Environmental Protection For the Non-Smoker: Consumer Behavior Aspects of Encouraging Non-Smoking

ABSTRACT - It is becoming more widely recognized that cigarette smoke is harmful to non-smokers, yet there has been very little study of the ways in which non-smokers can protect their environments from smoke. This paper reviews and recasts studies on cigarette smoking to bring their results to bear on the problem of non-smoker environmental protection. It also offers some ideas for both research and action.

Citation:

Lawrence H. Wortzel and Roberta Clarke (1978) ,"Environmental Protection For the Non-Smoker: Consumer Behavior Aspects of Encouraging Non-Smoking", in NA - Advances in Consumer Research Volume 05, eds. Kent Hunt, Ann Abor, MI : Association for Consumer Research, Pages: 521-524.

Advances in Consumer Research Volume 5, 1978      Pages 521-524

ENVIRONMENTAL PROTECTION FOR THE NON-SMOKER: CONSUMER BEHAVIOR ASPECTS OF ENCOURAGING NON-SMOKING

Lawrence H. Wortzel, Boston University

Roberta Clarke, Boston University

ABSTRACT -

It is becoming more widely recognized that cigarette smoke is harmful to non-smokers, yet there has been very little study of the ways in which non-smokers can protect their environments from smoke. This paper reviews and recasts studies on cigarette smoking to bring their results to bear on the problem of non-smoker environmental protection. It also offers some ideas for both research and action.

INTRODUCTION

The existing research and related literature on cigarette smoking can be broken down into three major categories. The first category, which makes up the bulk of the literature, details and seeks to prove the physical and health-related damage experienced by those individuals (and experimental animals) who smoke cigarettes. The second category of literature, somewhat less substantial in nature, directly addresses the smoke and those who would wish to influence the smoker not to smoke. This literature is concerned with the smoker's own good.

It is the third category, however, which this paper addresses. In this category is literature which seeks to educate the non-smoker about how to prevent the smoker from lighting up a cigarette in the non-smoker's presence for the non-smoker's good. There are, at present, few studies and little literature dealing with this topic. However, we believe that this category will soon become more actively studied for several reasons.

First, while it has long been widely accepted (at least on the cognitive if not the affective level) that cigarette smoking is harmful to the health of the smoker, only recently has it been recognized that smoking can also be deleterious to the health of the non-smoker who is in close proximity to smokers. Scientific evidence that cigarette (as well as pipe and cigar) smoke is harmful to the non-smokers who are exposed to it (U.S. P.H.S., 1972) points to such harmful effects as eye and nose irritation which is immediately apparent but transitory; children particularly are sensitive to these effects (Lugnette et al., 1970). Of a more lasting nature, however, is the possible increased probability of lung cancer and emphysema, neither of which is apparent to the non-smoker at the time of exposure. In fact, many non-smokers, unless they are specifically allergic to cigarette smoke, have probably been relatively unaware of the long term hazards of smoke from others' cigarettes.

However, this situation can be expected to change. There are significant efforts being made to inform nonsmokers of both the short and long term hazards of exposure to smoke. The American Lung Association, for example, publishes a pamphlet, Second Hand Smoke, the majority of which is devoted to explaining the dangers of smoke. This pamphlet also briefly suggests some defensive actions which non-smokers can take to protect their environments. Moreover, Action on Smoking and Health (ASH) offers bumper stickers, buttons and small message stickers which either promote non-smoking or request that the reader not smoke. GASP (Group Against Smokers' Pollution) of Massachusetts, another consumer activist anti-smoking, exists to publicize the hazards of sec-ond-hand smoke and to support legislation aimed at insuring non-smokers' rights.

The ultimate solution to the second hand smoke problem may be the enactment and vigorous enforcement of anti-smoking legislation. Indeed, significant progress has been made in this direction, with the establishment of "no smoking" sections in airplanes and (some) restaurants as well as "no smoking" regulations in some public places. But, in the short term, the smoker must still defend against smoke in many of the environments in which he or she finds himself or herself.

A second and related reason why we expect this area (the protection of the non-smoker's air rights) to become more heavily researched is that the growing emphasis on preventive health care has made us all more aware of personal health risks and more active in seeking to maintain our health. Why jog, for example, to fill our lungs with clean air and then breathe others' smoke?

