Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Department of Public Health, University of Otago, Wellington, New Zealand.
Nicotine Tob Res. 2021 Mar 19;23(4):724-731. doi: 10.1093/ntr/ntaa227.
Smoking among young adults is often associated with social contexts and alcohol use. Although many countries, including New Zealand, have prohibited smoking inside licensed premises, outdoor areas have enabled smoking and alcohol co-use to persist. We examined whether and how outdoor bar areas facilitate and normalize young adult smoking and explored potential policy implications.
We conducted in-depth interviews with 22 young adults who had recently smoked in a New Zealand bar or nightclub and investigated how physical design attributes (atmospherics) influenced experiences of smoking in outside bar settings. We used qualitative description to identify recurring accounts of the outdoor bar environment and thematic analysis to explore how participants experienced the bar in relation to smoking.
Participants valued outdoor smoking areas that were comfortable and relaxing, and saw attributes such as seating, tables, heating, protection from inclement weather, and minimal crowding, as important. We identified four themes; these explained how participants used smoking to gain respite and make social connections, showed how bar settings enabled them to manage smoking's stigma, and identified potential policy measures that would decouple smoking and alcohol co-use.
Evidence bar environments facilitate and normalize smoking among young adults questions whether smokefree policies should be expanded to include all bar areas. Introducing more comprehensive smokefree outdoor policies could reduce the influence of design attributes that foster smoking while also reframing smoking as outside normal social practice.
Bar environments contain many stimuli that cue and reinforce smoking and integrate smoking into social experiences. Expanding smokefree bar settings to include outdoor areas would reduce exposure to these stimuli, decrease opportunities for casual smoking, help maintain young people's smokefree status, and support longer-term goals of sustained reductions in smoking prevalence.
年轻人吸烟通常与社交环境和饮酒有关。尽管包括新西兰在内的许多国家已经禁止在有执照的场所内吸烟，但户外区域仍然使吸烟和饮酒同时发生的情况持续存在。我们研究了户外酒吧区域是否以及如何促进和规范年轻人吸烟，并探讨了潜在的政策影响。
我们对 22 名最近在新西兰酒吧或夜总会吸烟的年轻人进行了深入访谈，研究了物理设计属性（氛围）如何影响户外酒吧环境中的吸烟体验。我们使用定性描述来识别户外酒吧环境的常见描述，并使用主题分析来探讨参与者如何体验酒吧与吸烟之间的关系。
参与者重视舒适和放松的户外吸烟区，并认为座位、桌子、供暖、免受恶劣天气影响和最小化拥挤等属性很重要。我们确定了四个主题；这些主题解释了参与者如何利用吸烟来获得喘息和建立社交联系，展示了酒吧环境如何使他们能够管理吸烟的耻辱感，并确定了可能会将吸烟和饮酒同时发生分开的政策措施。
有证据表明酒吧环境促进和规范了年轻人吸烟，这使得人们质疑是否应该将无烟政策扩大到包括所有酒吧区域。引入更全面的户外无烟政策可以减少促进吸烟的设计属性的影响，同时将吸烟重新定义为正常的社交行为之外的行为。
酒吧环境包含许多提示和强化吸烟的刺激因素，并将吸烟融入社交体验中。扩大无烟酒吧场所，包括户外区域，将减少接触这些刺激因素的机会，减少随意吸烟的机会，有助于维持年轻人的无烟状态，并支持长期降低吸烟率的目标。
