CIGARETTE SMOKING, HEALTH, AND DISSONANCE (PROJECT LIBRA) II: TOP-LINE ANALYSIS REPORT NO. RD.1697-C 18.10.1979 AUTHOR: M. Oldman ISSUED BY: D.J. Wood PROG. REF.: 13.02.05 DISTRIBUTION: Dr. L.C.F. Blackman Copy No. 1, 2, 3, 4, 5 Dr. I.W. Hughes 6 Dr. R.A. Sanford 7, 8 R.M. Gibb, Esq. 9 R.S. Wade, Esq. 10, 11, 12 R.G. Nicholls, Esq. 13, 14 Herr E. Rittershaus 15 Dr. F. Seehofer 16 Mr. A.J. Kruszynski 17 Dr. C.J.P. de Siqueira 18 Dr. D.G. Felton 19 Library 20, 21 COPY NO.: c0 110 C:D BATCo document for Province of BritiSh Columbia 29 October 1999 BATCo document for Province of British Columbia 29 October 1999 Group Research & Development Centre, British-American Tobacco Co. Ltd., SOUTHAMPTON. MO/CAL/46J 18th October 1979. CIGARETTE SMOKING, HEALTH, AND DISSONANCE (PROJECT LIBRA): II: TOP-LINE ANALYSIS (Report No. RD.1697-C) SUMMARY A comprE~iensive presentation of the responses given by 2018 respondents t_- the Project LIBRA questionnaire is made. Smokers are differentiated according to the degree of consonance /dissonance admitted to and recent and established ex-smokers are distinguished. The data support the conclusion that within the smoker category, the intention to quit and the past history of attempts to do so are influential ;_2 determining an individual's disposition to smoking and health issues and to attitudes and behaviours related to health in general. WhiLst the present level of analysis does not allow firm conclusions ti be reached, subsequent treatment of the data will be aimed at more precisely differentiating between and within the sub- classifications of smokers and ex-smokers adopted here. CC) BATCo document for Province of BritiSh Columbia 29 October 1999 I . I-I' CD I -I I ~-p co \-C CIN I- Q1-j BATCo document for Province of British Columbia 29 October 1999 CONTENTS Page INTRODUCTION Questionnaire Administration 2 Data Analysis 4 Demographic Analysis 6 ATTITUDES TO HEALTH Visits to Doctor 10 Beliefs About Own Health 12 Use of Drugs 23 THE SMOKER Smoking Behaviour 30 Smoking Motivation 38 Attempts to Quit 61 Attitudes to Smoking and Health 76 Social Acceptability of Smoking 90 IV. THE EX-SMOKER Previous Smoking Behaviour 95 Previous Smoking Motivation 102 Quitting Behaviour 117 Attitudes to Smoking and Health 127 Social Acceptability of Smoking 133 V. SMOKING AND HEALTH CONCERN Substances in Cigarettes 136 Effects of Smoking on Health 142 VI. CONCLUSION 155 REFERENCES 157 CC) Z!, BATCo document for Province of British Columbia 29 October 1999 C:D Q-71 (-n co ON (-M BATCo document for Province of British Columbia 29 October 1999 I. INTRODUCTION This report is a commentary on an initial inspection of the Project LIBRA data and is based upon the set of computer generated tabulations supplied by England, Grosse and Associates Limited. Detailed analysis, including sub-group profiling and factor analytic studies, and consideration of the psychographic data, will be presented in subsequent reports. The presentation which follows is based upon the top-line analysis only and should be regarded as a preliminary examination rather. than a definitive interpretation of the LIBRA data. Following discussions with E.G.A. Ltd. , it was decided that, rather than setting the top-line sorts on the traditional demographic bases, the majority of the classifications would be derived from categories pertinent to the overall objectives of the study. Thus, the principal categories used for analysis at this stage included, for smokers, degree of consonance/dissonance; for ex-smokers, recent and more established ex-smokers are differentiated. Questionnaire Administration Details of the questionnaire content and structure were described in an earlier report (1). The target quotas for Project LIBRA were derived from the recent Operation AQUARIUS (2) and a comparison of the target with the achieved sample distributions is shown in Table 1. Interviewing was conducted in 100 sampling points spread throughout the U.K. and selected on a representative basis proportional to the population. 0 _1 ON BATCo document for Province of British Columbia 29 October 1999 TABLE I QUOTA AND TARGET COMPARISON Current Smokers of Manufactured Cigarettes Target Achieved Total 740 746 by Sex M.ale 48 47 F e---ia I e 52 53 Z by Age 16-44 Years 52 54 43-75 Years 48 46 X by Class A, B, Cl 29 30 C2 38 37 D ,E 33 33 Ex-Smokers of Manufactured Cigarettes Target Achieved 520 525 Male Female T A T A 65 65 35 35 33 35 41 42 67 65 59 58 41 41 34 34 25 25 Never Smokers of Manufactured Cigarettes Target Achieved 740 747 Male Female T A T A 36 36 64 64 65 64 49 51 35 36 51 49 42 41 32 32 26 27 BATCo document for Province of British Columbia 29 October 1999 The length of interview varied by sub-group but respondents qualifying for the longer interview (current and ex-smokers of manufactured cigarettes) were given a voucher to the value of E1.10 as an incentive. In the event, 77% of current smokers completed within 60 minutes, compared with 83% of ex-smokers and 92% of never smokers. Data Analysis For the first part of this report, attention is focussed on differences between smokers, ex-smokers and never smokers and, within the ex-smokers, according to the length of time they had been an ex-smoker. Smokers were assigned to one of four categories according to their degree of consonance/dissonance as defined by their responses to two questions: Have you ever tried t 0 to give up smoking manufactured cigarettes altogether? How seriously would you like to give up smoking manufactured cigarettes altogether? (Show card) I I NOT VERY FAIRLY SERIOUSLY/ SERIOUSLY/ VERY SERIOUSLY NOT AT ALL SERIOUSLY I HIGHLY CONSONANT DISSONANT YES How seriously would you like to give up smoking manufactured cigarettes altogether? (Show card) I I NOT VERY FAIRLY SERIOUSLY/ SERIOUSLY/ VERY SERIOUSLY NOT AT ALL SERIOUSLY I CONSONANT DISSONANT It should be noted that degree of consonance/dissonance thus defined is not the same as that used in Operation AQUARIUS. The primary top-line.categories are described in Table 2. CC) \-0 c0 BATCo document for Province of BritiSh Columbia 29 October 1999 xx ~ V I C----) (-rl (-n co 011 1-0 BATCo document for Province of British Columbia 29 October 1999 TABLE 2 PRIMARY TOP-LINE CATEGORIES Number Description Abbreviation 1. TOTAL SAMPLE TOT 2. SMOKERS OF PACKETED CIGARETTES SMO Degree of Consonance/Dissonance 3. Highly consonant - have not tried to give up smoking cigarettes, nor seriously want to. HIC 4. Consonant -have tried to give up smoking cigarettes, but do not seriously want to. CON 5. Dissonant -have not tried to give up smoking cigarettes, but seriously want to. DIS 6. Highly dissonant - have tried to give up smoking cigarettes, and seriously want to. HID 7. EX-SMOKERS OF PACKETED CIGARETTES EXS When Quit Smoking Packeted Cigarettes 8. Up to two years. <2Y 9. Over two years ago. >2Y 10. NEVER SMOKERS OF PACKETED CIGARETTES NEV 00 BATCO document for Province of BritiSh ColUrnbia 29 October 1999 C=) (-n (-n CC) 1 ~0 CDIN (-.n r,-) BATCo document for Province of British Columbia 29 October 1999 Demographic Analysis The distribution of the total sample according to the ten primary top-line categories is shown in Table 3 which also records the distributions according to sex, age and socioeconomic class. Segmenting the market according to degree of consonance/dissonance yields a difference in the present data compared with the Operation AQUARIUS results: AQUARIUS LIBRA (7.) M Highly Consonant 20 21 Consonant 16 29 Dissonant 13 8 Highly Dissonant 50 43 The difference is probably due in most part to the changed wording of the second differentiating question which, in the case of AQUARIUS, was: "Would you like to give up smoking altogether if you could do so easily?" The stability of the highly consonant segment and the apparent drift from the two dissonant groups towards the consonant category support our contention that the present definition is more realistic. Highly dissonant smokers tend to be younger, being most represented in the 25 to 34 year age band, whereas highly consonant smokers are most likely to be aged between 45 and 54 years. A greater proportion of ex-smokers and never smokers than current smokers are to be found in classes A and B. co \..0 BATCo document for Province of British Columbia 29 October 1999 TABLE 3 BASIC CLASSIFICATION (BY SEX, AGE, SOCIOECONOMIC CLASS) ALL SMOKERS EX-SMOKERS NEVER SMOKERS CONSONANCE/DISSONANCE WHEN QUIT TOT SMO HIC CON DIS HID EXS <2Y >2Y NEV TOTAL 2018 746 154 213 56 323 525 150 371 747 As Z of Total 100 37.0 7.6 10.5 2.8 16.0 26.0 7.4 18.4 37.0 As % of Class - 100 20.6 28.6 7.5 43.3 100 28.6 70.7 100 Z BY SEX Male 48 47 45 55 39 45 65 59 67 36 Female 52 53 55 45 61 55 35 41 33 64 : BY AGE 16-24 14 14 16 13 7 15 6 12 4 19 25-34 21 22 9 23 16 28 17 24 15 22 35-44 16 18 16 19 20 18 14 17 13 14 45-54 19 18 23 15 23 17 23 19 24 17 35-64 15 15 18 13 23 14 20 19 20 11 65+ 16 13 19 17 11 8 20 9 24 16 BY S.E. CLASS A, B 11 6 6 4 9 8 13 15 12 15 Cl 26 24 25 25 18 23 28 31 27 26 C2 35 37 36 35 39 38 34 28 37 33 D, E 28 33 32 36 34 31 25 25 24 27 CZ) c0 110 011 BATCo document for Province of British Columbia 29 October 1999 Further demographic data, in respect of marital status and age finished full time education, is presented in Table 4. Proportionally, more highly dissonant smokers are married and less are single. The influence of family pressure on motivation to quit will be discussed later, but the progression from highly consonant through highly dissonant to ex-smoker in respect of percent married is worth noting. CD CC) \~o ON BATCo document for Province of BritiSh Columbia 29 October 1999 J. ci> Q~Fi (-n CC) \_0 C7 \ (-M CC) BATCo document for Province of British Columbia 29 October 1999 TABLE 4 BASIC CLASSIFICATION (BY MARITAL STATUS, A.F.F.T.E.*) NEVER ALL SMOKERS EX -SMOKERS SMOKERS CONSONANCE/D ISSONANCE WF--N QUIT TOT SMO HIC CON DIS HID EXS <2Y >2Y NEV TOTAL 2018 746 154 213 56 323 525 150 371 747 As % of Total 100 37.0 7.6 10.5 2.8 16.0 26.0 7.4 18.4 37.0 As % of Class - 100 20.6 28.6 7.5 43.3 100 28.6 70.7 100 ',Y MARITAL STATUS Married 75 76 69 74 79 80 82 74 86 70 Single 13 11 14 12 13 8 7 12 4 19 Wid./Sep./Div. 12 14 17 14 9 12 11 14 10 11 % BY A.F.F.T.E.* 13-14 Years 33 33 41 34 45 26 38 31 40 30 15 Years 31 33 28 34 23 36 32 34 31 28 16 Years 20 20 22 19 18 20 18 20 17 21 17+ Years 16 15 9 12 15 19 12 16 12 20 *A.F.F.T .E. - Age Finished Full Time Educa tion. LJI (-r1 co \-0 BATCo document for Province of British Columbia 29 October 1999 _10- II. ATTITUDES TO HEALTH The first section of the questionnaire to be discussed comprised items designed to gauge individuals' general attitudes to health. The same questions were asked of all respondents and before any mention of health related to smoking. Visits to Doctor Respondents were asked about the number of times during the preceding twelve months they had visited their doctor with an ailment. Sixty-five percent of all smokers had made at least one such visit and within the sub-classification of smokers, a trend is apparent (Figure la). It would appear that the highly dissonant smoker is most likely to have visited his doctor, and the highly consonant least likely. The ex-smoker, particularly the recent ex-smoker, has the highest average number of visits. When questioned about the reasons for visiting the doctor, only 2% of all respondents refused to give information. Mentions of " chest/ bronchitis/bad chest/pleurisy" (Figure 1b) were highest for the highly dissonant smoker. The relatively high percentage of similar mentions by ex-smokers appears to be unrelated to the length of time since quitting. The dissonant smoker seems to be more susceptible to sore throats (Figure 1c) than any other group. Mentions of "angina/heart" were made by only 3% of never smokers, 4% of smokers and 5% of ex-smokers. "Depression/nervous trouble/nervous tension" was reported by 4% of never smokers, 6% of ex-smokers and 7% of smokers. In response to the question: "How many times have you been in hospital during the past five years?"no clearly apparent differences between the primary groups emerged. Ln c0 1 _0 0 N 0111 CZD BATCo document for Province of BritiSh Columbia 29 October 1999 KEY HIC. = HIGHLY CONSONANT CON.= CONSONANT SMOKERS 015. = DISSONANT HID. = HIGHLY DIS50NANT E XS. = EX- SMOKERS (< 2 yr. LEFT.> 2 yr RIGHT) NEV. = NEVER SMOKERS 0 FIGURE 1b 20 0 MENTIONS OF CHEST/ . BRONCHITIS/BAD CHEST/ - PLEURISY 15- 10- 5- 0 HIC CON DIS HID EXS NEV FIGURE la 0 ;Y. 'Do- MADE AT LEAST ONE VISIT TO 90- DOCTOR IN LAST 12 MONTHS 80- 70- 60- 50- 40- 30- 20- 10. 0 HIC CON 015 HID EXS NEV 0 FIGURE 1c 20 MENTIONS OF SORE THROAT 15- 10- 0 HIC CON DIS HID EXS NEV co ON BATCo document for Province of British Columbia 29 October 1999 x L QIn Q-n co CrN ON r,,-) BATCo document for Province of British Columbia 29 October 1999 -12- Beliefs About Own Health There followed a series of statements for which respondents were required to indicate their agreement/disagreement by selecting from one of the following five responses: STRONGLY AGREE AGREE NEITHER AGREE NOR DISAGREE DISAGREE DISAGREE STRONGLY The statements were presented in the following order: "I consider myself to be a very healthy person" "I eat more than I should" "I am in very good physical condition" "I exercise regularly" "I eat more sweets than I should" "I am careful to eat a balanced diet" "I think about my physical condition a lot" "There is too much fuss about what one should and should not eat" "I am overweight" "I get out of breath easily" "I often feel tense" "I am very health conscious" "I am very weight conscious" "I am generally a very relaxed person" In Figures 2a-2n the percentage of each group who responded strongly agree or agree is represented. BATCo document for Province of British Columbia 29 October 1999 A/ ~I C (. ejo- ( I % :,'. f - , - '. " , CD U-I (-.n cc 110 CN ON XI' BATCo document for Province of British Columbia 29 October 1999 (-rl (-rI co 1-0 ON G-1 Q-n BATCo document for Province of British Columbia 29 October 1999 FIGURE 2a '00 "1 CONSIDER MYSELF TO BE go- A VERY HEALTHY PERSON" 80- 70- 60- 50- 40- 30- 20- 10- 0 HIC CON DIS HID EX5 NEV -13- FIGURE 2 b I THINK ABOUT MY PHYSICAL CONDITION A I-Of HIC CON DIS HID EX5 NEV (:D Q.ii (-n co \-0 Cr\ 011 Cr\ BATCo document for Province of British Columbia 29 October 1999 -13- FIGURE 2a FIGURE 2 b "0 "1 CONSIDER MYSELF TO BE I THINK ABOUT MY go- A VERY HEALTHY PERSON" PHYSICAL CONDITION A I-Oi 80- 70- 60- 50- 40- 30- 20- 10- 0 HIC CON 015 HID EX5 NEV HIC CON DIS HID EX5 NEV Belief in themselves as healthy persons is most exemplified by highly consonant smokers and those who have never smoked (Figure 2a). The overall high level of agreement with this statement is perhaps a little surprising but the relatively low level of agreement in the dissonant and highly dissonant groups is consistent with expectation. Similarly, it is reasonable to find the highly dissonant smokers most likely to think about their physical condition a lot (Figure 2b). There appears to be an almost reciprocal relationship between the responses given to these two statements with the highly dissonant smoker least absorbed in introspection. cz:) co 1 ~0 BATCo document for Province of BritiSh Columbia 29 October 1999 -14- FIGURE 2c 100 0/0 '~ AM IN VERY GOOD go- PHYSICAL CONDITIOq 80- 70- 60- 50- 40- 30- 20- 10- 0 HIC CON 015 HID EXS NF-11 FIGURE 2d EXERCISE REGULARLi HIC CON DIS HID EX5 NEY The statement regarding physical condition (Figure 2c) yielded a similar U-shaped pattern of responses to that seen in Figure 2a, although the proportions of each group agreeing are smaller. The highly consonant smoker is most likely to believe that he is in good physical condition and the dissonant smoker least likely. Length of time since quitting marginally differentiates within the ex-smoker category in the expected direction. Responses to the statement regarding exercise (Figure 20) seem to be correlated with those regarding physical condition. Less than fifty percent of the overall sample agreed with this statement. CX:) I'D GN BATCo document for Province of British Columbia 29 October 1999 iI Q,71 Un CC) \.0 01, --j BATCo document for Province of British Columbia 29 October 1999 -15- % FIGURE 2 e FIGURE 2f 100- AM VERY HEALTH CONSCK)U~ AM VERY WEIGHT CON5CUZ 90- 80- 70" 6 o- so- 40- 30- 20- 10. 