As noted previously, whatever smoking-related health education literature there was existed primarily to educate the smoker to the dangers of smoking. This literature is essentially passivist with regard to whatever health risks smoking presented to the non-smoker. However, preventive health care education is now beginning to extend itself to educate the non-smoker in smoking-related preventive care; that is, how to prevent smokers from smoking near you. The growing activist stance in non-smoker preventive care is certain to have an effect upon future research in this area.

While there is not much literature directly on the topic of non-smoker environmental protection, there is a considerable body of literature, some of which has been reviewed, (Fishbein, 1977) which can be considered as having some relationship to this anti-smoking problem; however, the literature has never been examined from the non-smokers point of view. If the literature has been reviewed in any kind of action format, that format has been one aimed toward either encouraging non-smokers not to start or encouraging smokers to stop (permanently). The question here is a much more temporary one; it is concerned only with encouraging non-smoking for short or finite lengths of time in specific places. Thus, the primary emphasis is on identifying consumer behavioral reasons that are amenable to immediate attack.

This paper, therefore, deals with the short-run (non-legislative) problem of activist non-smoker environmental defense: how the non-smoker can defend whatever environment he or she is in and only for the length of time he or she happens to be in that environment. The paper relies upon consumer behavior analysis as a basis for selecting marketing tools and promotional context which can be effectively used to inhibit smokers in distinct situations.

The studies which have been reviewed fall into two broad areas: 1) internal cues: smoking and personality/social behavior characteristics, and 2) external cues: factors which trigger the smoker to light up a cigarette. Both areas will be discussed; included in the discussion are suggestions for strategies and tactics that might inhibit short term smoking. The format will be first to review the studies and then to suggest action strategies. This review will be in no sense exhaustive as the authors' own reasonably exhaustive review indicated a considerable degree of redundancy in the literature. Therefore, only a representative group of studies deemed to have actionably useful findings will be reported here.

In addition to the literature on psychosocial correlates of smoking, there is also a literature on physiological correlates. Some of this literature (Schachter, 1977) presents evidence that cigarette smoking produces physical dependency if not addiction. This literature will not be addressed here; while a recognition of the role that physiology plays may be significant in inducing an individual to stop smoking permanently, there is not any strong evidence that physical symptoms are so intense as to prevent smokers from postponing a smoke for a finite length of time. The review begins, therefore, with internal cues.

INTERNAL CUES: PERSONALITY AND SOCIAL BEHAVIOR CHARACTERISTICS

There have been quite a few studies covering the relationship between smoking and personality and various social behavior characteristics. None of these studies have demonstrated that any of the factors that were studied actually caused smoking; however, their presence may offer some clues to the non-smoker who wishes to take action.

Review of Studies

A number of studies examine the motivations for and correlates of smoking among adolescents, since many smokers begin smoking during adolescence.

Adolescents begin their smoking in a peer-group atmosphere which they perceive as accepting of smoking. In a national study including both smokers and non-smokers conducted in 1975 by Yankelovich, Skelly and White, over 80% of teenaged boys and girls said they usually think of teenagers as smokers, and 67% said they usually think of teachers as smokers. This indicates that teenagers believe smoking was an activity accepted by both their peers and their school authority figures. (U.S. Dept. of HEW, 1977). Perhaps the most insightful description of adolescents' motivations for smoking is offered by Neeman & Neeman, who comment:

It is possible that the act of smoking itself is, in part, a component of the communication process, namely an "emblem" or display: the blowing out of a plume of smoke has been likened to the display of a peacock's plumes, decoded as an emblem of status or dominance vis-a-vis peers of the same or opposite sex, communicating the smoker's toughness, independence, and a precocious type of sexual maturity, and conveying social acceptance and recognition. Smoking also provides a means of offering or accepting social contact. (Neeman & Neeman, 1975)

These comments are well supported and sex-differentiated by data from the survey conducted by Yankelovich et al., which was referred to earlier. This survey concluded that cigarette smoking among teenaged boys was associated with social uneasiness, the desire to be popular with girls and demonstrating one's masculinity. Girls, on the other hand, do not see smoking as a social asset, but rather as a sign of a rebellious independence, and a somewhat defiant social maturity. For example, a much larger proportion of teenaged girl smokers, as compared to non-smokers, said they drink alcohol and had had sexual relations (U.S. Dept. of HEW, 1977).

