The author of a 10-year study of Australian smokers has criticised messaging that conveys they are ignorant of its harms, instead finding that they can get “very creative” in avoiding health warnings.
Simone Dennis, an associate professor at the Australian National University, interviewed smokers in public places over the course of a decade and found they increasingly felt marginalised from society because of strict legislation.
“Ten years ago, it was relatively easy to walk up to people and ask them about their smoking. But towards the end of the research, people would be suspicious because they thought I was going to ask them to move on or criticise them in some way.”
She said hostility to smokers in public was not necessarily congruent with science, which found limited evidence of the impact of smoke-laced air in the outdoors. “But it is completely congruent with the de-normalisation campaign that the state has done.”
Dennis said messaging that smokers were ignorant and simply needed to be educated of its harms to be motivated to quit was not held up by her research. She said they could be “very creative” in picking and choosing the messages that reached them.
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She spoke to male smokers who would ask for or select packets with health warnings relating to pregnancy, and people with blue eyes who would avoid “the eye packet”.
“It’s almost like the cigarettes in particular packets had different qualities.”
It was common for people to negate the warnings or distort their meaning, such as by putting the cigarettes in another container or covering the packets with stickers.
Dennis interviewed a group of pregnant teenagers who were concerned about their first experience of childbirth, and were smoking in the hope it would reduce the weight of their babies.
“Their greatest fear was giving birth to a large baby ... some of them had taken up smoking as a strategic response to alleviate their fear of giving birth to a large infant, while others were smoking harder. That’s obviously not the way messaging is intended to work ...
“What it told me was this is not a situation of ignorance. They absolutely knew cigarettes were going to have an effect on their bodies, but they wanted it to.”
She said it was evidence of anti-smoking measures not working the way policymakers had intended; equally, pushing up the price of packets just forced some smokers to rearrange their budgets.
Dennis said she was neutral on the issue of smoking but had received a large volume of complaints from people unhappy with her approach, as well as resistance from public health.
“I’m not trying to encourage people to smoke or get them to stop. I’m just trying to understand their experience.”
According to Department of Health figures, smoking kills an estimated 15,000 Australians and has a social and economic cost of $31.5bn.
The federal and state governments have together committed to reduce the national adult daily smoking rate to 10% by 2018, as well as halve the Aboriginal and Torres Strait Islander adult daily smoking rate (from 47% in 2008).
The excise on tobacco products is to be increased by 12.5% each year from 2017 to 2020, by which point a packet will probably cost $45 or more.
Dennis said anti-smoking campaigns often targeted people belonging to lower-socioeconomic or marginalised groups, and had significant costs but limited success in terms of getting smokers to quit.
Australian smokers to pay more than $45 for a packet of cigarettes from 2020
She said little was known about why smokers persisted with the habit in spite of warnings, the expense, and unshakeable evidence of the damage to health.
“It’s really hard to ask those questions in a tobacco-controlled space, so we don’t have research on it.”
She said the government needed to involve smokers more in the creation of public health campaigns.
“My research is recommending that we break down barriers between people that are crafting policy and people who are experiencing that policy as smokers,” she said.
“It seems the targets are critical to include as architects if they’re going to bear the brunt of it.”
Her findings have been published in a book, Smokefree, which documents the changing experience of smokers as Australia introduced world leading anti-tobacco laws. She will now pursue further research into third-hand smoke.
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