4.14 Public attitudes to secondhand smoke

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The most recent data published on prevalence of exposure to secondhand smoke are presented in this section, findings reported by the National Drug Strategy Household Survey (2004) providing the basis for much of the following discussion. It should be noted that public awareness of the damage to health caused by secondhand smoke is likely to have continued to increase with the progressive introduction of further legislation for smokefree workplaces and public places in most Australian states and territories, and the launch of television campaigns to raise awareness of the dangers of exposure to secondhand smoke for children.[6] The following information may therefore underrepresent the current state of public attitudes and perceptions about the extent of the health effects of secondhand smoke.

In general, the community has rapidly responded to the findings that secondhand smoke is harmful to health, in turn influencing broader attitudes to restrictions on smoking in many public places, the workplace, and more recently in private domains such as the home and in motor vehicles. Attitudes to smoking in these settings are explored in Chapter 15 .

4.14.1 General perception that secondhand smoke is harmful to health

The majority of the population, smokers and non-smokers, believe that living and working with a smoker could affect the health of non-smokers, although non-smokers are more likely to have this perception. The proportion of Australians believing that the health of non-smokers is affected by exposure to secondhand smoke has increased over time. In 1985, a Victorian study showed that 80% of non-smokers and 57% of current smokers agreed that the health of non-smokers could be damaged by secondhand smoke.81 In 2004, the National Drug Strategy Household Survey reported that about 90% of non-smokers and 70% of smokers thought that living, working or socialising with smokers could cause health problems (Table 4.5). Living in a smoky environment was considered by both non-smokers and smokers to be slightly more likely to affect a non-smoker's health than working or socialising with smokers.64 [7][8]

4.14.2 Changes in smoking behaviour due to beliefs about secondhand smoke

The National Drug Strategy Household Survey (2004) found that among smokers who had modified their smoking behaviour (for example by attempting to quit, by cutting back or by switching to lower tar or nicotine brands), about one in five (21%) had been motivated by the concern that their smoking was affecting the health of those around them (Table 4.6).

Female smokers were more likely to be prompted to alter their behaviour out of concern for the health of those around them than males (23% compared with 19%).63[9][10]

4.14.3 Knowledge of specific health effects

A range of state-based surveys have confirmed that although there is a high general awareness that secondhand smoke is harmful, knowledge about specific health outcomes is less consistent. Studies from New South Wales,82 Victoria83 and South Australia72 have shown that awareness tends to be higher for lung cancer and other respiratory effects, whereas the increased risk of heart disease is generally under-recognised.

Table 4.7 presents the findings of a survey undertaken in Victoria in 2005.83 This study found that non-smokers were more likely than smokers to believe that exposure to secondhand smoke caused a range of health problems. The highest awareness was for secondhand smoke as a cause lung cancer, followed by other respiratory problems. There was lower awareness about the effects of secondhand smoke on children and babies, but since the introduction of new graphic health warnings on tobacco packages in 2006, which includes a warning about infants and children, awareness about pneumonia, SIDS and middle ear infections may have increased.[11][12][13]

4.14.4 Avoidance of cigarette smoke

Results from the National Drug Strategy Household Survey in 200484 show that about 40% of non-smokers 'always' avoid smoky environments, and a further 49% attempt to avoid exposure to other people's cigarette smoke 'sometimes' (Table 4.8). Except in the youngest age group surveyed (14–19 years), in which findings were similar between the sexes, female non-smokers are more likely to report always avoiding secondhand smoke than male non-smokers. The likelihood of consciously avoiding secondhand smoke increases with age. Overall, nearly 90% of non-smokers either always or sometimes take measures to avoid exposure to secondhand smoke.[14]

Some smokers also prefer not to be exposed to secondhand smoke. The 2001 NDSHS survey reported that of recent smokers, 3% 'always' avoided places where they might be exposed to secondhand smoke and 30% 'sometimes' took steps to avoid secondhand smoke.85

4.14.5 Behaviour around cigarette smoke

A Victorian study asked a sample of smokers and non-smokers how they would respond if someone lit up a cigarette nearby.86 Most non-smokers said that they would move away (70%), and a minority said that they would request the smoker to stop (6%) (Table 4.9). Smokers were more likely to do nothing (46%), or to light up a cigarette as well (27%). However a quarter of smokers said that they would take action to avoid smoke (either by moving away or asking the smoker to stop). Women were more likely than men to say that they would move away from the smoke (68% compared with 53%).86[15][16]

The author of this report makes the observation that although it is clear that most non-smokers (and many smokers as well) prefer not to be exposed to cigarette smoke, only a minority of individuals are prepared to ask a smoker to put out their cigarette. This indicates that a 'common courtesy' approach to smoking is insufficient on its own to provide protection from secondhand smoke.86

 

Acknowledgements

We are grateful to Konrad Jamrozik, Professor of Evidence-Based Health Care and Head, Division of Health Systems, Policy and Practice, School of Population Health, University of Queensland, for his review of this chapter.