Studies have also been conducted among college students. Some of these studies have used general personality inventories to try and differentiate between smokers and non-smokers. Schubert gave the MMPI, along with measures of tobacco usage to two samples of college students, totaling 1270 respondents. His results were not consistent between the two samples when these results were analyzed in terms of traditional MMPI categories. There was no consistent personality differentiation between smokers and non-smokers. However, an item analysis did indicate some constant differences. Smokers' self-descriptions indicated they were more likely to be bored, impulsive and thrill-seeking, to behave in a socially unacceptable fashion, to ascribe this trait to others and to have masculine traits. These characteristics were described generally as arousal-seeking (Schubert, 1965).

These findings were both reinforced and extended by a later study using 517 male college students as subjects and the Boston University Personality Inventory as the instrument. Heavy smokers (as compared to non-smokers) were more impulsive, defiant and danger-seeking. These results also were reported as suggesting that smokers used smoking as a means of warding off manifest distress conditions such as tension, irritability and boredom (Jacobs & Spilken, 1971).

There is also some evidence that adult smokers have considered their behavior as deviant but not defiantly so. As early as 1966, 45% of all smokers (then currently smoking) interviewed in a National Survey agreed that "cigarettes are morally wrong." (Nuehring & Markle, 1974). During the years between 1966 and 1974, the authors argue, many smokers have become 'repentant deviants' (as opposed to the younger defiant deviant) who admit the reprehensibility of their actions and by doing so gain license to persist in smoking. But the more mature smoker has integrated smoking into his or her personality and/or into his or her psychomotor behavior. When one becomes an established, regular smoker, smoking becomes a means of telling others about oneself, but the acts associated with smoking become habitual and autonomic. Possibly, in fact, smoking becomes an idiosyncratic behavior akin to foot tapping, pencil twirling, nail biting and the like (Dunn, 1973).

Action Implications

These findings present some intriguing yet contradictory possibilities for action. However, if non-smokers are to take these actions, they would have to do so as a group as the action possibilities might best be defined as media advertising in public places. The content of this advertising could be communicated by individual non-smokers as well, but less successful results would be expected.

The opportunities for action in terms of "advertising" would differ between more experienced vs. newer smokers, especially if the newer smokers and teenagers or college students. Among more experienced smokers, the general tenor of messages should be (1) to emphasize that smoking in that particular place is deviant behavior and that the only way to repent is not to smoke and (2) to raise consciousness that one is smoking in that place if one does so, since smoking for some individuals is so habitual that they are at a conscious level momentarily unaware that they are smoking.

On the other hand, messages such as these should cause young, newer smokers, especially males, to light up a cigarette. These messages would reinforce deviant (smoking) behavior among this group since teen-aged male smokers are defiant deviates; moreover, raising consciousness about the act of smoking raises the importance of the situation as an opportunity to display one's masculinity or one's social maturity as the case may be. Therefore, it should be more effective instead for advertisements to portray smoking in such environments as unmasculine, socially immature and a sign of social weakness. Unfortunately, this type of advertising (which would probably be communicated in print through buttons, brochures, posters and youth newspapers, given the higher cost of broadcast media) is not likely to be very effective principally because of the importance of the peer group in guiding smoking behavior.

In summary, the studies of personality and social behavior characteristics suggest a possible line of attack for producing non-smoking behavior among experienced mature smokers but a considerably less attractive line of attack for younger, less experienced smokers. Since specific attitudes and behavior are usually better predictors of action than the generalities discussed in the above studies, it is possible that in the future more specific research could direct us toward more effective action.

EXTERNAL CUES: FACTORS THAT TRIGGER SMOKING AMONG SMOKERS

There have been several studies focusing on relationships between smoking and various external cues. First, we will examine those studies with indirect action implications, followed by studies that indicate action directly. This second section will also rely to some extent on non-academic literature and information provided by anti-smoking groups, as such material considerably broadens the action possibilities open to the non-smoker.

Review of Studies-with Indirect Action Implications

Shapiro et al., studied 750 smokers to determine what links, if any, existed between environmental events and "lighting up." They found that it was usual for smokers to smoke on specific occasions although these occasions varied across people. There were, however, some situations that were popular among all smokers. These were situations that were stressful, required concentration, or were relaxing (Shapiro, et al., 1977). In these situations, individual smokers originally began to smoke to reduce negative affect or to cope with an unpleasant or stressful situation. For others, smoking was initiated to experience or to increase the experience of positive affect, excitement, relaxation and enjoyment associated with the situation. Over time, however, what is experienced by the individual in many such situations is neither enhanced nor dampened by smoking, but instead the specific situation becomes a strong cue to smoke and the individual does so without becoming aware that he or she is doing so (Tomkins, 1966).