0 HIC CON DIS HID EX5 NEV HIC CON DIS HID EX5 NEY co BATCo document for Province of British Columbia 29 October 1999 0 FIGURE 2 e FIGURE 2f X. - 1. 11 '0 0 AM VERY HEALTH CONSCIOU~ I AM VERY WE!GHT CONSCIOUS 90- 80- 70- 60- 50-- 40- 30- 20- 10- 0 HIC C'~*i D15 HID EXS NEV HIC CON DIS HIC EXS NEV Ex-smok.-:rs are the most heal th-cons c ious group (Figure 2e). Eighly consonant suckers and highly dissonant smokers are similarly represenced with the cor-:-onant smokers least health conscious. Overall, 31% of smokers agrE--d with this statement (cf. 41% all ex-smokers and 37: never smoke7s). Weight zonsciousness (Figure 2f) distinguishes between the two dissonant a=:- the two consonant groups, the former aligning with t---e non-smoker g--oups. Established ex-smokers (>2 years) are proport-;Znately the most we;-zht conscious. (_n co BATCo document for Province of British Columbia 29 October 1999 16- o/ FIGURE 2 g 0 100 - I AM OVERWEIGHi 90- 80- 70- 60- 50- 40- 30- 20- 10- 0 HIC CON DIS HID EXS NEV FIGURE 2h I EAT MORE THAN I SHOULD" HIC CON DIS HID EX5 NEV C;0 110 CD-1 BATCo document for Province of British Columbia 29 October 1999 -16- 100 0/0 FIGURE 2g I AM OVERWEIGHi 90- 80 - 70- 60- 50- 40- 30- 20- 10- 0 HIC CON DIS HID EX5 NEV FIGURE 2h EAT MORE THAN I SHOULD" HIC CON DIS HID EXS NEV The highly consonant smoker is the least likely to be - or at least admit to being - overweight (Figure 2g). Conversely, ex-smokers are most likely to agree with this statement. A disparity between responses to "I am very weight conscious" (Figure 2f) and "I am overweight" is evident for both highly consonant and consonant smokers, particularly the latter. Recent ex-smokers are most likely to admit to eating more than they should (Figure 2h). Consonant and highly dissonant smokers and never smokers appear to be differentiated from the other two smoker groups. 00 BATCo document for Province of BritiSh Columbia 29 October 1999 5 z QJ-1 U-I co I'D CN -,j U-I BATCo document for Province of British Columbia 29 October 1999 FIGURE 2 i 0 100 Y. I AM CAREFUL TO EAT 90- A BALANCED DlEf 80. 70 60- 50- 40- 30- 20- 10" 0 HIC CON DIS HID EXS NEV FIGURE 2j - I EAT MORE SWEETS THAN I SHOULD" HIC CON DIS HID EXS NEV CZ) U-I (-n c0 CrIN ----j CrI, BATCo document for Province of British Columbia 29 October 1999 -17- 100 0/0 FIGURE 2 i FIGURE 2j I AM CAREFUL TO EAT I EAT MORE SWEETS 90- A BALANCED. DIED' THAN I SH.OUL6' so- 70- 60- 50 - 40- 30- 20 - 10- 0 HIC CON DIS HID EXS NEV HIC CON DIS HID EXS NEY Care in eating a balanced diet distinguishes between dissonant smokers, ex-smokers and never smokers and the two consonant groups and the highly dissonant smoker (Figure 2i). The position of the dissonant group in this regard is reinforced by reference to Figure 2j where this group is seen to be least likely to eat more sweets than they should. Recent and more established ex-smokers are clearly differentiated by this statement with over-consumption being most prevalent amongst those who have quit within the past two years. Excessive sweet consumption is more prevalent amongst never smokers than amongst current smokers. Un c0 110 cr\ ---_j CC) BATCo document for Province of British Columbia 29 October 1999 0 FIGURE 2k 1130 THERE IS TOO MUCH FUSS 90- ABOUT WHAT ONE SHOULD AND SHOULD NOT EAT" 80- 70- 60- 50- FIGURE 21. I GET OUT OF BREATH EASIL~ 40- 30- 20 - 10- 0 HIC CON DIS HID EXS NEV HIC CON DIS HID EX5 NEV CD c0 \j-, t7 \ BATCo document for Province of British Columbia 29 October 1999 -18- 0 Y FIGURE 2k 10 100 THERE IS TOO MUCH FUSS 90- ABOUT WHAT. ONE SHOULD AND SHOULD NOT EAT" so- 70- 60- 50- 40- 30- 20 - 10- 0 HIC CON DIS HID EXS NEV FIGURE 2L I GET OUT OF BREATH EASILY HIC CON DIS HID EX5 NEV There is almost uniform agreement that there is too much fuss about what one should and should not eat (Figure 2k) with only recent ex-smokers and never smokers being slightly less likely to agree with the statement. The highly dissonant smoker is most likely to get out of breath easily and the never smoker least (Figure 2t). Time since quitting appears to differentiate slightly within the ex-smoker category and in the direction which might be expected. The highly consonant smoker is again distinguished from other smokers in this regard. co BATCo document for Province of British Columbia 29 October 1999 0 FIGURE 2m 1/0 '00- 1 OFTEN FEEL TENSE 90- 80- 70- 60- 50- 40- 30- 20- 10- 0 HIC CON DIS HID EX5 NEV FIGURE 2n 0/0.. I AM GENERALLY A VERY RELAXED PERSON" HIC CON DIS HID EX5 NEV co ,-~D cr\ CXD BATCo document for Province of British Columbia 29 October 1999 -19- FIGURE 2 m "'o I OFTEN FEEL TENSE" 90- 80- 70- 60- 50- 40- 30- 2 0 10- 0 HIC CO~ DIS HID EX5 NEV 0%. FIGURE 2n I AM GENERALLY A VERY - RELAXED PERSON" HIC CON DIS HID EX5 NEV Figures 2m and 2n relate the data concerning the two statements referring to tenseness/relaxation. It is not surprising, perhaps, that the highly dissonant smoker is most prone to frequent feelings of tenseness and least likely to agree to being a (generally) very relaxed person. Length of time since quitting again distinguishes marginally between recent and established ex-smokers in both cases. It is interesting to note the claim of highly consonant smokers and consonant smokers to being the most "relaxed" groupsi although the latter category departs from the highly consonant group in relation to feeling tense. co 011 co BATCo document for Province of British Columbia 29 October 1999 -20- Simmarising the results from this battery of items, several clear differences between the seven defined groups can be identified. In a number of respects the differences within the smoker sample are more noteworthy than those between all smokers as a group and the two categories of non-smoker. Considering first gross differences between all smokers, all ex-smokers, and never smokers (Table 5), it can be seen that for several items an apparent increase in percentage agreeing runs from smoker through ex-smoker to never smoker, (statements A, C and D). For other items, the progression runs in the opposite direction (H, J and K) . Ex-smokers yield the highest level of agreement on seven items (B, F, G, I, L, M, and N) and the lowest level on statement E (N.B., however, that 36% of recent ex-smokers and 20% of established ex-smokers have been averaged to yield this low level). At this level of analysis, it would appear that: 1. Smokers, more than the other two groups, believe that there is too much fuss made about what one should and should not eat, get out of breath more easily and most often feel tense. 2. Never smokers, more than the other two groups, consider themselves to be very healthy persons, believe that they are in very good physical condition, and are more likely to exercise regularly. 3. Ex-smokers fall midway between smokers and never smokers in respect of the statements referred to above. In additionv more than the other two groups they eat more than they should, are more likely to be overweight but are nevertheless careful to eat a balanced diet. They think about their physical condition a lot and are more health conscious than the other two groups. They are the most weight conscious but are generally very relaxed persons. cc \~O ON CC) (-M BATCo document for Province of British Columbia 29 October 1999 A, ~., C X on -I CD r-n co I'D CrN co C", BATCo document for Province of British Columbia 29 October 1999 TABLE 5 SL--MARY OF RESPONSES GIVEN TO GENERAL HEALTH ITEMS SMO EXS NEV M M M A. I cousider myself to be a very healthy persan. 67 70 76 B. I eat more than I should. 40 48 45 C. I am in very good physical condition. 53 55 59 D. I exercise regularly. 39 46 48 E. I eat more sweets than I should. 25 24 29 F. I am careful to eat a balanced diet. 40 54 52 G. I think about my physical condition a lot. 47 49 45 H. There is too much fuss made about what one should and should not eat. 67 65 61 I . I am overweight. 35 45 38 J. I get out of breath easily. 34 26 20 K. I of:en feel tense. 46 39 37 L. I am very health conscious. 31 41 37 M. I am very weight conscious. 34 45 41 N. I am generally a very relaxed person. 63 67 62 C=) 0-- BATCo document for Province of British Columbia 29 October 1999 (-rl (-n c0 110 ON c0 CC) BATCo document for Province of British Columbia 29 October 1999 -22- The closer examination of the smoker group according to degree of consonanceldis3onance (Figures 2a-2n) reveals ~the following: 1. The 'aighly consonant smoker, relative to other smoker groups, is nost likely to consider himself a very healthy person but leas: likely to think about his physical condition a lot. He is most likely to believe that he is in very good physical con,iition and most likely to exercise regularly. He is the most healtb conscious, least likely to be overweight and least likeLy to eat more than he should, although he shares with the higl--:y dissonant smoker a tendency to eat more sweets than he should. He is the least likely to get out of breath easily, to oftEz- feel tense and is generally a very relaxed person. 2. The :onsonant smoker is distinguished by being the least heal:h conscious and least weight conscious - despite tending to overweight and admitting to eating more than he s~iould. 3. The 4issonant smoker is least likely to consider himself to te a very healthy person and is the most weight conscious. More dissonant smokers admit to being overweight although, like the highly consonant smoker, do not tend to eat more thaz they should. They are most careful to eat a balanced diet and the least likely to eat more sweets than they should. 4. The ---ighly dissonant smoker is the one most likely to think abou: his physical condition a lot and to eat more than he shou:d, although he is least careful to eat a balanced diet. More than any other smoker group, he gets out of breath easily, often feels tense and is least likely to be a very relaxed person. Ex-smokers who have quit within the past two years arep relative to ex-smokers :f longer standing, less likely to feel themselves to be in very good p'--ysical condition, less likely to exercise regularly, less health comscious, less weight conscious, more likely to eat more than they should and less careful to eat a balanced diet. They are particularly p7one to eating more sweets than they should and are less likely to beliEve that there is too much fuss made about what one should and should not Pat. Recent ex-smokers are more likely to get out of breath easily and more often feel tense. Established ex-smokers are generally more relaxed. CO 011 CO \-O BATCo document for Province of BritiSh Columbia 29 October 1999 Use of Drugs A further section of items within the general health battery sought information on respondents' use of drugs, including caffeine and alcohol. For each of four common ailments (headache, cold, sore throat, indigestion) respondents were asked whether they always/usually/sometimes/rarely/never take some medicine or a tablet. The percentages of the primar-Y groups 'ho reported never suffering from these ailments are recorded in Table 6. TABLE 6 PERCENTAGE NEVER SUFFERING FOUR COMMON AILMENTS ALL SMOKERS EX-SMOKERS NEVER SMOKERS CONSONANCE/DISSONANCE WHEN QUIT TOT SMO HIC CON DIS HID EXS <2Y >2Y NEV HEADACHE 10 9 10 13 9 7 12 8 13 10 COLD 3 3 3 2 - 4 2 2 2 4 SORE THROAT 13 12 14 10 7 13 17 15 17 12 INDIGESTION 43 40 44 38 29 43 39 40 39 48 co 011 BATCo document for Province of British Columbia 29 October 1999 'A/ ~J,j it L C, I x / f, 1. 1 \1 Uri Un co ON 1-0 Nj BATCo document for Province of British Columbia 29 October 1999 0 / FIGURE 3a . luu ALWAYS/USUALLY TAKE SOME MEDICINE OR A 90- TABLET: HEADACHE 80- 70- 60- 50- 40- 30- 20- 10- 0 HIC CON DIS HID EXS NEV % FIGURE 3 c '0 0 ALWAYS/USUALLY TAKE go- SOME MEDICINE OR A TABLET 'SORE THROAT 80- 70- 60- 50- 40- 30- 20- 10- 0 HIC CON D15 HID EXS NEV FIGURE 3 b ALWAYS/USUALLY TAKE 50 ME MEDICINE OR A TABLET: COLD HIC CON DIS HID EX5 NEV FIGURE 3 d ALWAYS/USUALLY TAKE SOME MEDICINE OR A TABLET: INDIGESTION co 110 HIC CON DIS HID EX5 NEV BATCo document for Province of British Columbia 29 October 1999 -25- On the basis of the data presented in Table 6, the dissonant smoker is the person most likely to suffer any of the four ailments referred to and is particularly prone to indigestion. Almost half of the group of never smokers never suffer from indigestion, although compared with other non-smokers, appear more liable to sore throats. Established ex-smokers have a lower incidence of headaches which seem to be a particular problem for the highly dissonant smoker. The percentages of each group who always or usually take some medicine or a tablet for each of these four common ailments are shown in Figure 3. The data have been adjusted to exclude those who never suffer each particular ailment. Overall, ex-smokers appear to be most likely to take medication, particularly in respect of colds, sore throats and indigestion. Consonant and highly consonant smokers are those highly represented in respect of headache; dissonant smokers exhibit a particularly low level of drug utilization when suffering a cold. Respondents were asked if they had ever been prescribed one or more of a variety of tranquillizers or hypnotic drugs. The two most "popular" prescriptions of those listed were Valium (diazepam) and Mogadon (nitrazepam). The former is usually prescribed for anxiety states, the latter for insomnia and sleep disturbances due to anxiety, worry, tension, depression, etc. Table 7 records those who have been prescribed Valium and/or Mogadon and those who are currently taking them. c0 110 011 110 Xlt. BATCo document for Province of BritiSh Columbia 29 October 1999 -26- TABLE 7 PAST AND PRESENT USACE OF VALIUM AND MOGADON ALL SMOKERS EX-SMOKERS NEVER SMOKERS CONSONANCE/DISSONANCE WHEN QUIT TOT SMO RIC CON DIS HID EXS <2Y >2Y NEV VALIUM Ever 20 22 22 20 13 25 20 23 19 18 Currently 4 5 5 5 2 6 5 7 4 2 MOGADON Ever 10 10 6 10 4 14 13 16 11 8 Currently 4 4 3 5 - 5 5 6 4 4 Whilst it is not possible, on the information thus received, to attribute cause to these data, some interesting points arise from these responses. The highly dissonant smoker is the most likely person to have used each of these drugs and the recent ex-smoker is the most likely current user. Conversely, the dissonant smoker has least recourse to such treatments. Sleep disturbance is apparently most prevalent amongst ex-smokers. Again, it is interesting to note that only 2% of the total sample either did not knowv or refused to state, their answers to these two questions. co BATCo document for Province of BritiSh Columbia 29 October 1999 'N- I ~?.. (ZD U-I Uri 00 0-11 110 BATCo document for Province of British Columbia 29 October 1999 FIGURE 4a 7- TEA CONSUMPTION 6- 5- W IL o 4' a- 0 a: 3- Uj CC) z w LD 2 - HIC CON DIS HID EXS NEV FIGURE Q 7- COFFEE CONSUMPTION 6. 