Abstract
Using data from a 1996 random-digit-dialling computer-assisted telephone survey of Ontario adults, 424 smokers and 1,340 non-smokers were compared regarding knowledge about the health effects of tobacco use, attitudes toward restrictions on smoking and other tobacco control measures, and predictions of compliance with more restrictions. The response rate was 65%. Smokers were less knowledgeable than nonsmokers. Smokers were also less likely to support bans on smoking in specific locations, but majorities of both groups supported some restriction in most settings. Smokers were more likely than nonsmokers to predict that most smokers would comply with more restrictions, and more than three quarters indicated that they, themselves, would comply. Sizable proportions of both groups, especially smokers, failed to appreciate the effectiveness of taxation in reducing smoking. Support for other control measures also differed by smoking status. Both knowledge and smoking status were independently associated with support for more restrictions and other tobacco control policy measures.
Résumé
À partir de données recueillies en 1996 lors d’un sondage téléphonique à numéros aléatoires assisté par ordinateur et mené auprès d’adultes de l’Ontario, nous avons comparé les réponses de 424 fumeurs et de 1 340 non-fumeurs concernant les effets du tabagisme sur la santé, les attitudes à l’égard de restrictions et d’autres mesures de contrôle de l’usage du tabac et les prédictions quant au respect de restrictions plus nombreuses. Le taux de réponse au sondage a été de 65 %. Les fumeurs avaient moins de connaissances que les non-fumeurs. Les fumeurs étaient également moins portés à appuyer l’interdiction de fumer à certains endroits précis, mais la majorité des répondants des deux groupes appuyaient l’idée d’imposer certaines restrictions dans la plupart des endroits. Les fumeurs étaient plus portés que les non-fumeurs à prédire que la plupart des fumeurs se conformeraient à un plus grand nombre de restrictions; plus des trois-quarts d’entre eux ont indiqué qu’eux-mêmes s’y conformeraient. Une grande proportion des deux groupes, surtout parmi les fumeurs, ne croyait pas que les taxes étaient un moyen efficace de réduire l’usage du tabac. Les deux groupes ne donnaient pas le même appui à d’autres mesures de contrôle du tabagisme. La connaissance et le statut de fumeur ou de non-fumeur étaient associés de façon indépendante à l’appui donné à des restrictions plus nombreuses et à d’autres mesures de contrôle de l’usage du tabac.
References
- 1.Peto R, Lopez AD, Boreham J, et al. Mortality from Smoking in Developed Countries 1950–2000: Indirect Estimates from National Vital Statistics. Oxford: Oxford University Press; 1994. [Google Scholar]
- 2.Makomaski Illing EM, Kaiserman MJ. Mortality attributable to tobacco use in Canada and its regions, 1991. Can J Public Health. 1995;86:257–65. [PubMed] [Google Scholar]
- 3.Single E, Robson L, Xie XD, Rehm J. The economic costs of alcohol, tobacco, and illicit drugs in Canada, 1992. Addiction. 1998;93:991–1006. doi: 10.1046/j.1360-0443.1998.9379914.x. [DOI] [PubMed] [Google Scholar]
- 4.Kaiserman MJ. The cost of smoking in Canada, 1991. Chron Dis Can. 1997;18:13–19. [PubMed] [Google Scholar]
- 5.Health Canada, Statistics Canada, and the Canadian Institute for Health Information. Statistical Report on the Health of Canadians. Ottawa: 1999.
- 6.Health Canada. Directions. The Directional Paper of the National Strategy to Reduce Tobacco Use. An Update: 1993. Ottawa: Health Canada; 1993. [Google Scholar]
- 7.Office of Tobacco Control. Smoking By-Laws in Canada 1995. Health Canada, Health Protection Branch, Ottawa: Minister of Health Canada; 1995. [Google Scholar]
- 8.National Clearinghouse on TobaccoHealth. Federal and Provincial Legislation in Canada: An Overview. 1995. [Google Scholar]
- 9.Pederson LL, Bull SB, Ashley MJ, Lefcoe NM. A population survey in Ontario regarding restrictive measures on smoking: Relationship of smoking status to knowledge, attitudes, and predicted behaviour. Int J Epidemiol. 1987;16:383–91. doi: 10.1093/ije/16.3.383. [DOI] [PubMed] [Google Scholar]
- 10.Ashley MJ, Bull SB, Pederson LL. Support among smokers and nonsmokers for restrictions on smoking. Am J Prev Med. 1995;11:283–87. doi: 10.1016/S0749-3797(18)30431-8. [DOI] [PubMed] [Google Scholar]
- 11.Martin G, Steyn K, Yach D. Beliefs about smoking and health attitudes toward tobacco control measures. S Afr Med J. 1992;82:241–45. [PubMed] [Google Scholar]
