School of Psychology, Curtin University, Perth, Australia.
Cancer Council WA, Perth, Australia.
Drug Alcohol Rev. 2019 Jan;38(1):92-100. doi: 10.1111/dar.12869. Epub 2018 Oct 9.
Despite substantial reductions in smoking prevalence in many countries, rates remain high among people who are experiencing disadvantage. This study aimed to explore attitudinal and behavioural responses to population-wide tobacco control policies among Australian smokers experiencing disadvantage.
Semi-structured qualitative interviews were conducted with 84 smokers attending community service organisations in the mental health, homelessness, and alcohol and other drug sectors. Interviewees discussed various tobacco control policies (tobacco taxes, smoke-free areas, plain packaging and graphic health warnings). The interview transcriptions were coded and thematically analysed.
Responses to tobacco taxes were mixed. Some interviewees reported smoking less as a result of price increases, while others reallocated funds from other budget areas. Many perceived smoke-free area policies as effective, although some described strategies they use to circumvent this policy, thereby diminishing its effectiveness. Plain packaging and graphic warnings were perceived as being least effective.
While tobacco control policies can elicit intended attitudinal and behavioural responses, additional efforts are needed to enhance their effectiveness among smokers experiencing disadvantage. Future efforts to reduce smoking rates should address responses that diminish policy effectiveness among groups exhibiting high smoking prevalence. This could be achieved through strategies that address the specific needs of these groups, such as providing additional cessation support, enforcing existing smoke-free policies in ways that minimise inequitable effects, and addressing self-exempting beliefs.
尽管许多国家的吸烟率大幅下降，但在处于不利地位的人群中，这一比例仍然很高。本研究旨在探讨澳大利亚处于不利地位的吸烟者对全人群烟草控制政策的态度和行为反应。
对参加心理健康、无家可归和酒精及其他药物领域社区服务组织的 84 名吸烟者进行了半结构化定性访谈。受访者讨论了各种烟草控制政策（烟草税、无烟区、平装和图形健康警示）。对访谈记录进行了编码和主题分析。
对烟草税的反应喜忧参半。一些受访者表示由于价格上涨，吸烟量减少了，而另一些人则从其他预算领域调拨资金。许多人认为无烟区政策是有效的，尽管有些人描述了他们用来规避这一政策的策略，从而降低了其有效性。平装和图形警示被认为是最无效的。
虽然烟草控制政策可以引起预期的态度和行为反应，但需要做出额外的努力来提高其在处于不利地位的吸烟者中的有效性。未来减少吸烟率的努力应该解决那些降低高吸烟率群体政策有效性的反应。这可以通过解决这些群体特定需求的策略来实现，例如提供额外的戒烟支持，以最小化不公平影响的方式执行现有的无烟政策，并解决自我豁免的信念。