5- 4" 3- 2- f 0 HIC CON DIS HID EX5 NEV C=) (-:I U-1 c0 0-1 110 00 BATCo document for Province of British Columbia 29 October 1999 -27- Respondemts were asked how many cups of tea and/or coffee they 6rink in a typical --'ay. Eight percent of the total sample never drink tea and 27 percent do aot drink coffee. The average level of consumption, adjusted to ta-ke account of non-consumers, for each of the seven prizcipal categories is shown in Figure 4. FIGURE 4ci 7 - TEA CONSUMPTION 6- 5- C3 ir W (L 0 3- W co LU 2 LU < 0 FIGURE 4b 7- COFFEE CONSUMPTION 6- 5 - 4- 3- 2 0 HIC CCN DIS HID EX5 NE'i HIC CON DIS HIC EXS NEV The average daily consumption of alcohol is given in Figure 5, excluding those who never take an alcoholic drink (16% of all smokers, 18% of all ex-smokers an6 23% of all never smokers). c0 BATCo document for Province of British Columbia 29 October 1999 FIG. 5 ALCOHOL CONSUMPTION 1-2 - 1-0- 0.8. 0 z FIGURE 6a 20" REGULARLY VISIT PUBLIC HOUSES U 10-6- 0 _r 0 - 4 Uj z Ld 0-2 X Uj 10. 5- 0 HIC CON D15 HID EXS NEV % FIGURE 6b DRINK AT LEAST 20, ONE PINT OF BEER PER DAY 15- 10. 5' 0 HIC CON DIS HID EXS NEV 0 HIC CON DIS HID EX5 NEV 0/. FIGURE 6c DRINK FOUR OR MORE 20- WHISKYS PER WEEK 15- 10. 5- n 0 HIC CON DIS HID EXS NEV BATCo document for Province of British Columbia 29 October 1999 -29- The higher consumption level of highly consonant and consonant smokers is reflected in the fact that they are more likely to visit public houses (Figure 6a), are more likely to drink at least one pint of beer per day (Figure 6b) and are more likely to drink four or more whiskys per week (Figure 6c). In all these instances it is the consonant smoker who is most highly represented and in every case it is the never smoker who is least likely to be involved with alcohol. CD CC) BATCO document for Province of BritiSh COIUMbia 29 October 1999 -30- III. THE SMOKER Those respondents who were classified as current smokers of manufactured cigarettes answered questions in three areas related to their own smoking: Smoking behaviour (consumption, brand choice, etc.) Smoking motivation Smoking and health. In this section, the following additional abbreviations are used in the Tables and Figures. SEX Male M Fe=ale F AGE 16-24 years 16+ 25-44 years 25+ 45 or more years 45+ CLASS A, 3, Cl I C2 II D, E III Smoking Behaviour Respondents were asked: "About how many years ago did you start smoking packeted cigarettes?" Resolution of any significant differences according to the consonance/dissonance criteria is confounded by age and, to a lesser extent, class factors, and therefore no data on this aspect will be presented at this stage. c0 CD U-4 BATCo document for Province of British Columbia 29 October 1999 FIGURE 7 20 % RESPONDENTS SMOKING LESS THAN 10 CIGARETTES/DAY 10 F1 HIC CON DIS HID M F 16+ 25+ 45+ 1[ Di co BATCo document for Province of British Columbia 29 October 1999 One third of all highly dissonant smokers come from families where both parents smoke whereas, for dissonant smokers, the equivalent proportion is only one fifth. Detailed consumption figures for all groups are available but, as illustration, Figure 7 presents the percentage of each category of smoker who smokes less than ten cigarettes per day. It is noteworthy that a clear break between the consonant and dissonant groups emerges which is not so marked when the distribution for 20+ per day is considered (HIG = 62%, CON - 50%, DIS = 65%, HID - 59%). FIGURE 7 20 % RESPONDENTS SMOKING LESS THAN 10 CIGARETTES/DAY 10 F] HIC CON DIS HID M F 16+ 25+- 45+ 1 R Iff Comprehensive information on brand choice was collected in respect of current brand and most often previous brand. For the purposes of this report, brand choice data has been summarised in Tables 8 (current) and 9 (previous), adopting a simple criterion. Only those brands which overall, or for any of the twelve respondent categories, accounted for 5 percent or more of that category's choice are shown. C:D Q-n U-1 CC) 0-11 BATCo document for Province of British Columbia 29 October 1999 -32- M O S T P O P UL A T R A B B L R E AN 8 D S ( S M O KE R S ) S M O K E R S C O N S O N A N C E / D I S S O N AN C E S E X A G E S. E. C LAS S S M O H I C C O N D I S H I D M F 1 6 + 2 5 + 4 5 + 1 1 1 1 1 1 B ENS O N H E D G E S K . S . 1 1 1 0 9 1 6 1 1 1 1 1 0 1 7 1 2 8 8 1 2 1 1 C ARL T O N L . S . I I - 5 2 1 2 1 2 1 2 2 D UNH I L L K . S . 5 6 4 2 5 5 5 5 5 4 6 5 4 E MBA S S Y N O . I F. T . 6 6 5 4 6 8 4 1 7 6 6 4 7 E MBA S S Y R E G A L F. T . 4 4 5 - 4 4 4 4 5 3 3 5 4 E MBA S S Y F . T . 3 3 3 9 3 4 3 1 4 4 4 4 3 J OHN P L A Y E R K . S. 5 5 8 5 4 7 4 8 6 4 4 6 6 J OHN P L A Y E R K . S. E . M. 3 3 3 5 2 1 4 1 2 4 5 1 2 M ARL B O R O 1 1 4 2 2 1 6 1 1 2 1 P LAY E R S N O . 6 F. T . 7 7 8 5 6 7 6 1 7 4 6 5 4 1 0 P LAY E R S N O . 6 K. S . 5 3 8 2 5 8 3 7 6 4 3 7 5 P LAY E R S N O . 6 PL A I N 1 - 1 5 - 1 R S OTH ILK M A C N U S T K K . . S S . . 3 4 4 5 3 2 4 - 4 6 3 1 4 6 7 4 3 3 3 5 5 5 4 5 2 2 c 8 0 6 8 ~ J 0 0 0 CL 0 0 0 CD 0 h W 0 0 cr ro, 0 0 cr CD CD co co It can be seen that some brands qualify for inclusion "across the board". For example, Benson & Hedges K.S. has the largest market share amongst all smokers and is particularly well represented within the lower age group. Dunhill K.S., Embassy No. I F.T., John Player K.S. and Players No. 6 (Regular F.T. and K.S.) similarly have a wide appeal. Players No. 6 F.T. appears to be favoured by young, lower class smokers, whereas Rothmans K.S. qualifies for inclusion (5%+) only because of its high popularity amongst the youngest age group and the A, B, Cl social classes. Other brands have particular relevance only for specific smoker categories. For example, Carlton L.S. is smoked predominantly by the dissonant smoker. The same group also account for the inclusion of Players No. 6 Plain, which for the other categories is a product of minimal appeal. Marlboro qualifies by virtue of its favour within the 16-24 year old group. Silk Cut K.S. is most popular amongst highly dissonant and highly consonant smokers and particularly amongst women. Otherwise, sex differences are most apparent in respect of Embassy No. I F.T., John Player K.S. and Players No. 6 K.S. Trends with age are evident in respect of Benson & Hedges K.S., John Player K.S., John Player K.S. Extra Mild. Adopting the same 5%+ criterion for previous regular brand provides the data presented in Table 9. Further analysis is required before specific switching patterns can be determined. CX:) BATCo document for Province of British Columbia 29 October 1999 P R E V I O U S T B A R B A LE ND 9 ( S MO KE RS ) S M O KE R S C O N S O N A N C E / D I S S O N AN C E S E X A GE S. E. C L AS S s mo H I C C O N D I S H I D M F 1 6+ 2 5+ 4 5 + 1 1 1 1 11 B E N SO N & HE DG E S K. S. 4 6 1 5 4 4 6 4 3 4 5 2 E M1 3 AS S Y No . 1 F . T. 3 3 5 3 2 4 7 3 2 3 3 4 E ~M AS S Y RE G AL F . T. 3 2 3 4 4 3 4 6 3 3 3 3 4 E M B AS S Y F. T . 1 0 7 8 5 1 3 1 1 9 2 1 4 9 11 1 2 7 P L A YE R S ME D I UM N AV Y C U T PL A I N 4 5 5 2 3 6 3 1 2 7 4 3 5 P L A YE R S NO . 6 F . T. 1 1 7 1 1 7 1 4 1 0 1 2 2 1 1 5 5 7 1 3 1 3 S E N IO R S ER V IC E P LA IN 5 8 3 7 4 6 4 - 3 8 7 6 2 W O O DB I NE P L AI N 4 6 4 1 1 2 6 3 - 2 8 3 3 7 O T H ER 3 2 2 7 3 3 3 1 3 3 3 2 3 TI PP E D N O PR E VI OU S R E G U LA R B R AN D S M O KE D 1 4 1 8 1 6 1 4 1 1 1 6 1 2 2 8 1 0 1 4 13 1 2 1 8 II Z 6 6 S S O I 0 0 CL 0 0 T 0 0 (D 0 to :r 0 0 cr ii, K) to 0 0 r+ 0 cr 0 -L c0 co to ,-- '. " - - : t ~ ~, - , 1. r. (ZD (-n U-1 c0 I--0 ---j rN-) BATCo document for Province of British Columbia 29 October 1999 % FIGURE 8 50- HOW LONG HAS BEEN YOUR MOST OFTEN BRAND ? PERCENTAGE RESPONDING 12 MONTHS OR LESS 40 - 30 20 10. 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 co BATCo document for Province of British Columbia 29 October 1999 -35- Respondents were asked how long they had been smoking their current brand. Figure 8 represents the distribution of responses for those answering twelve months or less. The highly dissonant female young smoker appears to be the most likely to switch, although these variables are probably not independent. It is important to note, however, that 75% of the 16 to 24 year old group have been smoking for between 3 to 10 years and therefore it seems likely that, as a group, they are most prone to switching. This view is reinforced by the observation (Table 9) that 28% of this group had no previous regular brand. 0/. FIGURE 8 50- HOW LONG HAS 13EEN YOUR MOST- OFTEN BRAND ?! PERCENTAGE RESPONDING 12 MONTHS OR LESS 40 - 30 20 10- 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 The main reasons for changing to the current regular brand are summ,grised in Figures 9 and 10. C:D 1-71 Q.n c0 BATCo document for Province of BritiSh Columbia 29 October 1999 - - -I- 0 FIGURE 9 Y. 40- (a) THEY WERE CHEAPER 30- 20- 10- 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 M 30 - (b) THEY WERE MILDER 20 10 0 HIC CON DIS HID M F 16-* 25+ 45+ 1 11 M 0 3 0 (c) TRIED THEM AND PREFERRED THEM 20 - 10 U-11 (.-n 0 C-0 HIC CON DIS HID M F 16-f 25+ 45+ in BATCo document for Province of British Columbia 29 October 1999 0 FIGURE 10 YO 50- MENTIONS OF HEALTH 40- 30 - 20- 10 0 HIC CCNI D15 HID M F 16+ 25+ 45+ 1 11 z BATCo document for Province of British Columbia 29 October 1999 That the now current brand was cheaper (Figure 9a) was particularly cited by the highly consonant smoker. The slight trend according to class is perhaps in a direction opposite to that which might be expected. The dissonant smoker is least likely to be motivated by cost consideration. Relative mildness (Figure 9b) is most influential in the case of the highly dissonant smoker. Female more than male, older rather than younger, and lower class more than higher class respondents cite mildness as a factor in making a switch. Simple preference (Figure 9c) is most often quoted by the highly consonant smoker. Other responses, not presented here, were recorded and the total response set was analysed to yield all mentions related to health (Figure 10). The apparent lack of differentiation by consonance/dissonance and the low level recorded for the youngest age group are worthy of note. 0 FIGURE 10 0 Y 50 MENTIONS OF HEALTH 40- F 30 - 20- 10- 0 HIC CON DIS HID M F 16+ 25-4-- 45-4- H CZ) co CC) BATCo document for Province of British Columbia 29 October 1999 -38- Smoking Motivation The items in this section included those derived in an earlier study, Project VIRGO (3). In addition, questions regarding the most enjoyable cigarette of the day and specific occasions when the respondent smoked were asked. The responses recorded in this section will be the subject of further detailed analysis towards the evolution of a contemporary smoker typology. For the present, the distribution of answers to the individual items only will be discussed. For all respondents the most enjoyable cigarette was the one smoked "first thing in the morning/when I get up" (Table 10). This response appears to be favoured by all groups, but particularly by the highly consonant and consonant smokers. Fifty-nine percent of all respondents find the first cigarette of the day the most enjoyable, although the time of day when this is taken varies considerably. There appears to be a trend with increasing age and descending social class. The major part of this section of the questionnaire comprised statements to which respondents were required to respond according to the following five point scale: STRONGLY AGREE AGREE NEITHER AGREE NOR DISAGREE DISAGREE DISAGREE STRONGLY In Figures lla to liz, the percentage of each group who responded strongly agree or agree is presented. co BATCo document for Province of BritiSh Columbia 29 October 1999 CD U7 Un co I'D F\j c=:) BATCo document for Province of British Columbia 29 October 1999 S.E. CLASS 1 11 111 53 61 64 -39- TABLE 10 CIGARETTE OF THE DAY FOR YOU? WHICH IS THE MOST ENJOYABLE AGE 16+ 25+ 45+ 50 54 65 F CONSONANCE/DISSONANCE SEX CON DIS HID m HIC SHO 9 8 8 4 1 2 32 7 6 8 6 4 4 2 7 13 6 6 8 1 3 24 11 9 5 4 4 2 3 8 6 6 14 8 8 7 7 7 8 8 6 8 6 8 4 6 - I 1 1 1 3 1 1 21 21 32 22 9 10 9 10 11 10 6 10 13 a 3 8 3 5 5 4 4 4 3 3 5 4 2. 4 6 2 1 3 9 7 10 11 10 11 9 8 5 8 7 6 8 7 6 5 1 1 1 2 2 2 24 26 26 10 10 9 9 a 9 7 5 9 5 4 5 3 5 3 4 4 3 1 3 2 7 9 8 THE FIRST ONE (ALL MENTIONS) 59 57 63 49 THE FIRST ONE - AFTER BREAKFAST 10 11 9 9 - NID MORNING/COFFEE 7 4 9 2 - AFTER LUNCH 7 7 8 4 - AFTER DINNER 6 5 5 9 - IN EVENING 1 1 1 - - UNSPECIFIED 2 2 3 2 - FIRST THING IN THE MORNING/WHEN I GET UP 26 29 28 23 AFTER MEALS (UNSPECIFIED) 9 8 8 13 AFTER DINNER/EVENING MEAL 8 7 8 11 AFTER WORVIN THE EVENING 7 6 8 7 WHEN RELAXING 5 5 4 5 LAST THING AT NIGHT 4 6 4 - AFTER LUNCH 3 3 2 2 WITH A DRINK 2 6 3 - NO PARTICULAR TIME 9 8 10 16 0 0 CL 0 CD 0 0 (D 0 U) 0 0 cr ii, K) w 0 0 cr CD 19 -L w CD co /I. --- (-- n (-M Co 110 r,-) r--) BATCo document for Province of British Columbia 29 October 1999 0 100~- 50, 0 FIGURE 11 a 1. 11 I REALLY ENJOY SMOKING HID CON DIS HID M F 16+ 25+ 454 1 11 111 Q-T, cc BATCo document for Province of British Columbia 29 October 1999 -40- Enjoyment of smoking (Figure lla) shows a clear relationship with degree of con-zonance/ dissonance with nearly all highly consonant smokers and less than sixty percent of highly dissonant smokers agreeing with the statement. Enjoyment is also apparently related to age, althoug~l the highly diSsonant group has a younger mean age. A very similar pattern of reSponses is shown in Figure llb relating to satisfaction. Smoking =-s a reward after a task, appeals less to the dissonant smoker than t'--e other three sub-groups but is marginally more likely to be acknowledged by younger smokers (Figure 11c). 