Social-cognitive beliefs, alcohol, and tobacco use: a prospective community study of change following a ban on smoking in public places.

OBJECTIVE

To examine social-cognitive change associated with behavior change after the introduction of a smoke-free public places policy.

DESIGN

Adults (N = 583) who use public houses licensed to sell alcohol (pubs) completed questionnaires assessing alcohol and tobacco consumption and social-cognitive beliefs 2 months prior to the introduction of the smoking ban in England on July 1, 2007. Longitudinal follow-up (N = 272) was 3 months after the introduction of the ban.

MAIN OUTCOME MEASURES

Social-cognitive beliefs, daily cigarette consumption, and weekly alcohol consumption.

RESULTS

Smokers consumed considerably more alcohol than did nonsmokers at both time points. However, a significant interaction of Smoking Status x Time showed that while smokers had consumed fewer units of alcohol after the ban, nonsmokers showed an increase over the same period. There was a significant reduction in number of cigarettes consumed after the ban. Subjective norms concerning not smoking, and perceived severity of smoking-related illness increased across time. Negative outcomes associated with not smoking were reduced among former smokers and increased across time among smokers. Regression analyses showed that changes in subjective norm and negative outcome expectancies accounted for significant variance in change in smoking across time.

CONCLUSION

Results suggest that the smoking ban may have positive health benefits that are supported by social-cognitive change.