Herman, using eating behavior as an analogy, divided smoking cues into external (situational, such as other people smoking) and internal (deprivation of cigarettes). He conducted an experiment using approximately 100 college students as subjects in which internal and external cues were manipulated for both light and heavy smokers. He found that heavy smokers were affected primarily by internal cues (although they were not insensitive to external cues), while light smokers were affected by both internal and external cues.(Herman, 1974). It would seem fruitful to explore further the relationship between smoking and external cues since these are "mar-keter-controllable'' variables. There is further evidence that external cues are important in the situations with which we are concerned.

The nature of external cue situations may differ across social classes. Meyer et al. point out that many blue collar jobs, for example, prescribe or proscribe the amount of smoking that can take place during work. White collar workers, on the other hand, are usually free to smoke on the job (Meyer et al., 1973). Thus, blue collar workers may be exposed to many fewer external cues than are white-collar workers and therefore may be differentially (either more or less) sensitive to external cues. Thus, Herman might have had different results had he used blue collar workers instead of college students.

There has been some attempt to identify some of the specific situations providing external cues that trigger smoking. Hochbaum, early on, pointed out that smokers link smoking with entering a room where there are people or with seeing someone else smoke (Hochbaum, 1965). Foss reports on a study of 87 present and former smokers; both groups smoked primarily in social situations or social gatherings; 54% of present smokers and 79% of former smokers reported having done so (Foss, 1973). Both Hochbaum and Foss, however, say that the overt act is simply a manifestation or expression of some less apparent but deeper feeling such as anxiety or inadequacy.

In summary, while both internal and external cues influence smokers' behavior, much smoking is done in social situations in which external cues are present in abundance. These cues may serve to trigger smoking, for example, by reminding the smoker of the anxiety inherent in the situation. There is also evidence that people continue to smoke in situations that no longer produce affect, thus suggesting that cues can simply produce smoking behavior for no other reason than the presence of the cue.

Action Implications

With respect to external cues, essentially there are two smoker populations to be considered: those for whom smoking in a given situation produces affect and those for whom the situation is merely a cue, and no affect is produced. The action implications are different in each situation. Where affect is produced, the goal of action is to modify the affect, providing substitute sources of gratification or relieving anxiety as indicated. Where there is no affect present, it would seem that the goal of action is simply to make the smoker aware that he or she is smoking for no particular reason.

The action problem is more difficult when the smoker is motivated primarily by affective cues. Perhaps, the best that can be done is for the non-smoker to recognize the motivation and simply ask for delay.

REVIEW OF STUDIES THAT INDICATE ACTION DIRECTLY

This section of the paper departs slightly from the previous format in that action ramifications will be discussed with the studies or will be suggested independent of experimental data. Non-verbal action possibilities will be discussed first followed by direct verbal communication strategies.

Two relevant studies deal with behavior under the presence or absence of specific external cues, essentially suggesting non-verbal active strategies. These two will be reviewed first.

One such study found that women (but not men) were more likely to smoke when in proximity to others who were smoking (Tryon et al., 1977). The other concerned college students' smoking in a classroom without ash trays. Students refrained from smoking either because of fear of criticism from the instructor or because of guilt about dropping ashes on the floor (Ritter & Holmes, 1969).

These two studies suggest some specific actions. The first study suggests that the non-smoker probably needs to keep as much territory as possible around him or her smoker free; if a woman is more likely to smoke when in proximity to other smokers, she may want to do so when juxtaposed between the non-smoker and a group of smokers. Obviously, this also suggests segregating all smokers from the non-smoker rather than intermingling smokers and non-smokers. The second study, besides indicating the obvious strategy of ash tray removal, argues that in the non-smoker's own environment, placing an expensive-looking rug where visitors sit could silently inhibit others from smoking (but at some risk).

Commercial programs which help smokers to stop smoking also want to protect their successful graduates from having to deal with smokers. Their recommendations for non-verbal action included not only the removal of ashtrays and matches, but also the wearing of anti-smoking buttons (which they point out may label the button wearer as a fanatic or "nudnik" but are also to some extent successful in temporarily postponing smoking behavior). The balance of the studies to be reviewed deal with specific communication content of various types, each of which suggests some possibility for action.

Horn & Waingrow have proposed using mastery as a motivation to get people to stop smoking. They argue that, for some people, inability to keep control of themselves is more frightening than the health hazards attached to smoking. Thus, presenting smoking as out-of-control behavior may motivate some smokers to give it up (Horn & Waingrow, 1966). Such a strategy might be dubious over the long-term, but for short periods of time could be an extremely effective bit of personal selling. The non-smoker could ask the smoker, "are you so out-of-control that you have to smoke right now?"