0 FIGURE 11 a 100 I REALLY ENJOY SMOKIN6' 50- 0 HID CZN DIS HID M F 16+ 25+ 454 i 11 C-:) co BATCo document for Province of BritiSh Columbia 29 October 1999 K - A (Z:) Q-TI Q-n CXD 1 ~0 ---j r\-) Q~M BATCo document for Province of British Columbia 29 October 1999 100 50- -41- FIGURE 11 b "1 FIND SMOKING VERY SATISFYINd 0 HIC CON DIS HID M F 16+ 25* 45+ 1 % FIGURE 11c 100" 1 SMOKE AS A REWARD AFTER A HARD OR BORING TAS~ 50- 0 HIC. CON DIS HID M F 16t 25+- 45+ 1 CD cc BATCo document for Province of British Columbia 29 October 1999 A 11 V, C:D (-rl (-TI CC) I-D FI-) -_j BATCo document for Province of British Columbia 29 October 1999 0 FIGURE lid A 1. 1. 100- 1 LIKE TO SMOKE WHEN I HAVE A DRINK 50- 0 HIC CON D15 HID M F 16+ 2S+ 45+ 1 11 M CZ:) BATCo document for Province of British Columbia 29 October 1999 -42- Smoking as an accompaniment to drinking appeals to most smokers in all groups but, again, the dissonant smoker is relatively least likely to agree with the statement (Figure lld). An age trend, favouring the younger smokers, is also apparent. Figures lle and llf deal with the relationship between smoking and relaxation. In both cases, the pattern of responses is broadly similar, but the level of agreement in the first case - when relaxing - is higher than in the second - in order to relax. In both cases, it is the highly consonant smoker who is most likely to agree with the statements. Use of cigarettes in order to relax is more likely for women smokers than for men. 0 100- 50 0 FIGURE Ild 1 LIKE TO SMOKE WHEN I HAVE A DRIN~ HIC CON DIS HID M F 16+ 25+ 45+ 1 11 BATCo document for Province of British Columbia 29 October 1999 -43- 0/0 FIGURE 11 e 60. 1 SMOKE WHEN RELAXING 50- 0 HIC CON DIS HID M F 164- 25+ 454- 1 U M FIGURE 11f 100 I SMOKE IN ORDER TO RELA~' 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 co c::) BATCo document for Province of British Columbia 29 October 1999 -W j &U- 11 ~1 0 (-.7. (-rI cz) \.-D Q--j BATCo document for Province of British Columbia 29 October 1999 0 FIGURE lig 100 1 SMOKE IN ORDER TO BREAK THE ICE WITH OTHER SMOKERS . 50- 0 HIC CON DIS HID M F 16+ 25+ 45+ CC) BATCo document for Province of British Columbia 29 October 1999 -44- The statement presented in Figure 11g was one which emerged as a somewhat novel motivation for smoking from Project VIRGO. The general low level of agreement suggests that smoking as a social ice-breaker is not, in fact, a powerful reason for smoking. Smoking to help concentration (Figure 11h) also achieves a modest level of agreement overall, but does differentiate consonant and older smokers from the rest. Again, the factors are probably not independent, however. A higher level of agreement has been achieved in respect of Figure lli and, again, it is the consonant smoker who is most likely to find himself smoking under the conditions of the statement. Here, however, the higher age group is the least likely to agree. Men more than women agree with this statement. 0 FIGURE 11g 100~ 'I SMOKE IN ORDER TO BREAK THE ICE wrfH OTHER SMOKERS7 50- 0 HIC CON D15 HID M F 16+ 25-1- 45t I I IU BATCo document for Province of British Columbia 29 October 1999 100, 50- 0 -45- FIGURE Ilh 1 SMOKE IN ORDER TO HELP ME CONCENTRAT~' HIC CON 015 HID M F 16+ 25+ 45+ 1 ir M 100 0/. FIGURE Ili I SMOKE WHEN WORKING BUT NOT DEEPLY ABSORBED IN THE TASK 50- 0 HIC CON DIS HID M F 16+ 75+ 45+ 1 11 Ili ci~) Q-rl U-1 BATCo document for Province of British Columbia 29 October 1999 100 FIGURE Ili 'SMOKING IS ONE OF MY FEW INDULGENCE~' 50- 0 HID CON DIS HID M F 16+ 25+ 45+ 1 U in Q-n c0 CIT" BATCo document for Province of British Columbia 29 October 1999 -46- Women more than men perceive smoking to be one of their few indulgences (Figure 11j) and older rather than younger smokers are more likely to agree. The statement is relatively more appealing to dissonant smokers. It is the dissonant smoker also who most acknowledges the pleasure of cigarette handling (Figure Ilk) which is also recognised more by men than women, older rather than younger and by the lower socio-economic class members. The most noticeable feature of the data relating to cigarettes as comforting is the marked age trend (Figure IIZ). 100 U/0 FIGURE Ili SMOKING IS ONE OF MY FEW INDULGENCES 50- 0 HID CON DIS HID F 164 25+ 45+ 1 CC) BATCo document for Province of British Columbia 29 October 1999 -47- 0 FIGURE 11k 10 YO HANDLING A CIGARETTE IS PART OF THE JOY OF SMOKING 50 - 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 11 IE 0 FIGURE 11 L A 1. 100 CIGARETTES ARE COMFORTINd 50 0 co HIC CON DIS HID M F 16+ 25t- 45+- c0 BATCo document for Province of British Columbia 29 October 1999 \1 ol Cp c::) (-711 Q-rI co \-0 Q'IJ 1-0 BATCo document for Province of British Columbia 29 October 1999 0 FIGURE 11m YO . 100 1 SMOKE BECAUSE CIGARETTES ARE BEING HANDED AROUNd 50 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 X M c0 C-D BATCo document for Province of British Columbia 29 October 1999 -48- Smakin.g because cigarettes are being handed around (Figure 11m) is admitted by less than half the sample and does not markedly differentiate between the smoker sub-groups. Trends with age and socio-economic class are apparen:, however. The role of habit in cigarette smoking is most strongly acknowledged in the dissonant and highly dissonant smoker (Figure lln, and perhaps reflects their relatively lower level of enjoyment (cf. Figure Ila). Overall, more than three quarters of the smokers questioned agreed or agreed strongly with this statement and only 2% disagreed s:rongly. FIGURE 11 m 100- SMOKE 13ECAUSE CIGARETTES ARE BEING HANDED AROUND" 50 0 HIC CON DIS HID M F 16+ 25+ 45+ CXD BATCo document for Province of British Columbia 29 October 1999 FIGURE 11n 10 0' THERE ARE TIMES WHEN I LIGHT UP A CIGARETTE JUST OUT OF HA131T 50' 0 HIC CON DIS HID M F 16+ 25+ 45+ CZ> Un cc BATCo document for Province of British Columbia 29 October 1999 -49- 0 FIGURE 11n X... '0 0 THERE ARE TIMES WHEN I LIGHT UP A CIGARETTE JUST OUT OF HA13d 50- 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 The next four statements (Figures 11o, P, q, r) relate to smoking in relation to emotional states. In all cases it is the highly dissonant smoker who is most likely to agree with the statements, which also appeal more to women than to men. The differences noted earlier in respect of relaxation are again evident in the case of feeling tense. That is, smoking is more likely to accompany feeling tense (Figure l1q) than to be used as a means of reducing tension (Figure l1r). The pattern of responses is broadly similar in both cases, however. CXD BATCo document for Province of BritiSh Columbia 29 October 1999 % 100" 50" 0 HIC CON DIS HIIJ 0 100 50- 0 -50- FIGURE 11 o 1 SMOKE WHEN FEELING DOWN M F 16+ 25+ 45+ 1 FIGURE 11p SMOKE WHEN FEELING ALONE" HIC CON DIS HID M F 16+ 25+- 45+ BATCo document for Province of British Columbia 29 October 1999 -51- FIGURE 1Iq 100, 1 SMOKE WHEN FEELING TENSE OR ANXIOU~ 50- 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 11 M 100% FIGURE 11 r I SMOKE IN ORDER TO FEEL LESS TENSE OR LESS IRRITABLE 50- C::) 0 HIC CON DIS HID M F 16+ 25+. 45+- CC) BATCo document for Province of British Columbia 29 October 1999 , ( J, U-I Cn CC) ----j r- CC) BATCo document for Province of British Columbia 29 October 1999 -X0 .. I FIGURE 11 5 11 0 1 SMOKE WHEN I M FEELING HUNGRY BUT I CAN'T OR DON'T WANT TO EAT 50- 0 HIC CON DIS HID M F 164- 25+ 45+ 1 U M co BATCo document for Province of British Columbia 29 October 1999 -52- Smoking as an inhibitor of appetite has often been quoted as a reason for not quitting. A low level of agreement with the statement "I smoke when I'm feeling hungry but I can't or don't want to eat" (Figure lls) is a little surprising. The food substitute motivation is clearly strongest in the highly dissonant smoker and, as expected, noted more by women than men. The trend with age is in a direction to be expected with the younger smokers most likely to agree with the statement. Figure Ils refers to a statement specifically mentioning hunger. Ingestion, however, can be an activity unrelated to such a basic drive. Consumption level of sweets, peanuts, potato crisps, etc., or even chewing the end of a pencil, was tapped in the statement given in Figure lit. Here a higher level of agreement was reached and the differentiations within smoker sub-groups and age groups are less marked. 07 0. FIGURE ii '00' 1 SMOKE WHEN I'M FEELING HUNGRY BUT I CAN'T OR DON'T WANT TO Ed so - 0 HiC CON DIS HID F 164- 25+ 45+ 1 11 M BATCo document for Province of British Columbia 29 October 1999 % 100' 50 0 FIGURE 11t 1 SMOKE INSTEAD OF NIBBLING SOMETHING HIC CON DIS HID M F 16+ 25+ 45+ 1 U M c0 BATCo document for Province of British Columbia 29 October 1999 -53- FIGURE lit 100- 1 SMOKE INSTEAD OF NIBBLING SOMETHING 50 0 HIC CON Di5 HID M F 16+ 25+ 4 Si- According to the analysis of the Project VIRGO data, smoking in order to relieve boredom appeared to be an important factor in smoking. In boring situations, smoking a cigarette gives the smoker something to do. The use of cigarettes as a self-administered reward has already been alluded to (Figure 11c). Allied to this reward role of cigarette smoking, cigarettes may be used to make a break in tasks. As noted previously (3), however, Project VIRGO respondents tended not to smoke when doing something interesting. c_::) QT1 (_T1 co U-1 BATCo document for Province of BritiSh Columbia 29 October 1999 % FIGURE 11 u 100" 1 SMOKE WHEN FEELING BORE6' 50- 0 HIC CCN DIS HID M F 16+ 25+ 45+ 1 11 BATCo document for Province of British Columbia 29 October 1999 -54- Smoking when feeling bored (Figure llu) is particularly favoured by the highly dissonant smoker, women more than men, younger rather than older, and more by the lower socio-economic groups. Being deeply absorbed in an activity (Figure llv) provokes a differential attitude to smoking in men compared with women and is more relevant to older respondents. Smoking in order to make a break in tasks (Figure l1w) is least likely to be found amongst the dissonant smoker who is also the least likely to smoke as a reward after a hard or boring task (Figure 11c). 0/. 100 FIGURE I I u SMOKE WHEN FEELING BORE6 50 0 HIC CON 015 HID M F 16+ 25+ 45+ 1 11 R1 Q1 M (-n co Q-n (7 N BATCo document for Province of BritiSh Columbia 29 October 1999 11 % FIGURE 11V 100- 1 SMOKE WHEN DEEPLY ABSORBED IN WHAT I M DOING 50 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 100% .1 FIGURE 11w I SMOKE IN ORDER TO MAKE A BREAK IN TASKS 50 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 n x Q17 BATCo document for Province of British Columbia 29 October 1999 0/6 FIGURE 11 x '00' SMOKE AFTER RECEIVING BAD NEWS OR A SUDDEN SHOCK" 50 - 0 HIC CON DIS HID M F 16+ 25+ 454- 1 U M CZ) co c0 BATCo document for Province of British Columbia 29 October 1999 -56- Smoking in response to trauma (Figure 11x) is likely amongst all smokers and particularly women. Perception of a need for nicotine in cigarettes (Figure lly) is most acknowledged amongst highly dissonant smokers and least amongst the two consonant groups. Overall, however, there is a low level of agreement with this statement, although the results in respect of age and class are what might be expected. The final statement (Figure llz) separates the highly consonant smoker from the rest. Those smokers responding positively to this statement were questioned further on the times or occasions at which they always smoke. 0/0 FIGURE 11 x '00 1 SMOKE AFTER RECEIVING 13AD NEWS OR A SUDDEN SHOC~ 50 0 HIC CON 015 HID M F 16+ 25+ 45+ 1 cc 110 ---j U-1 BATCo document for Province of British Columbia 29 October 1999 -57- FIGURE 11 y 0/0 100 1 NEED THE NICOTINE IN CIGARETTES 50' 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 1 Iz % FIGURE 11 z 100, 1 ALWAYS HAVE CIGARETTES AT CERTAIN TIMES OR OCCASION5 DURING THE DAY" 50, 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 1 1 co BATCo document for Province of British Columbia 29 October 1999 -58- The most popular times of day/occasions for those who have cigarettes at certain times of the day (59% of all smokers) are shown in Table 11. TABLE 11 After meals (unspecified) First thing in the morning/when I get up Tea break/tea time/with a cup of tea Coffee break/mid-morning After lunch/midday meal With a drink (alcoholic) Last thing at night/before going to bed After dinner/evening meal Evenings at home After breakfast HIC CON DIS HID M M (7.) M 50 54 65 54 24 27 15 23 28 21 24 20 23 21 21 21 19 19 12 16 12 18 9 11 12 11 6 12 9 11 6 12 8 9 12 10 9 9 6 8 C:D co BATCo document for Province of British Columbia 29 October 1999 I / tirt 1( ~ CZ) (_n UM co ---j 011 _r~z- BATCo document for Province of British Columbia 29 October 1999 -59- As noted earlier, the data collected in this section will be subjected to more detailed statistical analysis. For the present, however, a few tentative conclusions can be stated regarding the motivation to smoke as a function of degree of consonance/dissonance. Relative to the other three sub-groups of smoker, the highly consonant smoker perceives smoking more in relation to relaxing, as an accompaniment to as well as a facilitator of relaxation and, not surprisingly, is most likely to smoke as an accompaniment to drinking, to break the ice with other smokers, and a; a reward after a hard or boring task. More than any other sub-group member he is likely to find smoking comforting and is most likely to really enjoy smoking and find it very satisfying. He is least likely to admit to smoking as a habit or to need the nicotine in cigarettes. Smoking is not so readily seen as one of a few indulgences and the highly consonant smoker is least likely to smoke when bored or dejected. Overall, the highly consonant smoker might be considered to be motivated by positive affect and has an apparently straightforward disposition to smoking. In contrast, the highly dissonant smoker, relative to the other smoker sub-groups, appears to be motivated by negative affect. Thus he smokes when feeling bored, when feeling alone, tense, anxious or "down". He is the most likely to smoke in response to trauma and at certain times during the day. Like the highly consonant smoker, he values smoking as an accompaniment to drinking but unlike the highly consonant smoker, admits to smoking instead of nibbling. He is the most likely to smoke when feeling hungry, when deeply absorbed in an activity, and in order to feel less tense or irritable. (Z:) QIn Ull CC) CN U-I BATCo document for Province of British Columbia 29 October 1999 -60- He is the most likely to smoke to make a break and, more than any other sub-group, acknowledges his need for nicotine. The highly dissonant smoker is least likely to smoke because cigarettes are being handed around and least values handling the cigarette as part of the pleasure of