginalised or excluded. Bauman, 1991, Bauman, 1998) argues that, although contemporary society may protest its tolerance and respect for ‘strangers’, the reality is that individuals who do not, or cannot, conform are labelled and allocated to the transitory state of ‘suspended extinction’ where treatment is attempted prior to ultimate exclusion (Bauman, 1998).

Section snippets

The University of Edinburgh smoking policy

The University of Edinburgh smoking policy, banning smoking in University buildings or in any of its vehicles, was introduced on 1 October 1997 and applies to all staff members, students, outside contractors and visitors to the University. The policy is supported by pre-existing University disciplinary procedures for staff and through faculty representation for students. There are three exceptions to the ban: licensed premises, some selected residential accommodation for students and University

Methods

The paper draws primarily upon qualitative data collected in the course of an evaluation of the smoking ban, commissioned by the University. The objective of the evaluation was to ascertain the effectiveness of the smoking ban policy in terms of the processes which characterised the initiation, development and implementation of the policy; ease of implementation perceived by staff responsible for implementing the policy; perceived changes in working conditions occurring as a result of the

Results

The entire staff group (n=5835 on 1 January 1997) was included in the survey and 61% (3592) returned completed questionnaires. The achieved sample comprised 46.6% (1675) males and 52.8% (1898) females. [No information on gender was available for <1% (19) respondents.] Dispatch and return of questionnaires is shown in Table 1. The lowest response rate was recorded among manual staff who mainly comprised servitors and domestic employees. One probable explanation is that manual staff members tend

Conclusion

Our data suggest that institutionally bordered risk-reduced environments, while aiming to diminish or control the level of risk behaviour within, can have implications for participants who are either unwilling or unable to adapt. The implementation of the University smoking ban has clearly impacted negatively on how smokers see themselves and how they perceive they are seen by others (non-smokers) at work. Effectively, this widening of social differences between smokers and non-smokers at work

Acknowledgements

The Research Unit in Health and Behavioural Change is jointly funded by the Scottish Office Department of Health and the Health Education Board for Scotland. All opinions expressed in the article are those of the authors and are not necessarily those of the funders.

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