Parks Tom, Wilson Clare Vr, Turner Kenrick, Chin Joel We
University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge CB02SP, UK.
BMC Public Health. 2009 Jul 15;9:238. doi: 10.1186/1471-2458-9-238.
Smoke-free policy aims to protect the health of the population by reducing exposure to environmental tobacco smoke (ETS), and World Health Organisation (WHO) guidance notes that these policies are only successful if there is full and proper enforcement. We aimed to investigate the problem of resistance to smoking restrictions and specifically compliance with smoke-free policy. We hypothesised that an explanation for non-compliance would lie in a measurable difference between the smoking behaviours of compliant and non-compliant smokers, specifically that non-compliance would be associated with nicotine dependence and different reasons for smoking.
We conducted a questionnaire-based, descriptive, cross-sectional study of hospital employees. Seven hundred and four members of staff at Addenbrooke's Hospital, Cambridge, UK, completed the questionnaire, of whom 101 were smokers. Comparison between compliant and non-compliant smokers was made based on calculated scores for the Fagerström test and the Horn-Waingrow scale, and level of agreement with questions about attitudes. For ordinal data we used a linear-by-linear association test. For non-parametric independent variables we used the Mann-Whitney test and for associations between categorical variables we used the chi-squared test.
The demographic composition of respondents corresponded with the hospital's working population in gender, age, job profile and ethnicity. Sixty nine smokers reported they were compliant while 32 were non-compliant. Linear-by-linear association analysis of the compliant and non-compliant smokers' answers for the Fagerström test suggests association between compliance and nicotine dependence (p = 0.049). Mann-Whitney test analysis suggests there is a statistically significant difference between the reasons for smoking of the two groups: specifically that non-compliant smokers showed habitual smoking behaviour (p = 0.003). Overall, compliant and non-compliant smokers did not have significantly different attitudes towards the policy or their own health.
We demonstrate that those who smoke in this setting in contravention to a smoke-free policy do so neither for pleasure (promotion of positive affect) nor to avoid feeling low (reduction of negative affect); instead it is a resistant habit, which has little or no influence on the smoker's mood, and is determined in part by chemical dependence.
无烟政策旨在通过减少接触环境烟草烟雾（ETS）来保护公众健康，世界卫生组织（WHO）的指导意见指出，只有全面且恰当地执行这些政策，它们才会取得成功。我们旨在调查对吸烟限制的抵制问题，特别是对无烟政策的遵守情况。我们假设，不遵守规定的一个解释在于遵守规定和不遵守规定的吸烟者在吸烟行为上存在可衡量的差异，具体而言，不遵守规定与尼古丁依赖及不同的吸烟原因有关。
我们对医院员工进行了一项基于问卷的描述性横断面研究。英国剑桥阿登布鲁克医院的704名工作人员完成了问卷，其中101人是吸烟者。根据法格斯特罗姆测试和霍恩 - 温格罗量表的计算得分以及对态度问题的认同程度，对遵守规定和不遵守规定的吸烟者进行了比较。对于有序数据，我们使用了线性 - 线性关联检验。对于非参数自变量，我们使用了曼 - 惠特尼检验，对于分类变量之间的关联，我们使用了卡方检验。
受访者的人口构成在性别、年龄、工作岗位和种族方面与医院的工作人群相符。69名吸烟者表示他们遵守规定，而32人不遵守规定。对遵守规定和不遵守规定的吸烟者在法格斯特罗姆测试中的回答进行的线性 - 线性关联分析表明，遵守规定与尼古丁依赖之间存在关联（p = 0.049）。曼 - 惠特尼检验分析表明，两组吸烟原因存在统计学上的显著差异：具体而言，不遵守规定的吸烟者表现出习惯性吸烟行为（p = 0.003）。总体而言，遵守规定和不遵守规定的吸烟者对该政策或自身健康的态度没有显著差异。
我们证明，在这种环境下违反无烟政策吸烟的人，这样做既不是为了愉悦（促进积极情绪）也不是为了避免情绪低落（减少消极情绪）；相反，这是一种抵制性习惯，对吸烟者的情绪几乎没有影响，并且部分由化学依赖决定。