smoking. Less than others he finds smoking comforting, enjoyable and satisfying. The dissonant smokers might be characterised as indulgent smokers who, more than any other sub-group, admit to smoking out of habit, because cigarettes are being handed around and because they are comforting. They also more often find handling the cigarette part of the joy of smoking and most readily admit to smoking being an indulgence. Relative to the other sub-groups, dissonant smokers are least likely to smoke when relaxing, in order to relax, to make a break, to help concentration, to "break the ice" with other smokers, as a drinking accompaniment, when deeply absorbed, when "down", after trauma, when hungry, as a reward. They are least likely to smoke in order to feel less tense or irritable. The consonant smoker is characterised by relatively highest or lowest responses on very few statements. More than any other sub-group, consonant smokers smoke to help concentration or when working but not deeply absorbed in what they are doing. They are least likely to smoke because cigarettes are being handed around, when they feel alone, tense or anxious and, like the highly consonant smoker, they disavow their need for nicotine. They are, however, the group most likely to smoke .first thing in the morning. cc \-C BATCo document for Province of BritiSh Columbia 29 October 1999 -61- Attempts to Quit By definition, all of the consonant smokers and all of the highly dissonant smokers had, at some time, attempted to give up smoking cigarettes. Together these two groups comprised 72 percent of the smoker sample. They were asked "How hard have you tried to give up smoking manufactured cigarettes altogether?" and the responses are summarised in Table 12 below. TABLE 12 NOT AT ALL HARD NOT VERY HARD QUITE HARD VERY HARD CONSONANT HIGHLY M DISSONANT M 11 6 45 28 22 31 22 36 By and large, the highly dissonant group reported the greater mean effort but it is clear that, without further information on the recency of attempting to quit, little can be concluded about the actual resolve to do so. For the two groups, the average length of time since making their last attempt was 3.25 years (consonant) and 2.18 years (highly dissonant). The full profile of this data is given overleaf in Table 13. (J1 c0 \0 BATCo document for Province of British Columbia 29 October 1999 !~t O~ I (-J- Ln cc 11 C -,j --j (::~D BATCo document for Province of British Columbia 29 October 1999 L E N G T H O F T I M E S I N C E T A L B A L S E T 1 A 3 T T EM PT T O Q U I T S M O K I N G C D O I N S S S O O NA NA N N C C E E / S E X A G E S. E. C LAS S S MO C O N 1l t D M F 1 6 + 2 5 + 4 5 + 1 1 1 1 1 1 L e s s t h a n 1 m o n t h 7 . 3 9 6 7 9 6 6 3 8 8 1 - 3 mo n t h s 1 0 5 1 4 9 1 1 2 4 7 9 9 1 0 1 2 3 - 6 mo n t h s 7 5 9 7 8 1 1 8 6 7 7 9 6 - 9 mo n t h s 4 2 4 4 3 8 2 4 4 4 2 9 - 1 2 m o n t h s 9 7 1 1 1 0 8 8 1 3 6 6 1 1 1 0 1 2 - 1 8 m o n t h s 1 1 1 2 1 1 1 0 1 3 1 5 1 3 9 1 2 1 0 1 2 1 8 - 2 4 m o n t h s 8 9 8 8 9 4 1 0 8 9 8 8 2 - 5 ye a r s 2 4 3 0 2 1 2 5 2 3 2 1 2 7 2 2 2 4 2 8 2 0 O C v a e n r ' 5 t r y e e m a e r m s b e r 1 7 2 2 2 4 1 3 1 1 8 3 1 5 1 - - 1 4 - 2 5 5 2 3 3 1 3 2 1 5 3 IZZ68SSOI 0 0 CL 0 0 r- 0 1 T 0 CD 0 k =r 0 0 F 3 0 0 r-f~ 0 cr CD co to L. ''. "..I (-TI Un c0 'I'D --j --4 NJ BATCo document for Province of British Columbia 29 October 1999 0 FIGURE 12 .0/10 11 5 ON THE LAST OCCASION THAT YOU GAVE UP SMOKING CIGARETTES HOW LONG DID YOU GIVE UP FOR 40- so- 20 10- 0 7' 1 wk 1 wk 1-2wk 2-3wk 3-,4wk I mo F--j CONSONANT HIGHLY DISSONANT ;7 i-3mo 3-6mo 6-12 mo >I yr Uri (-n co (--4 BATCo document for Province of British Columbia 29 October 1999 -63- Less than fifty percent of the highly dissonant group have made an attempt to quit in the last year and yet, by definition, they remain at least fairly seriously committed to giving up. The length of time for which they gave up on the last attempt to quit is presented in Figure 12 and compared with similar data in respect of the consonant smoker group. 0 FIGURE 12 50 ON THE LAST OCCASION THAT YOU GAVE UP SMOKING CIGARETTES HOW LONG DID YOU GIVE UP FOR ? 40- 10- 20 10- 0 7- .C 1wk CONSONANT HIGHLY 015SONANT 7 7- / FP 17 ~ F / I I A 1 wk 1- 2 %*A 2-3wk 3-4wk 1 mo 7 1-3mo 3-6mo 6-12mo >1 yr The number of serious attempts to give up smoking in the last two years is shown in Figure 13 (overleaf). (Z) co %10 --j BATCo document for Province of BritiSh Columbia 29 October 1999 CD (-,I U-1 co ',D -Ij ---,I U1 BATCo document for Province of British Columbia 29 October 1999 0 Y FIGURE 13 O . - 1, HOW MANY SERIOUS ATTEMPTS TO GIVE UP 5MOKING 50- HAVE YOU MADE IN THE LAST TWO YEARS ?' CONSONANT (MEAN- 0-611) 40- HIGHLY DISSONANT (MEAN 1 -39) 30- 20 io, P-3 0 0 1 2 3 4 5 6 7 B 9 10 NUMBER OF ATTEMPTS CD CC) 01 \ BATCo document for Province of British Columbia 29 October 1999 -64- 0 FIGURE 13 HOW MANY SERIOUS ATTEMPTS TO GIVE UP SMOKING 50- HAVE YOU MADE IN THE LAST TWO -YEARS ? CONSONANT (MEAN- 0-68) 40- HIGHLY D15SONANT (MEAN 1 -39) 30- 20 10 7- 0 0 1 2 3 4 6 7 a 9 10 NUMBER OF ~rTEMPTS Whilst the highly dissonant smoker has, on average, made twice as many attempts to quit during the past two years (1.38 cf. 0.68 for the consonant smoker), one third have made no attempt at all during this period. Further analysis is required to determine the size of the sample who might be classified as "active" highly dissonant smokers. From Figure 12, it would appear that the consonant smoker was able to quit smoking for longer than the highly dissonant smoker. Almost a third of the highly dissonant group returned to smoking in less than one week after their last attempt to quit. The main reasons for attempting to give up smoking are summarised in Table 14 where the corresponding data from Operation AQUARIUS are also given for comparison. (Z) Lyi (-n c0 BATCo document for Province of BritiSh Columbia 29 October 1999 -65- TABLE 14 WHAT WERE THE MAIN REASONS THAT MADE YOU TRY TO GIVE UP SMOKING MANUFACTURED CIGARETTES? PROJECT LIBRA OPERATION (N=536) AQUARIUS (N=1225) CON HID SMO M M (Z) COST 35 42 39 43 HEALTH (GENERAL) 18 34 28 30 CHEST/BRONCHITIS 3 9 6 7 DOCTOR'S ADVICE 2 5 4 5 PREGNANT 7 6 6 4 COUGHING 5 6 6 4 CANCER 4 5 4 4 FAMILY PRESSURE 7 8 7 4 SEE IF I COULD 11 7 9 6 ADVERTISING 3 3 3 3 Reasons related to health are more prevalent in the highly dissonant group although, for both sub-groups, cost is the most frequently mentioned specific reason. It is interesting to note that, compared with the Operation AQUARIUS data, the influence of advertising has remained stable, whereas family pressure is now quoted more often. Will-power is a more significant motive for the consonant than the highly dissonant smoker. 03 BATCo document for Province of BritiSh Columbia 29 October 1999 -66- When asked why they started to smoke again, the responses presented in Table 15 were obtained. Overall, these data for the two sub-groups are consistent with the impressions of their motivation to smoke noted earlier. TABLE 15 WHY DID YOU START TO SMOKE MANUFACTURED CIGARETTES AGAIN? ALL MENTIONS OF HABIT/WEAKNESS ALL MENTIONS OF RELAXATION/ RELIEVES NERVES/IRRITABILITY CRAVING/COULDN'T DO WITHOUT OFFERED ONE AND STARTED AGAIN OTHER PEOPLE WERE SMOKING BOREDOM LIKE TO SMOKE FELT HUNGRY/PUTTING ON WEIGHT TO BE SOCIABLE LIKE A CIGARETTE WITH A DRINK WHEN HAD MONEY WENT BACK TO IT CIGAR/PIPE LED BACK TO CIGARETTES NO PARTICULAR REASON CONSONANT HIGHLY DISSONANT (N=213) (N=323) (7.) (7.) 12 23 23 31 14 15 14 8 9 8 8 7 11 4 6 7 3 5 3 1 2 1 - 1 6 4 c::> QJ1 C-M 00 00 BATCo document for Province of British Columbia 29 October 1999 CD (-n L-rI cc 110 co r--) BATCo document for Province of British Columbia 29 October 1999 -67- It will be recalled that the distinction between, on the one hand, the dissonant and the highly dissonant smoker and, on the other, the consonant and highly consonant smoker was determined by the seriousness of the intent to quit smoking. The two dissonant sub-groups comprised those smokers who expressed a very or fairly serious intention to quit, whereas those not very seriously or not at all seriously intending to do so were classified as consonant. The highly consonant and dissonant smokers have made no attempt to give up smoking whereas the consonant and highly dissonant smokers have made at least one attempt. Respondents were asked to support with reasons their responses to the discriminating question and these are listed overleaf in Tables 16 (dissonant groups) and 17 (consonant groups). For the two dissonant groups (Table 16) general or specific mentions of health were most mentioned with cost somewhat more frequently quoted by the highly dissonant smokers. Family pressure and/or the smell of cigarettes is slightly more relevant to the dissonant smoker than the highly dissonant smoker. Acknowledging the pleasure and enjoyment derived from smoking is the most popular reason for not wishing to give up (Table 17). The highly consonant smoker more often than the consonant smoker believes that he does not smoke enough to injure his health, whereas the consonant smoker more often acknowledges the value to him of smoking in order to aid relaxation or relieve tension. Mentions of habit and simple inability to quit are much more likely from the consonant smoker. c0 00 BATCo document for Province of British Columbia 29 October 1999 CD (-n (-P c0 \-0 -,j cc BATCo document for Province of British Columbia 29 October 1999 -68- TABLE 16 WHY DO YOU SAY YOU WOULD VERY/FAIRLY SERIOUSLY LIKE TO GIVE UP SMOKING? HEALTH REASONS (GENERAL) HEALTH REASONS (SPECIFIC) FINANCIAL REASONS WOULD LIKE TO STOP IF I COULD JUST A HABIT SOCIAL NON-ACCEPTANCEANTI-SOCIAL YOU SMELL OF CIGARETTES FAMILY PRESSURE THEY ARE DIRTY/MAKE A MESS DISSONANT HIGHLY DISSONANT (N=56) (N=323) M (Z) 48 59 23 16 34 48 5 11 9 6 5 4 5 3 5 2 2 2 co CX) CJ7 BATCo document for Province of British Columbia 29 October 1999 A " ~11 z C=) (-n (-n co I'D --_j co Cr\ BATCo document for Province of British Columbia 29 October 1999 -69- TABLE 17 WHY DO YOU SAY YOU WOULD NOT VERY/NOT AT ALL SERIOUSLY LIKE TO GIVE UP SMOKING? HIGHLY CONSONANT CONSONANT (N=154) (N=213) (7.) (7.) ENJOY SMOKING/GET PLEASURE 65 60 DON'T SMOKE ENOUGH TO INJURE HEALTH 19 10 HELPS ME TO RELAVRELIEVE TENSION 6 14 HAVE NO REASON TO 10 9 WOULD BE UNABLE TO/ITS A HABIT 3 11 WOULD PUT ON WEIGHT 4 5 PEOPLE DIE OF CANCER WHO DON'T SMOKE 2 1 When asked "What do you think would happen if you gave up smoking?", the most popular first reply for all sub-groups was that they would eat more and/or suffer weight problems (Figure 14a). Half of the dissonant smokers and more women than men expressed this concern which also shows trends with age and social class. The second most popular first response referred to bad temper, irritability and moodiness (Figure 14b). The dissonant smoker is least likely to perceive this consequence which is most often voiced by the consonant groups and more by men than by women. Reference to Figure 14c shows that the "benefit" of saving money appeals least to the highly consonant smoker, most to the 25 to 44 year old group and least to the A, B, Cl group of social classes. As might be expected, the prospect of better health is mentioned first by more U-1 c0 BATCo document for Province of BritiSh Columbia 29 October 1999 -70- smokers in the dissonant groups than in the consonant groups (Figure 14d) Women more than men see the prospect of becoming a "nervous wreck" as a consequence of quitting and this is a function of age (Figure 14e). Almost a fifth of the highly consonant smokers believe that there would be no effect if they gave up smoking (Figure 14f) . The data presented in Figures 14a-14f were those relating to "first mentions". In Figures 15a-15b, the four most popular categories of all mentions (i.e. first and after prompting) are given. (ZD (-n Qn co c0 BATCo document for Province of BritiSh Columbia 29 October 1999 -71- FIGURE 14 a WEIGHT PROBLEMS/ EAT MORE 0 50 40 30- 20 10 0 HIC CON DIS HID M F 16+ 25+ 45+ % FIGURE 14 b 50 GET 13AD TEMPERED/ IRRITABLE/MOODY 40 30 20 10 U-1 co 0 HIC CON 015 HID M F 16+ 25+ 45+ r 11 M BATCo document for Province of British Columbia 29 October 1999 0 20 -X0 FIGURE 14 c SAVE MONEY/BE BETTER OFF 10, 0 HIC CON DIS HID M F 164 25+ 45+ 0 FIGURE 14 d 20 /0 13E BETTER HEALTHWISE/FITTER 10- M F1 0 r-i HIC CON DIS HID M F 16+ 25+ 45+ r n M 20 0~0 FIGURE 14e WOULD BEA NERVOUS WRECK 10. 0 F-1 MF]n HIC CON DIS HID M F 16+- 25* 45+ 1 ff M 0/1 FIGURE 14 f 20 NOTHING 10- C0 0 HIC CON DIS HID M F 16+ 254- 45+ 1 11 M BATCo document for Province of British Columbia 29 October 1999 -73- FJGURE 15a % MENTIONS OF EAT/DRINK MORE 60- 50- 40 - 30 20 10- 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 IL 2 % FIGURE 15 b 60 MENTIONS OF NERVES/IRRITABLE /IMPOSSIBLE 50 40. 