- 12.Velicer WF, Laforge RG, Levesque DA, Fava JL. The development and initial validation of the smoking policy inventory. Tobacco Control. 1994;3:347–55. doi: 10.1136/tc.3.4.347. [DOI] [Google Scholar]
- 13.Laforge RG, Velicer WF, Levesque DA, et al. Measuring support for tobacco control policy in selected areas of six countries. Tobacco Control. 1998;7:241–46. doi: 10.1136/tc.7.3.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Samuels B, Glantz SA. The politics of local tobacco control. JAMA. 1991;266:2110–17. doi: 10.1001/jama.1991.03470150082035. [DOI] [PubMed] [Google Scholar]
- 15.Traynor MP, Begay ME, Glantz SA. New tobacco industry strategy to prevent local tobacco control. JAMA. 1993;270:479–86. doi: 10.1001/jama.1993.03510040083034. [DOI] [PubMed] [Google Scholar]
- 16.Ashley MJ, Pederson L, Poland B, et al. Smoking, Smoking Cessation, Tobacco Control and Programming: A Qualitative and Quantitative Study. 1997. [Google Scholar]
- 17.Northrup DA, Rhyne D. Smoking, Smoking Cessation, Tobacco Control and Programming: A Qualitative and Quantitative Study. Technical Documentation. North York: Institute for Social Research, York University; 1996. [Google Scholar]
- 18.O’Rourke D, Blair J. Improving random respondent selection in telephone surveys. J Marketing Research. 1983;20:428–32. doi: 10.1177/002224378302000409. [DOI] [Google Scholar]
- 19.Groves RM, Lyberg LE, et al. An overview of nonre-sponse issues in telephone surveys. In: Groves RM, Biemer PP, Lyberg LE, et al., editors. Telephone Survey Methodology. New York: John Wiley and Sons; 1988. pp. 191–211. [Google Scholar]
- 20.Bondy S, Ialomiteanu A. Smoking in Ontario, 1991 to 1996. Can J Public Health. 1997;88:225–29. doi: 10.1007/BF03404785. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Cox BG, Cohen SB. Methodological Issues in Health Care Surveys. New York: Marcel Dekker, Inc.; 1985. [Google Scholar]
- 22.Goodman LA. On simultaneous confidence intervals for multinomial proportions. Technometrics. 1965;7:247–54. doi: 10.1080/00401706.1965.10490252. [DOI] [Google Scholar]
- 23.Fleiss JL. Statistical Methods for Rates and Proportions. Second Edition. New York: John Wiley and Sons; 1981. [Google Scholar]
- 24.Hosmer D, Lemeshow S. Applied Logistic Regression. New York: John Wiley and Sons; 1989. [Google Scholar]
- 25.U.S. Department of Health and Human Services. Reducing the Health Consequences of Smoking. 25 Years of Progress. A report of the Surgeon General. 1989. Chapter 4. Trends in public beliefs, attitudes, and opinions about smoking. Public Health Service, Centers for Disease Control. Office of Smoking and Health. Rockville, Maryland. pages 171–258.
- 26.Law MR, Morris JK, Wald NJ. Environmental tobacco smoke exposure and ischaemic heart disease: An evaluation of the evidence. Br Med J. 1997;315:973–80. doi: 10.1136/bmj.315.7114.973. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Borland R, Hill D. Initial impact of the new Australian tobacco health warnings on knowledge and beliefs. Tobacco Control. 1997;6:317–25. doi: 10.1136/tc.6.4.317. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Borland R. Tobacco health warnings and smoking-related cognitions and behaviours. Addiction. 1997;92:1427–35. doi: 10.1111/j.1360-0443.1997.tb02864.x. [DOI] [PubMed] [Google Scholar]
- 29.Millar WJ. Reaching smokers with lower educational attainment. Health Reports. 1996;8:11–19. [PubMed] [Google Scholar]
- 30.Repace JL. Risk management of passive smoking at work and at home. Saint Louis Univ Public Health Law Rev. 1994;13:763–85. [Google Scholar]
- 31.Province of Ontario. Bill 119, 35th Legislature. Chapter 10, Statutes of Ontario, 1994. An Act to Prevent the Provision of Tobacco to Young Persons and to Regulate its Sale and Use by Others. Toronto: Legislative Assembly of Ontario; 1994. [Google Scholar]
- 32.U.S. Department of HealthHuman Services. Preventing Tobacco Use Among Young People. Atlanta, GA: Public Health Service; 1994. [Google Scholar]
- 33.Lewk EM, Hyland A, Keerebrock N, Cummings KM. Price, public policy, and smoking in young people. Tobacco Control. 1997;6(Suppl.2):S17–S24. doi: 10.1136/tc.6.suppl_2.s17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 34.Koh HK. An analysis of the successful 1992 Massachusetts tobacco tax initiative. Tobacco Control. 1996;5:220–25. doi: 10.1136/tc.5.3.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 35.Chaloupka FJ, Wechsler H. Price, tobacco control policies and smoking among young adults. J Health Economics. 1997;16:359–73. doi: 10.1016/S0167-6296(96)00530-9. [DOI] [PubMed] [Google Scholar]