Another stop-smoking motivation might be humiliation. Premack posits that it's acutely humiliating to be identified as belonging to an interdicted class (Premack, 1970). To the extent that smokers view themselves as deviants and are really contrite about their position, it can be speculated a humiliating message might work, "Gee, I didn't think anyone in your position would smoke...". However, the success of such a message might depend also on the relative status of the smoker and the non-smoker.

Anti-smoking consumer groups and smoke-ending programs have developed a grocery list of actions which nonsmokers might take to protect themselves from second hand smoke. However, some of these groups take pains to point out that non-smokers must first believe they have the right to take these actions against smokers before they will do so. Therefore, the groups believe the first step is to educate the non-smoker as to his or her rights. This has been done by (1) indicating to the non-smoker that smokers are now a minority (46%) of the U.S. population, in a country of majority rule and (2) educating the non-smoker to the dangers he or she may be inflicting on him or herself by breathing second hand smoke. Second hand smoke contains such poisonous substances as ammonia, benzene, carbon monoxide and hydrogen cyanide. The anti-smoking groups' contention is that if the non-smoker recognizes the risks of breathing second hand smoke, he or she is more likely to take an activist stance in attempting to prevent smoking in her or his immediate area.

These groups have also raised the question of whether non-smokers as a group should also attempt to educate smokers about the dangers of second hand smoke. Ail communications from non-smoker to smoker all likely to be more effective if the smoker is able to appreciate the physical and psychological irritation which smoke causes to the non-smoker.

The communications suggested by anti-smoking groups which a non-smoker may use to temporarily prevent nearby smoking tend to fall into three categories: courtesy, empathy and medical. Courtesy communications such as "Please don't smoke," or "Could you wait until we are off the elevator before you smoke" are viewed as sometimes effective but also sometimes hostility-arousing as the smoker may believe this his/her rights are being trodden on.

The empathy communication, which tends to be a good deal more personal, is best used by a previous smoker who has stopped smoking permanently (or by a non-smoker who is willing to lie). The message is basically "Please don't smoke right now. I am a former smoker and being so close to someone who is smoking makes me extremely uncomfortable (makes me feel like smoking, makes me anxious, etc.) If you could just wait until I'm gone..."

However, the literature of the anti-smoking groups seems to favor the medical communication which clearly indicates a negative physical effect suffered by the nonsmoker due to the smoker's smoke. Complaints of eye and nose irritation or of general allergic reactions to smoke may produce the desired results. However, the stronger the medical complaint, the greater the likelihood of no-smoking behavior, according to the anti-smoking groups. Thus, complaints of emphysema and asthma by the nonsmoker to the smoker appear to be the most effective in postponing smoking behavior.

Finally, if all else fails, one may look to Powell and Axrin. They studied the effect of electric shock on cigarette smoking; they found that the effects of shock worked in the short run, as the number of cigarettes a smoker in this experiment smoked were a function of the intensity of the electric shocks he received (Powell & Axrin, 1968). Perhaps, as a last resort, timid nonsmokers should install electric chairs in their offices.

Conclusions

Modifying smokers' behavior, even for short periods of time, is a rather complex process and one that should be tailored both to the situation and to the smoker. It appears that group action on the part of non-smokers is likely to be effective only in the short-run. Soon, for example, if individual non-smoker action increases, smokers might start carrying their own ashtrays; moreover, their willingness to believe that the coughing non-smoker next to them has emphysema will decline as the number of self-proclaimed emphysemics increases.

In any event, there are significant opportunities to do research on the subject.

REFERENCES

W. L. Dunn, "Methods and Models Applied to Motivation in Cigarette Smoking," in Dunn, W. L., ed., Smoking Behavior: Motives and Incentives, V. H. Winston & Sons, Washington, D.C., 1973.

Martin Fishbein, Consumer Beliefs and Behavior with Respect to Cigarette Smoking: A Critical Analysis of the Public Literature, unpublished report prepared for the staff of the Federal Trade Commission, May 1977.

Robert Foss, "Personality, Social Influences and Cigarette Smoking," Journal of Health and Social Behavior, 14(September 1973), 279-286.

C. Peter Herman, "External and Internal Cues as Determinants of the Smoking Behavior of Light and Heavy Smokers," Journal of Personality and Social Psychology, 1974, Vol. 30, No. 5, pp. 664-672.

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