30 - 20 - 10- 0 HID CON DIS HID M F 16+ 25+ 45+ 1 FIGURE 15c 40 0/0 MENTIONS OF BETTER FOR HEALTH 30 - 20 - 10 r-1 F1 0 HIC CON DIS HID M F 16+ 251- 45+ CD Co 1 U III BATCo document for Province of British Columbia 29 October 1999 X,*' C5 (.r-1 (_rI co I'D -_j 1 ~0 QI-4 BATCo document for Province of British Columbia 29 October 1999 -74- Finally in this section, attention was turned to gauging the amoun: of pressure smokers were under to give up smoking altogether and/or to modify their smoking behaviour. The distribution between the smoker groups of those who felt themselves to be under a great deal or a fair amount of pressure to quit is shown in Figure 16a. It is clear that the two dissonant groups are more aware of pressure and that this is particularly felt in the middle age group and the higher socioeconomic classes. For 42 percent c-F the highly dissonant group and 30 percent of the dissonant groups atte--ts at persuasion had come from husbands and wives. Only one in five highl-. dissonant smokers and one in three dissonant smokers reported being undz-r no pressure at all compared with 47 percent of consonant smokers and 67 percent of highly consonant smokers. A broadly similar pattern emerges when pressure to modify smoking behaviour is considered (Figure 16b). In this case, the relative positions of the dissonant and highly dissonant smokers have been reversed. Agaia, it is the husbands and wives who are most likely to exert the pressure (35% for the highly dissonant and 29% for the dissonant). However, 37 percent of highly dissonant and 39 percent of dissonant smokers perceive themselves to be under no pressure at all to modify their smoking behaviour. The ways in which the various smoker groups have attempted to modify their smoking behaviour will be presented and discussed in a subsequent section of this report. CD CC) BATCo document for Province of British Columbia 29 October 1999 -75- 0/0 FIGURE 16 a 50. THOSE UNDER A GREAT DEAL/A FAIR AMOUNT OF PRESSURE TO GIVE UP SMOKING ALTOGETHER 40- 30 2 o - 10- 0 HIC CON D15 HID M F 16+ 25+- 45+ 1 H I FIGURE 16b 50 THOSE UNDER A GREAT DEAL/A FAIR AMOUNT OF PRE55URE TO MODIFY THEIR SMOKING BEHAVIOUR 40 30 20 10 - 0 HIC CON DIS HID M F 16+ 25+- 45+ 1 1 M BATCo document for Province of British Columbia 29 October 1999 -76- Attitudes to Smoking and Health Smokers were presented with a series of twenty-one statements relating to attitudes to smoking, health and social acceptability of smoking. As before, they were asked to respond according to a five point scale of agreement/ disagreement and in the Figures referred to in this section, the combined percentages of each group agreeing strongly or agreeing are presented. The statements were not presented in the order in which they are discussed here. The first two statements (Figures 17a and 17b) refer to the possible reduction of the conflict between smoking and health by attempting to rationalize the health issue. From what has been presented earlier in this report, it is not surprising to find that the highest level of belief that "tj2ere is too much fuss being made about smoking and health risks" is to be found amongst the highly consonant sub-group and least amongst highly dissonant smokers (Figure 17a). Interestingly, 37% of all smokers disagreed/disagreed strongly with this statement, implying that more fuss should be made, and even amongst the highly consonant sub-group, 18Z expressed this view. The rationalization expressed in Figure l7b clearly separates the dissonant from the consonant groups. Only eight percent of the highly consonant smokers disagreed with this statement compared with 42 percent of the highly dissonant sub-group. co BATCo document for Province of British Columbia 29 October 1999 (-M LTI c0 1-0 ---j 1-0 co BATCo document for Province of British Columbia 29 October 1999 0/0 FIGURE 17c 100- MANY NON-SMOKERS DIE OF ILLNESSES THAT ARE OFTEN SAID TO BE CAUSED BY SMOKING CIGARETTE5' 50 C=) CC) 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 X Ill BATCo document for Province of British Columbia 29 October 1999 -78- Responses to the statements referred to in Figures 17c, d and e reflect a fatalistic disposition to smoking and health based upon a ..s tatistical" rationalization. Agreement with the statement in Figure 17c is uniformly high across the smoker sub-groups but this is a statement with which it might be difficult to disagree. Consonant smokers are more likely to agree with the additive risk effect of smoking as are older and working class respondents (Figure 17d). The response pattern amongst smoker sub-groups to this statement is the inverse of that in Figure 17e where the truly fatalistic sentiment appeals most to the highly consonant smoker. The overall high level of agreement with this statement is somewhat surprising. 0 FIGURE 17 c 100- MANY NON-SMOKERS DIE OF ILLNESSES THAT ARE OFTEN SAID TO BE CAUSED BY SMOKING CIGARETTES" 50 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 C=> cc \~c CO BATCo document for Province of British Columbia 29 October 1999 -79- 100 FIGURE 17d CIGARETTE SMOKING SIMPLY MAKES IT MORE LIKELY THAT YOU WOULD GET AN ILLNESS YOU WOULD GET ANYWAY 50- 0 HIC CON D15 HID M F 16+ 25+ 45+ 1 Z M 100% FIGURE 17 e YOU COULD BE RUN OVER BY A BUS TOMORROW SO WHY WORRY ABOUT'SMOKING CIGARETTE5 50 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 co 110 co BATCo document for Province of British Columbia 29 October 1999 y A C=3 ~-p (-n cc \-I) c0 r\-) BATCo document for Province of British Columbia 29 October 1999 % FIGURE 171 100, THERE IS NOTHING WRONG WITH SMOKING AS LONG AS A PERSON SMOKES MODERATELY" 50- 0 HIC CON DIS HID CD c0 C-- M F 16+ 25+ 45+ a M BATCo document for Province of British Columbia 29 October 1999 -80- Rationalization through modifying smoking behaviour is a feasible means of conflict reduction. Moderation in consumption (Figure 17f) is highly endorsed by the consonant groups whilst more doubt is expressed by the highly dissonant group. The highly consonant smoker is, however, least likely to agree that mild cigarettes are safer than strong cigarettes (Figure 17g) or that low tar cigarettes are safer than other cigarettes (Figure 17h) . Whilst the responses to these two statements appear to be highly correlated, for all but the highly dissonant smoker, there is a drop in the level of agreement from the "mild" to the "low tar" statements. The generally high level of agreement across respondents is notable. 0/0 100- 50 FIGURE 17f THERE IS NOTHING WRONG WITH SMOKING AS LONG AS A PERSON SMOKES MODE R -~%-E LY" 0 HIC CON CiS HID -M F 16+ 25+ 45+ 1 co `10 CC) BATCo document for Province of British Columbia 29 October 1999 0 FIGURE 171 100~ I ENJOY SMOK NG AND DON'T SEE WHY I SHOULD CHANGE MY WAYS!' 50 0 HIC CON DIS HID M F 16+ 25+ 45+ r a IM CD BATCo document for Province of British Columbia 29 October 1999 IL" tn 1 :3 Z > z M aK m 0 + < Z Ln M LA L rn /OMS901 -82- Denial of authority is another possible mode of conflict resolution, directly or indirectly inferred from the three statements noted in Figures 17i, 17j and l7k. The consonant groups appear to be adamant in their reluctance to quit smoking (Figure 17i) and, not unexpectedly, a trend with age is evident. Dissonant and highly dissonant smokers, it will be recalled, are less likely to really enjoy smoking anyway (Figure lla) and this aspect of the present question may have influenced their response to the whole. There is a high level of accord regarding the disagreement amongst doctors with respect to smoking and health (Figure 17j) and this is again reflected in respect of belief in government pronouncements (Figure l7k). In both cases, however, it is the highly dissonant smoker who is least sceptical. 0 FIGURE 17i 100 YO 1. I ENJOY SMOKING AND DON'T SEE WHY I SHOULD CHANGE MY WAY5' 50 0 HIC CON DIS HID M F 16+ 25+ 45-t co 110 cc c::) c0 BATCo document for Province of British Columbia 29 October 1999 00 FIGI. RE 17 j 100Z DOCTORS DO NOT AGREE- AMONGST THEMSELVES ABOUT THE POSSIBLE DANGERS OF SMOKING TO HEALT~' 50- 0 HIC CON 015 HID M F 16-t 25+ 45+ 1 a z 100 50- 0 1. FIGURE 17k YOU CANNOT ALWAYS BELIEVE WHAT THE GOVERNMENT TELLS YOU ABOUT SMOKING AND HEALTH" HIC CON DIS HID M F 16+ 25+ 45+ 1 H M co 1 ~0 C-X:) CD BATCo document for Province of British Columbia 29 October 1999 C::) (-n (-P co co BATCo document for Province of British Columbia 29 October 1999 -84- In the introduction to this project (1) one of the questions posed for this research was: "How does the smoker remain a smoker despite the apparently good reasons for him to quit?" One way of reducing the conflict within the smoker is to deny, devalue or otherwise rationalize the health argument. The four modes of potential conflict reduction discussed so far rely on either a fatalistic disposition to health or a faith in "safer" smoking, or a denial of anti-smoking information. The fifth way of dealing with the internal conflict between smoking and health is perhaps the most rational and was hypothesised to be most appealing to the consonant group (1). Reference to Figure 17Z supports this contention where it is clear that the consonant groups are more likely to agree with the statement. As noted earlier, however, agreement presupposes that the risks are genuinely perceived as "small" or that some rationalization has allowed that conclusion to be reached. The data presented in Figure 17m are clearly influenced by an age effect which is not independent of the question. Even so, one fifth of smokers under 25 years of age feel that quitting now would not make any difference to them. Overall, the data again support the hypothesis that the sentiment of the statement is most appealing to the consonant sub-groups. OD BATCo document for Province of British Columbia 29 October 1999 BATCo document for Province of British Columbia 29 October 1999 -85- 100% FIGURE 17 1. THE ENJOYMENT I GET FROM SMOKING 15 WORTH J ANY SMALL RISKS IT MIGHT INVOLVe 50. 0 HIC CON 015 HID M F 16+ 25+ 45+ 1 9 11 0/. FIGURE 17 rn 100. 'I'VE SMOKED FOR 50 LONG THAT STOPPING WOULD NOT MAKE ANY DIFFERENCE NOW" 50 0 HIC CON DIS HID c0 M F 16+ 25+ 45+ r I a BATCo document for Province of British Columbia 29 October 1999 cc 11 C C--- BATCo document for Province of British Columbia 29 October 1999 100% FIGURE 17n FULLY INTEND TO GIVE UP SMOKING SOME DA; 50 - 0 F] HIC CON D15 HID M F 16+ 25+ 45+ 1 1 IM co 1 \0 cc BATCo document for Province of British Columbia 29 October 1999 -86- Intention to quit is, as expected, more strongly expressed by the dissonant sub-groups (Figure 17n). There is, however, for these groups an apparent conflict between this intention and their responses to the statement: "Smoking might be hazmful, but I can't stop" (Figure 17o) insofar as more than fifty percent agree with both statements. Ability to quit, assuming motivation to do so, (Figure 17p) is more firmly expressed by the highly consonant and consonant sub-groups, although the latter has, by definition, already failed to do so. 0 FIGURE 17n 100 ~0 I FULLY INTEND TO GIVE UP SMOKING SOME DA; 50 - 0 HIC CON DIS HID M F 16+ 25+ 45+ 1 11 CZ) CC) c0 0-1 BATCo document for Province of British Columbia 29 October 1999 5 c::) (--n C-71 c0 110 cc -_j BATCo document for Province of British Columbia 29 October 1999 _90- Social Acceptability of Smoking Included in the battery of attitudinal items were five statements relating to the social acceptability of smoking and the perception by smokers of public attitudes. Fifty-eight percent of all smokers believe that it is much less socially acceptable to smoke nowadays (Figure l7q). Amongst smokers it is those in the two dissonant groups who most strongly support the contention. Younger smokers are less likely to agree than those aged twenty-five and above and a relationship between level of agreement and socioeconomic class is clearly evident. This overall picture is largely replicated, albeit at a lower level, when feelings of embarrassment about smoking are measured (Figure 17r). Very few smokers from the two consonant groups agree with this statement and it is the highly dissonant who are most likely to be affected. Markedly more women than men support the statement, but in this case it is the oldest rather than the youngest age band which shows the least concern. The trend with class is similar to that noted above. It would appear that, despite the recognition by the majority of smokers that smoking is less socially acceptable nowadays, significantly fewer (28% overall) actually feel embarrassed about smoking. CD CO CO BATCo document for Province of BritiSh Columbia 29 October 1999 _89- also provided the highest level on three occasions. It would appear that the highly dissonant smoker group comprises individuals with a complex array of attitudes or idiosyncratic sub-groups yet to be defined. Dividing the sample according to sex reveals that men are slightly more ready than women to rationalize the health issue, but have less faith in mild or low tar cigarettes. More women than men express the intention to quit some day and yet they also more readily acknowledge their inability to stop smoking. They are less sceptical than men regarding doctors' ad7ice but tend to be more fatalistic. Segmenting according to age, trends are apparent in respect of the following items, with the highest level of agreement being expressed by the older (45 years +) group: "Smoking, may be harmful, but r can't stop" "The enjoyment I get from smoking is worth any small risks it might involve" "Many non-smokers die of illnesses that are often said to be caused by smoking cigarettes" "Mild cigarettes are safer than strong cigarettes" "Low tar cigarettes are safer than other cigarettes" Not surprisingly, the strength of intention to quit some day dininishes with age. QTI (.-n cc \_1) BATCo document for Province of BritiSh Columbia 29 October 1999 r p I C-+U (4-' t, IXI /X, (ZD (-M (-n c0 110 CC) NJ C7) BATCo document for Province of British Columbia 29 October 1999 _90- Social Acceptability of Smoking Included in the battery of attitudinal items were five statements relating to the social acceptability of smoking and the perception by smokers of public attitudes. Fifty-eight percent of all smokers believe that it is much less socially acceptable to smoke nowadays (Figure l7q). Amongst smokers it is those in the two dissonant groups who most strongly support the contention. Younger smokers are less likely to agree than those aged twenty-five and above and a relationship between level of agreement and socioeconomic class is clearly evident. This overall picture is largely replicated, albeit at a lower level, when feelings of embarrassment about smoking are measured (Figure 17r). Very few smokers from the two consonant groups agree with this statement and it is the highly dissonant who are most likely to be affected. Markedly more women than men support the statement, but in this case it is the oldest rather than the youngest age band which shows the least concern. The trend with class is similar to that noted above. It would appear that, despite the recognition by the majority of smokers that smoking is less socially acceptable nowadays, significantly fewer (28% overall) actually feel embarrassed about smoking.' CC) 110 CO BATCo document for Province of BritiSh Columbia 29 October 1999 0 FIGURE 17q 100 ~- . NOWADAYS IT IS MUCH LESS SOCIALLY ACCEPTABLE TO SMOKE 50- 0 HIC CON DIS HID M F 16+ 25+ 45+ % FIGURE 17r 100, NOWADAYS THERE ARE TIMES WHEN I FEEL EMBARASSED ABOUT SMOKINd' 50 0, HIC CON 015 HID M F 1 11 M 16+ 25+ 45+ 1 IE H1 C:~) (-Yl (-n co r-0 BATCo document for Province of British Columbia 29 October 1999 V, 0S ---I C:D (-n Q.ri c0 110 CXD r\-) (--I BATCo document for Province of British Columbia 29 October 1999 FIGURE 17, 100 CIGARETTE SMOKING IS A DIRTY HABd 50- 0 PIC CON DIS HID M F 16+ 25+ 45+ 1 1 in c0 \-0 cc NJ BATCo document for Province of British Columbia 29 October 1999 -92- Percepti-.-a of cigarette smoking as a dirty habit clearly differen-ciates the four smoke: sub-groups and men from women (Figure 17s). A broad17 similar patter-a of responses obtains in respect of the belief that cigarette smoking is harmful to the health of non-smokers (Figure 17t). Overall, 36 percent of smokers agreed with this statement and only six percent di3agreed strongly. The asser:ive response to social pressure is most marked in the two consonant groups (Figure 17u). Six percent of all smokers, and thirteen perceat of dissonant smokers disagreed strongly with the statement and, one may presume, acknowledge other people's feelings by not smoking in the presence of those who don't like it. 100 0/0 FIGURE 17s ~IC-ARETTE SMOKING IS A DIRTY HABIf 50- 0 HIC CON 215 HID M F 16+ 25+ 45+ 1 1 M cc BATCo document for Province of BritiSh Columbia 29 October 1999 -93- 10/0 FIGURE 17t 100, CIGARETTE SMOKING 15 HARMFUL TO THE HEALTH OF NON-SMOKERS" 50 0 HIC CON DIS HID M F 16* 25+ 45+ 1 1 x 100% FIGURE 17u 'JUST BECAUSE OTHER PEOPLE DONT LIKE SMOKING I DON'T BEE WHY I SHOULD NOT SMOKE IN THEIR PRESENCE, 50 0 HIC CON 015 HID M F 164- 25+ 454- CZ) 1 R M BATCo document for Province of British Columbia 29 October 1999 -94- Two items presented in this questionnaire were also presented in Operation AQUARIUS (2). For comparison, the data from smokers for both items are presented below. AQUARIUS LIBRA (7) M "CIGARETTE SMOKING IS A DIRTY HABIT" Agree strongly/agree 65 60 Disagree strongly/disagree 28 31 "CIGARETTE SMOKING IS HARMFUL TO THE HEALTH OF NON-SMOKERS" Agree strongly/agree 30 36 Disagree strongly/disagree 57 45 Belief by smokers that cigarette smoking is a dirty habit has apparently eased a little over the time between the two exercises whilst it has firmed in respect of the harmful effects on non-smokers. cc \_0 C.0 r1,) C-0 BATCo document for Province of BritiSh Columbia 29 October 1999 30 20 10. FIGURE 18 kW MANY YEARS IN ALL WERE YOU A CIGARETTE SMOKER RECENT EX-5MOKERS (-2 YEARS) 77- 0 <3yrs. 3-4 yrs. 5-6 yrs. ESTABLISHED n EX-SMOKERS 2 YEARS) 77 7-10yrs. 11-15 yrs 7, 16-20yrs. 21-30 yrs. > 31 yrs. C:D Cc- BATCo document for Province of British Columbia 29 October 1999 -95- IV. THE EX-SMOKER For the purposes of this report, two categories of ex-smoker have been defined on the basis of length of time since quitting - those who gave up two or less years ago and those who gave up more than two years ago. The mean length of time since quitting for the two groups was 0.74 years and 10.91 years respectively. Twenty-nine percent of all ex-smokers in the sample were classified as recent ex-smokers (<2 years) and the remainder as established ex-smokers (>2 years). The distribution of length of time as a smoker, for each group, is shown in Figure 18. FIGURE 18 0/0 HOW MANY YEARS IN ALL WERE YOU A CIGARETTE SMOKER ? 30 - RECENT ESTABLISHED EX-SMOKERS n EX-SMOKERS (<2 YEARS) (> 2 BEARS) 70 ' I- 77 77 10 X 77 Z 0 r7_ X <3 yrs. 3-4 yrs. 5-6yrs. 7-10yrs. 11-15yrs. 16-20yrs. 21-30 y r s. > 31 yrs. It can be seen that more than half of the both recent and established ex-smoker groups had been smokers for more than sixteen years before quitting. Previous Smoking Behaviour At the time of quitting, more than fifteen percent of now ex-smokers were smoking less than ten cigarettes per day (Figure 19). In this respect CC I'D BATCo document for Province of British Columbia 29 October 1999 Y/ >1 0 ~_-I CZ) \-0 Cc. NJ BATCo document for Province of British Columbia 29 October 1999 FIGURE 19 1 0 RESPONDENTS PREVIOUSLY SMOKING LESS THAN 10 30 CIGARETTES/DAY 20 10. 0 5 M0 <2Y :,-2Y M F 164 25+ 45+ 1 a X: CKD 1-0 CC) BATCo document for Province of British Columbia 29 October 1999 -96- FIGURE 19 0 RESPONDENTS PREVIOUSLY SMOKING LESS THAN 10 3 0 ~0 CIGARETTES/DAY 20 - 10 7 0 smo -2Y >2Y M F 164 25+ 4.5+ 1 EU they are similar to highly consonant and consonant current smokers (see Figure 7). The most popular brands amongst ex-smokers are shown in Table 18 where, to be included, a brand must have attracted at least 5% usage by at least one of the categories of respondent under consideration. It should be noted that the size of the sample in the 16 to 24 year age band is only 31 persons and therefore the 10% referred to under "other menthol" for this group derives from three respondents only. The most popular previous brands are listed (Table 19), again adopting the >5% criterion. It is interesting to note that, with the exception of Embassy Extra Mild (Table 18) and Silk Cut (Table 19) there is a conspicuous absence of low tar products. This is somewhat unexpected in the case of the recent quitters but not surprising in the case of established ex-smokers. The most popular reasons for changing to their most recent current brand are shown in Figure 20. CD C)c 1-~ 03 BATCo document for Province of BritiSh Columbia 29 October 1999 -97- M O ST P O P U L A R T AB BR L A E N D 1 S 8 ( E X - S M O KE R S ) WH E N Q U I T S E X A G E S. E. C LA S S E X 6 <2 Y > 2 Y M M 1 6 + 2 5 + 4 5 + 1 1 1 1 1 1 B E N S O N & H E D G E S K . S . 5 9 3 6 2 3 5 5 6 3 5 D U N H I L L K . S . 1 3 1 1 2 6 1 1 - 2 1 E M B A S S Y E . M . F . T . 1 5 - 1 2 - 1 2 3 - E M B A S S Y N O . 1 F . T . 5 5 5 4 5 1 3 8 2 6 4 2 E M B A S S Y R E G A L F . T . 3 6 2 4 3 6 4 3 3 3 5 E M B A S S Y F . T . 1 0 9 1 0 8 1 3 6 1 3 9 1 2 6 1 2 J O H N P L A Y E R S P E C I A L - 1 - - 1 6 - - - 1 - P A R K D R I V E P L A I N 2 - 3 3 2 - 2 2 - 5 2 P L A Y E R S M E D I U M N A V Y C U T P LA I N 1 0 3 1 3 1 3 5 - 2 1 5 1 0 1 1 1 0 P L A Y E R S N O . 6 F . T . 9 11 8 9 9 1 9 1 1 7 6 9 1 3 R O T H M A N S K . S . 2 3 2 1 3 1 0 2 1 2 2 2 S E N I O R S E R V I C E P L A I N 5 1 7 7 3 - 1 8 3 7 7 W O O D B I N E P L A I N 5 - 7 7 - 1 7 2 3 1 2 O O T T H H E E R R T M L 6 1 4 1 6 - 4 - 9 2 1 6 0 5 - 6 - 7 I 5 - 5 - I E P N P T E H D O 8 6 9 0 1 0 0 CL 0 0 0 0 < 0 :r 0 0 cr 0 0 cr m to to to T A - B 9 L 8- E 1 9 P R E V I O U S B R A N D ( E X - S M O K E R S) W H E N Q U I T S E X A G E S. E. C L A S S E X S < 2 Y > 2 Y M F 1 6 , 2 5 , 4 5 - 1 C O N S U L A T E F . T . - - 1 - 1 6 - - 1 E M B A S S Y F . T . 7 1 3 4 8 5 1 0 1 4 3 9 7 3 P L A Y E R S M E D I U M N A V Y C U T P L A I N 9 7 1 0 1 0 8 - 2 1 4 1 0 7 1 1 P L A Y E R S N O . 6 F . T . 5 1 0 3 4 6 6 8 3 3 6 5 S E N I O R S E R V I C E P L A I N 6 5 6 6 5 3 8 4 7 4 5 S I L K C U T F . T . 1 2 - - 2 6 1 - I I W O O D B I N E P L A I N 6 3 7 8 3 - 2 9 3 8 8 O N T O H E P R R E T V I I P O P U E S D R E G U L A R B R AN D S M O KE D 3 4 7 2 4 1 4 4 3 3 3 8 3 6 5 4 - 2 3 4 6 3 5 7 3 6 5 3 2 7 3 3 9 ZH68SS0j 0 0 CL 0 0 -h 0 0 < (D 0 h w 0 0 0 0 rol 0 cy CD c0 w FIGURE 20a a/. THEY WERE CHEAPER 40- 30- 77 20. 10- 0 SM0 <2Y >2Y M F 16+ 25t 45+ 0 FIGURE 20b /6 30 - THEY WERE MILDER 20- 7-7 10- 0 A SM0 <2y >2y M F 16+ 25+ 45+ FIGURE 20 c 30 - TRIED THEM AND PREFERRED THEM 20- 1 IE IM 77 10. Q'n 0 SIVIO <2Y >2Y M F 16+ 25+ 454 co Q-^j BATCo document for Province of British Columbia 29 October 1999 C:D (-.T-l Q11 cc 1-0 CC) -C~:. CZ) BATCo document for Province of British Columbia 29 October 1999 0 0 7 50 - 40 77 30 20. 10- 0 SM0 <2 Y >2Y FIGURE 21 MENTIONS OF HEALTH M F 164 25+ 45+ 1 K 11 co 110 Co BATCo document for Province of British Columbia 29 October 1999 -100- Cost considerations appear to be a constant factor regardless of whet'--er the ex-smoker is recent or established, but appealed particularly to t'--e middle aged respondents. Mildness was more relevant to the rece--t quitter. All mentions of health are summarised in Figure 21 and, as expected, this motivation is more readily quoted by recent ex-smokers. As with the smoker group (Figure 10), a trend with age is evident. The occasions of the most enjoyable cigarette of the day for ex-smokers are summarised in Table 20. Compared with current smokers (TaKe 10), "the first one" is markedly less often specified. 07 0 50 - 40 - 7-7 X 30 20- X 00/ 10- 0 Sli 0 -2Y >2Y FIGURE 21 MENTIONS OF HEALTH M F 16+ 25+ 45+ 1 H Ur Q-n cc CC) -.I!:, r1 J BATCo document for Province of British Columbia 29 October 1999 TA B L E 2 0 WH I CH W A S TH E M O S T E NJ O Y A BL E C T C AR S T T C O F n1 E D A Y FO R Y OU ? W H E N Q U I T S E X A G E S. E. C LA S S E X S < 2 Y > 2 Y m F 16 + 2 5 + 4 5 + 1 l I I I I THE FIRST O N E (AL L ME NTIO N S) 2 7 3 2 2 4 2 5 2 4 12 1 6 3 1 2 5 '2 0 3 3 THE F IRST O N E AFTER BR E A K FAST 2 3 2 2 2 6 - 2 2 1 3 MID MORN I N G /COF FEE 4 5 3 3 4 6 3 4 4 3 3 AFTER LU N C H 1 - 1 1 - - 1 1 - 1 - AFTER DI N N E R 1 1 1 1 - - 2 - 2 1 - - IN EVENI N G - - - - - - - - - - - - UNSPECIF I E D 2 3 2 2 2 6 - 2 2 1 3 WHEN I G E T UP 1 7 2 1 1 5 1 7 1 5 - 8 2 2 1 3 1 4 2 6 AFTER MEAL S ( UNSP ECIF IED) 1 1 1 0 1 2 1 2 9 3 i s 1 0 1 0 1 3 1 0 AFTER-DINN E R / EVEN ING MEAL 1 6 1 3 1 7 1 6 1 7 3 2 3 1 4 1 9 2 0 7 AFTER LUNC H / M IDDA Y HE AL 7 7 6 8 4 13 8 5 5 7 8 AFTER WORK / I N THE EVE NING 7 7 8 7 9 13 8 7 7 9 5 WHEN RELAX I N G 4 3 4 4 5 6 2 5 5 3 4 LAST THING A T NIG HT 2 3 2 2 2 3 2 2 2 2 2 WITH A DRI W K 3 3 3 3 4 3 7 2 4 2 3 NO PARTICU L A R TIM E 1 0 8 1 1 1 2 6 16 7 1 1 1 1 1 1 1 1 DON'T KNOW / N O T ST ATED 1 1 7 1 3 1 0 1 3 29 1 0 1 0 1 0 1 3 1 2 0 0 CL 0 0 c 3 0 0 0 h 0 0 E -9 0 0 r+ 0 cr (D -L c0 to 0 YO 100- 50- 0 SM0 FIGURE 22a 1 REALLY ENJOYED SMOKING < 2Y >2Y M F 16+ 25+ 45+ 1 CC) it M BATCo document for Province of British Columbia 29 October 1999 -102- Previous Smoking Motivation Ex-smokers were presented with the same battery of motivation statements as the smokers but these were phrased retrospectively. As before, the five point scale of agreement was employed and in the following Figures (2 la-21z), statements of strongly agree and agree have been consolidated into the percentages quoted. The Figures are presented without individual comment. It is important to stress that these responses are at the mercy of potentially faulty recall, particularly in respect of the established ex-smoker. For comparison purposes, the average response of the smoker group is shown at the extreme left of each Figure. The order of presentation is the same as in Figures lla-z. 0/6 100, 7-7 50- 0 SM0 FIGURE 22a 1 REALLY ENJOYED SMOKIN~ -2 Y >2Y M F 16+ 25+ 45+ Ia CXD \Z-1 cc BATCo document for Province of British Columbia 29 October 1999 -103-. 100% FIGURE 22b I FOUND SMOKING VERY SATISFYING 7-7 X 50 0 smo -2Y ~12Y' M F 16+ 25+ 45+ 1 ir M 0/. FIGURE 22 c 100 - I SMOKED AS A REWARD AFTER A HARD OR BORING TAS~ 50 - 0 smo <2y -2y M F 16+ 25+ 45+ 1 11 x c::) Un co cn_ r- cc BATCo document for Province of British Columbia 29 October 1999 -104- 00 FIGURE 22d 100 LIKED. TO SMOKE WHEN I HAD A DRIN~ 7 50 0 SM0 >-2Y 0/0 100, 50- 0 SM0 -2Y ::-ZY M F 16+ 25+ 45+ FIGURE 220 11 1 SMOKED WHEN RELAXING M F 16+ 25+ 45+ 1 CD c0 CO BATCo document for Province of British Columbia 29 October 1999 -105- % FIGURE 22 f 100- SMOKED IN ORDER TO RELAX 77 50 0 SIVIO <2Y >2Y M F 16-+ 25+ 45+ 100 0/1 . FIGURE 22g I SMOKED IN ORDER TO BREAK THE ICE WITH OTHER 5MOKERS 50 7, o CC) SM0 <2Y >2Y M F 16 25 45 + I I x BATCo document for Province of British Columbia 29 October 1999 -106- 0 FIGURE 22h 100 X0 1 9. I SMOKED IN ORDER TO HELP ME CONCENTRATE 50 77 0 SM0 < 2y >2y M F 16 + 25 + 45 1 100 0/0 FIGURE 22i I SMOKED WHEN WORKING BUT NOT DEEPLY ABSORBED IN THE TASK so 77 ~-n CC) 0 \-0 SM0 2Y ;:,-2Y M F 16+ 25+ 45f 1 11 M co Q-n BATCo document for Province of British Columbia 29 October 1999 -107- % FIGURE 22 100 'SMOKING WA S ONE OF MY FEW INDLILGENCE~ 7- so - 0 SM0 -,N > 2 Y M F 16+ 25+ 45+ 0/0 FIGURE 22 k 100 - HANDLING A CIGARETTE WAS PART OF THE JOY OF SMOKIN 50 CD c0 0 \-0 5 M0 --ZY >2Y M F 16+ 25+- 45+ 1 C-0 BATCo document for Province of British Columbia 29 October 1999 100 0/0 77 50 - 0 smo -log- FIGURE 22 1, CIGARETTES ARE COMFORTING -2 Y >2Y M F 16+ 25+ 45+ L U IT 100 FIGURE 22m 9 I SMOKED BECAU5E CIGARETTES WERE BEING HANDED AROUND 50 7' 0 SM0 <2Y >2Y M F 16+ 25-t. 45+ Ji M co 1-10 cc (_J-j BATCo document for Province of British Columbia 29 October 1999 -109- FIGURE 22 n 100- "THERE WERE OFTEN TIMES WHEN I LIT UP A CIGARETTE JUST OUT OF HABIT" 50 0 51 VIO <2Y >ZY M F 16+ 25+ 45+ 1 % 100 50 0 SIVIO FIGURE 22 o I SMOKED WHEN FEELING DOWN < ZY >ZY M F 16+ 25+- 45+ 1 U Im CZ) co co BATCo document for Province of British Columbia 29 October 1999 -110- 100% FIGURE 22 p SMOKED WHEN FEELING ALONE~ 50- X X 0 SM0 <2Y >ZY M F 16+ 25+ 45+ FIGURE 22q 0/1 100- 1 SMOKED WHEN FEELING TENSE OR ANXIOU5~ 77 50- cc 'I'D 0 5 MO <2Y >2Y M F 16+ 25+ 45+- 1 1 M BATCo document for Province of British Columbia 29 October 1999 0 FIGURE 22r 100 Y10 1. 1 SMOKED IN ORDER 'TO FEEL LESS TENSE OR LESS IRRITABLE' 50 smo < 7y >zy M F 16+ 25+ 45+ 0/1 FIGURE 22 s 100. SMOKED WHEN FEELING HUNGRY BUT COULDN'T OR DID t4T WANT TO EAT" 50 - 77 X X co 110 SM0 2y M F 16+ 25-1- 45+ 1 IL Z Co (-n CrI, BATCo document for Province of British Columbia 29 October 1999 100% 50 FIGURE 22t I SMOKED INSTEAD OF NIBBLING SOMETHIN6' 7, 0 SM0 <2Y >2Y M F 16+ 25+ 45+ 100% I FIGURE 22u I SMOKED WHEN FEELING BORE6 7- 50. CD Q-n (-T1 Co 0 SM0 -2Y >2Y M F 16+ 25+ 45+ t Er M cc BATCo document for Province of British Columbia 29 October 1999 -113- FIGURE 22 100 I -SMOKED WHEN DEEPLY ABSORBED IN WHAT I -WAS DOING 50 7 X 0 SM0 -2Y >2Y M F 16+ 25+ 45+ 1 M % FIGURE 22 w 100- I SMOKED IN ORDER TO MAKE A BREAK IN TASK~ 50 7-~ 0 5 M0 -ZY >2Y M F 16+ 25+ 45+ CD c0 1 1 M ~_n cx:> BATCo, document for Province of British Columbia 29 October 1999 -114- FIGURE 22x '00 1 SMOKED AFTER RECEIVING BAD NEWS OR A SUDDEN SHOCK 77 50 0 5 M0 < 2Y >2Y M F 16+ 25* 45+ FIGURE 22Y 100, 1 NEEDED THE NICOTINE IN CIGARETTE5" 50 7, X x 0 smo <2Y >2Y M F 16+ 25+ 45+. r u m BATCo document for Province of British Columbia 29 October 1999 co \_0 00 100 0y, FIGURE 22z I ALWAYS HAD CIGARETTES AT CERTAIN TIMES OR OCCASIONS DURING THE DAY" 7- s0 - 0 SIVIO 7Y > 2Y M F 16* 25+ 45+ 1 cc \.C C-- BATCo document for Province of British Columbia 29 October 1999 -115- 0 FIGURE 22z 100 ~0 01 ALWAYS HAD CIGARETTES AT CERTAIN TIMES OR OCCASIONS DURING THE DAY" 7- 50 - X X X S1140 < 2Y > 2Y M F 16+- 25+ 45+ Relative to any sub-group of smokers, ex-smokers are more likely to have smoked because cigarettes were being handed around and in order to break the ice with other smokers. They are less likely to believe that smoking was one of their few indulgences. Recent ex-smokers, compared with established ex-smokers are more likely to have smoked when bored, when tense or anxious, when feeling "down" and after a trauma. They are also more likely to have smoked when feeling alone and in order to feel less tense or irritable. Those ex-smokers strongly agreeing/agreeing with the statement in Figure 22z (49% of all ex-smokers) were questioned about the times of day or occasions on which they always had a cigarette and the results are presented in Table 21 and -compared with the responses of all smokers. cc 11.0 CXD BATCo document for Province of British Columbia 29 October 1999 -il6- TABLE 21 EXS SM0 <2 Y >2Y M (Z) (7.) AFTER MEALS (UNSPECIFIED) 49 60 54 FIRST THING IN THE MORNIVG/WHEN I GET UP 14 11 24 TEA BREAK/TEA TIME/WITH A CUP OF TEA 13 20 22 COFFEE BREAK/MID-MORNING 15 17 21 AFTER LUNCH/MIDDAY MEAL 16 16 17 WITH A DRINK (ALCOHOLIC) 1 12 13 LAST THING AT NIGHT/BEFORE GOING TO BED 6 6 11 AFTER DINNER/EVENING MEAL 22 13 11 EVENINGS AT HOME 10 10 10 AFTER BREAKFAST 14 7 8 It can be seen that the cigarette "first thing in the morning" is less often mentioned by ex-smokers than by current smokers, although "after breakfast" and "after dinner" are more often quoted. Ex-smokers are also less likely than current smokers to smoke a cigarette "last thing at night/before going to bed". The data collected in respect of ex-smokers' previous motivation to smoke will be the subject of further analysis. co 110 co BATCO document for Province of BritiSh Columbia 29 October 1999 -117- Quitting Behaviour All ex-smokers were asked how sure they are that they will not take up smoking packeted cigarettes again. The results are presented in Table 22 and, as might be expected, a greater confidence in remaining an ex-smoker is expressed by the more established ex-smoker group. TABLE 22 WHEN QUIT <2 Y >2Y VERY SURE 35 82 QUITE SURE 30 12 NEITRER SURE NOR UNSURE 22 4 QUITE UNSURE 7 2 VERY UNSURE 6 - Respondents were then asked to justify their statements depending upon the answers given above. Table 23 sm-arises the reasons given by those who are very/quite sure as a function of length of time since quitting and age. Tables 24 and 25 present similar data for those who were neither sure nor unsure and those who were very/quite unsure respectively. CD CC) \10 BATCo document for Province of BritiSh Columbia 29 October 1999 _118- TABLE 23 WHY DO YOU SAY YOU ARE VERY/QUITE SURE YOU WILL NOT TAKE UP SMOKING CIGARETTES AGAIN? WHEN QUIT AGE <2 Y >2Y 16+ 25- 45+ ALL MENTIONS OF HEALTH 45 43 37 40 46 WOULD BE SI-_LY/DON'T WANT TO 21 31 26 20 33 FINANCIAL P_TkSONS 30 23 26 27 24 HAVE TRIED z:~M DIDN'T LIKE 13 18 22 19 16 DISLIKE THE SMELL 11 10 7 19 7 R.Y.O./SMOK__ PIPE AND PREFER 3 5 8 4 2 WIFE/ HUSBAND /CHILDREN WOULDN'T LIKE IT 3 2 7 3 1 FOOD TASTES BETTER - 2 - 3 1 WOULD NOT CHILDREN TO SMOKE - 1 - 1 1 It will be recalled (Table 14) that, for smokers, the most often quoted reason for =-:tempting to quit was the cost of smoking. For ex-smokers, the major reasc=s for not taking up smoking again are related to health and not cost. This suggests that those smokers who have already quit were motivated by differen: reasons than those yet expressing the wish to. The ri-ck of a sudden lapse, even for established ex-smokers is surprisingly high, especially for the older person unsure about his intention to remain au ex-smoker (Table 24). Tension, and stress (Table 25) are potentiallv the greatest threat to the established ex-smoker's resolve. All those e-r-smokers who were neither sure nor unsure, quite unsure or very unsure that they will not take up smoking cigarettes were questioned further about their doubts (Table 26). CD (-M Q71 CC) CC) 0 _1 CXD BATCO document for Province of BritiSh C01urnbia 29 October 1999 _119- TABLE 24 WHY DO YOU SAY YOU ARE NEITHER SURE NOR UNSURE YOU WILL NOT TAKE UP SMOKING CIGARETTES AGAIN? WHEN QUIT AGE <2 Y >2Y 16+ 25+ MAY HAVE A SUDDEN LAPSE 45 62 50 46 QUIT BEFORE AND WENT BACK 27 - 50 17 MAY UNDER EXTREME TENSION 6 23 1 21 IF OFFERED ONE, I MAY SMOKE IT 9 - - - READY MADE ARE HANDIER THAN ROLL-UPS 6 - - 8 ROLL-UPS ARE CHEAPER - 8 - 4 TABLE 25 WHY DO YOU SAY 7-OU ARE VERY/QUITE UNSURE YOU WILL NOT TAKE :P SMOKING CIGARETTES AGAIN? WHEN QUIT <2 Y >2Y STILL CRAVE FOR THEM 37 38 HAVE NOT ENOUGH WILL POWER 42 25 UNDER STRESS I MAY 11 38 DON'T KNOW 11 - 16+ 50 50 - - AGE 25+ 45 45 - 9 45+ 55 20 - 15 - 45+ 29 29 36 7 1 _0 ~Do BATCo document for Province of British Columbia 29 October 1999 -120- TABLE 26 WHY DO YOU THINK THAT YOU MIGHT START SMOKING PACKETED CIGARETTES AGAIN? WHEN QUIT AGE <2 Y >2Y 16+ 25+ 45+ UNDER STRESS, I MAY 19 38 50 23 24 ENJOY THEM 17 24 25 20 18 LACK OF WILL POWER 25 5 25 14 24 SOMETIMES FANCY ONE/WHEN I WAKE UP 1 15 14 - 14 is WANT ONE HANDY/READY MADE 4 5 - 9 - MAY GO BACK WHEN HAVE HAD THE BABY 2 - - 3 - DON'T KNOW 21 10 - 20 18 It should be noted that only 14 percent of all ex-smokers qualified for inclusion in Table 26. It would appear from the data presented in Figure 23 that most successful quitters do not make repeated efforts to give up smoking before achieving their new status. Although the question included a time qualification, it would appear that established ex-smokers succeeded after fewer attempts than more recent ex-smokers. This may well be a reflection of the different motivations to quit expressed by the two groups. c0 1.10 c0 BATCo document for Province of British Columbia 29 October 1999 ox 0 FIGURE 23 100, BEFORE GIVING UP SMOKING, HOW MANY ATTEMPTS HAD YOU MADE IN THE PREVIOUS TWO YEARS" 2 y >2Y ]--(ME ANz 1-3 (MEAN 1-07) [ 50 0 Fb 0 1 2 3 4 5 6 7 a 9 10 NUMBER OF ATTEMPTS CD BATCo document for Province of British Columbia 29 October 1999 -121- % FIGURE 23 100, BEFORE GIVING UP SMOKING, HOW MANY ATTEMPTS HAD YOU MADE IN THE PREVIOUS TWO YEARS" ? 2 y tu>2Y ]--(MEAN= 1-3 (MEAN 1-07) [ 50 0 0 1 2 3 4 5 6 7 a 3 10 NUMBER OF ATTEMPTS Comparing the data on attempts to quit by smokers (Figure 13) with that from those who have been successful (Figure 23), it can be seen that the profile of responses for the highly dissonant smokers is broadly similar to that of the successful quitter. The data suggest that it is rare for a smoker to quit if he makes more than five attempts in two years to give up. The reasons cited by ex-smokers for quitting are summarised in Table 27. The distribution of responses reinforces the belief that those who have already given up smoking cigarettes were more motivated by health reasons than the average smoker for whom cost remains the primary incentive (Table 14). C:D Cx:) c0 --j U-1 BATCo document for Province of British Columbia 29 October 1999 -122- TABLE 27 WHAT WERE THE REASONS THAT MADE YOU GIVE UP SMOKING MANUFACTURED CIGARETTES? WHEN QUIT AGE <2 Y >2Y 16+ 25+ 45+ COST 31 26 39 31 24 HEALTH (GENERAL) 36 37 35 35 39 CHEST/BRONCHITIS 11 6 3 6 9 DOCTOR'S ADVICE 1 6 - 1 6 PREGNANT 3 4 10 4 2 COUGHING 7 6 - 7 6 TALK ABOUT CANCER/HEALTH WARNINGS 7 8 6 11 6 FAMILY PRESSURE 9 6 6 11 5 SEE IF I COULD 15 11 19 10 12 DISLIKED TASTE/WENT OFF THEM 5 11 6 10 9 Q.n (-M 03 \~o CXD ----j BATCo document for Province of British Columbia 29 October 1999 -123- Compared with those smokers still wishing to give up smoking (Figure 16a), relatively few of those who have successfully quit were under pressure to do so (Table 28). Those who have become ex-smokers in the last two years have experienced a greater amount of pressure with the older respondent more likely to have received a great deal of pressure. As with current smokers, husbands and wives were the most likely sources of influence and, for recent ex-smokers, children were mentioned by one in five respondents. General pressure from T.V./newspapers etc. was quoted by 4 percent of recent ex-smokers but only by I percent of established quitters. TABLE 28 HOW MUCH PRESSURE, IF ANY, DID YOU FEEL YOURSELF UNDER TO GIVE UP SMOKING CIGARETTES ALTOGETHER? WHEN QUIT AGE <2 Y >2Y 16+ 25+ 45+ A GREAT DEAL 14 13 3 15 14 A FAIR AMOUNT 19 11 32 16 10 NOT VERY MUCH 21 16 19 14 18 NONE AT ALL 47 59 45 55 57 C=) 00 1-10 00 ---_j 1-0 BATCo document for Province of BritiSh Columbia 29 October 1999 -124- TABLE 29 WHICH OF THESE PHRASES BEST DESCRIBES HOW YOU FEEL ABOUT HAVING STOPPED SMOKING? WHEN QUIT AGE <2 Y >2Y 16+ 25+ 45+ VERY HAP'-:'Y 40 70 48 59 64 QUITE HA?FY 33 20 39 22 23 NEITHER HAPPY NOR UNHAPPY 19 8 13 13 10 QUITE UNHAPPY 5 1 - 2 2 VERY UNF-kPPY 3 - - 2 1 Reference to Table 29 confirms that the longer a person has been an ex-smoker, the more content he is with having stopped smoking. The reported consequences of having stopped smoking are summarised in Table 30, from which it can be seen that the most often quoted effects related to food, either as a 'benefit' (tasted better) or as (presumably) a disadvantage (weight gain) . Gaining weight was particularly noted amongst older ex-smokers who were also the least likely to record improvement ia the taste of food. The number of generally positive mentions are greatly in excess of the negative reactions. cc 11 C (:0 cc 13 ATCo document for Province of BritiSh Columbia 29 October 1999 -125- TABLE 30 WHAT HAPPENED WHEN YOU GAVE UP SMOKING MANUFACTURED CIGARETTES? WHEN QUIT AGE <2 Y >2Y 16+ 25+ 45+ NOTHING 13 24 23 13 25 PUT ON WEIGHT/ATE SWEETS 27 28 13 27 30 MISERABLE/MOODY/BAD TEMPERED 17 10 13 14 10 MISSED HANDLING A CIGARETTE 3 1 3 2 1 COULD THINK OF NOTHING ELSE 1 - - 1 1 WITHDRAWAL SYMPTOMS 1 - - 1 - DRANK MORE - - - I - FOOD TASTED BETTERATE BETTER 26 22 32 25 22 FELT FITTER 15 25 13 27 20 MORE MONEY TO SPEND 20 18 32 22 16 NO COUGH 15 16 16 13 16 NOT SO SHORT OF BREATH 11 12 6 18 9 MOUTH FELT CLEANER 10 6 6 7 7 NO STALE SMELL IN MORNING/HOUSE DOESN'T SMELL 6 2 3 4 2 MORE ALERT 4 2 - 4 2 CLOTHES/HAIR SMELT BETTER 1 2 6 4 - NO SORE THROAT 3 1 3 2 1 LESS HEADACHES I I - 2 1 cc BATCo document for Province of British Columbia 29 October 1999 p acwfacLA &~- CD Ln Qn co co Co 411 BATCo document for Province of British Columbia 29 October 1999 -126- TABLE 31 WHAT, IF ANYTHING, DO YOU MISS MOST AS A RESULT OF NOT SMOKING MANUFACTURED CIGARETTES? WHEN QUIT AGE <2 Y >2Y 16+ 25+ 45+ NOTHING 58 57 45 68 75 AFTER DINNER/RELAXING/THE CALMING EFFECT 15 9 26 10 10 HANDLING A CIGARETTE 13 5 16 8 7 IN A SOCIAL SITUATION 8 6 10 10 5 WITH A DRINK 5 2 3 7 2 THE SATISFACTION 7 1 3 4 2 THE TASTE 2 1 3 1 1 WHEN CONCENTRATING I - - 1 - THE EARLY MORNING CIGARETTE - I - - - DON'T KNOW 1 2 - 1 2 The majority of ex-smokers claimed not to have missed anything as a result of not smoking (Table 31). This is particularly true of established ex-smokers but, as noted earlier, the accuracy of responses are dependent upon sometimes lengthy memory. Whilst for a large number of smokers, the early morning cigarette is the most enjoyable (Table 10), this was mentioned by only one of the 525 ex-smokers questioned here. co 110 c0 co Qlm BATCo document for Province of BritiSh Columbia 29 October 1999 0/. FIGURE 24. 100 THERE 15 TOO MUCH FUSS BEING MADE ABOUT SMOKING AND HEALTH RISKS~(see figure 17a) U-1 5 M0 2y M F 164 25+ 45+ 1 M CC) 50- 110 CC BATCo document for Province of British Columbia 29 October 1999 -127- Attitudes to Smoking and Health Responses to nine of the sixteen items on smoking and health presented to smokers were also elicited from the sample of ex-smokers. As before, the percentage of each category strongly agreeing or agreeing with each statement is shown in the following Figures. In every case, the level of agreement is lower for either category of ex-smoker than for the undifferentiated smoker sample and in most cases, lower for the establighed ex-smoker relative to the recent ex-smoker. The follc-jing Figures (24a-24i) are presented without individual comment, but to assist comparison, reference is made to the appropriate Figure for the smoker groups' responses. 0/0 FIGURE 24a i0 o THERE 15 TOO MUCH FUSS BEING MADE ABOUT -SMOKING AND HEALTH R15KS"(see figure 17a) 0 SM0 -2Y >2Y M F 164 254- 45+ in 50 - 7- U-I (-n c0 CC) co cc BATCo document for Province Of BritiSh Columbia 29 October 1999 -126- % FIGURE 24 b 100- MANY NON-SMOKERS DIE OF ILLNESSES THAT ARE OFTEN SAID TO BE CAUSED BY SMOKINGaGARET TES (see fi gure 17 c) 77 so 0 SM0 -2Y >2Y M F 16+ 25+ 45+ 1 R I 100 0/. " FIGURE 24c CIGARETTE SMOKING SIMPLY MAKES IT MORE LIKELY THAT YOU WOULD GET AN ILLNESS YOU WOULD GET ANYWAY (see figure T7d) 7- 50- 0 SIVIO <2Y >2Y M F 16+ 25+ 45+ 1 r M CD c0 %10 c0 c0 11.0 BATCo document for Province of British Columbia 29 October 1999 10 OOZO FIGU RE 24 d '~OU COULD BE RUN OVER BY A BUS TOMORROW 50 WHY WORRY ABOUT SMOKING CIGARETTE~ (see figure 17e) 7- 50 - SM0 -<2Y >2Y M F 16+ 25+ 45+ 1 Z El % " FIGURE 24e 100" THERE IS NOTHING WRONG WITH SMOKING AS LONG AS A PERSON SMOKES MODERATELY" (see figure 17f) 77 50 0 SIVIO <2Y >2Y M F 16+ 25+ 45+ 1 1 iff CC 1-C C-1- BATCo document for Province of British Columbia 29 October 1999 -130- 00 FIGURE 24 1 100 MILD CIGARETTES ARE SAFER THAN STRONG CIGARETTES (see figure 179) 77 50 0 smo <2Y >2~ M F 16+ 25+ 45+ r n x 0 ~ FIGURE 24g 0 100 ~OW TAR CIGARETTES ARE SAFER THAN OTHER CIGARETTE~ (see figure 17h) .50 0 smo 2Y >2Y M F 16+ 25+ 45+ 1 C::D ~_n (-n co 110 CXD BATCo, document for Province of British Columbia 29 October 1999 -131- 0 FIGURE 24 h YO "'o YOU CANNOT ALWAYS BELIEVE WHAT THE GOVERNMENT TELLS YOU ABOUT SMOKING AND HEALTH" (see. figure 17 k) 77 50 0 smo -,2Y >2Y M F 16+ 25+ 45+ 100% . FIGURE 24i DOCTORS DO NOT AGREE AMONGST THEMSELVES ABOUT THE P0551BLE DANGERS OF SMOKING TO HEALTH'(see figure 17j) so 0 smo <2Y >2Y M F 16+ 25+- 45+ 1 K El co 1-0 c0 BATCo document for Province of British Columbia 29 October 1999 -132- Compared with the average smoker, ex-smokers are less likely to believe that there is too much fuss made about smoking, and generally seem to be less fatalistically disposed. In almost all cases the established ex-smoker group is less highly represented in these data than the recent ex-smoker. Belief in the relatively greater safety of mild cigarettes and low tar cigarettes is generally high and particularly amongst younger ex-smokers. This group is, however, least sceptical about government and doctors' advice about smoking and least likely to endorse moderation in smoking. BATCo document for Province of BritiSh Columbia 29 October 1999 0 y0 it FIGURE 24j w 100- NOWADAYS IT IS MUCH LE55 SOCIALLY ACCEPTABLE TO SMOKE (see figure T7q) 7- 50- X 0 SM0 <2y >ZY M F 16+ 25+ 45+ 1 H X co \~o c0 I'D ON BATCo document for Province of British Columbia 29 October 1999 -133- Social Acceptability of Smoking Three of the five items on social acceptability of smoking presented to smokers, were also answered by the ex-smoker group (Figures 24j-24t). In these cases, the ex-smokers give firmer responses than the smokers and, within the ex-smoker sample, established ex-smokers are more likely to express agreement than recent quitters. 100 FIGURE 24i NOWADAYS IT IS MUCH LESS SOCIALLY ACCEPTABLE TO SIVICKE (see figure T7q) smo <2Y >2Y M F 16+ 25+ 45+ 1 U a co c0 BATCO document for Province of BritiSh Columbia 29 October 1999 z i Q-n U7 cc 110 CKD CC) BATCo document for Province of British Columbia 29 October 1999 -134- FIGURE 24 It 100. 0 d CIGARETTE SMOKING 15 A DIRTY HABIT (see fiqure 17s) 50- 0 SIVIO <7Y -2Y M F 16+ 25+ 45+ 0/1 d FIGURE 24 L 10" CIGARETTE SMOKING 15 HARMFUL TO THE HEALTH OF NON-SMOKERS (see figure 17t) 50- 7-, 0 SM0 < ZY > 2y M F 16+ 25-t- 45+ c0 cc BATCo document for Province of British Columbia 29 October 1999 ~-7 ~_r cc I-Z~ 1-0 --D BATCo document for Province of British Columbia 29 October 1999 -135- As with the smoker group, it is possible to compare the responses by ex-smokers to two items given here with ex-smokers' responses to the same items presented in Operation AQUARIUS (2). AQUARIUS LIBRA (7) M "CIGARETTE SMOKING IS A DIRTY HABIT" Agree strongly/agree 73 74 Disagree/disagree strongly 20 16 "CIGARETTE SMOKING IS HARMFUL TO THE HEALTH OF NON-SMOKERS" Agree strongly/agree 50 50 Disagree/disagree strongly 36 32 The response pattern in respect of both items is remarkably stable compared with the slight shift recorded for smokers in respect of the same items (p. 94). %10 BATCo document for Province of BritiSh Columbia 29 October 1999 r~~ I/ CD (-n Un c0 110 110 CD N.) BATCo document for Province of British Columbia 29 October 1999 -136- V. SMOKING AND HEALTH CONCERN The final section of the questionnaire contained q uestions answered by all respondents - smokers, ex-smokers, and never smokers and comprised items designed to gauge respondents' knowledge and beliefs about cigarettes and health. Substances in Cigarettes All respondents were asked: "Apart from tobacco and paper, what other substances are there in cigarettes?" The four most popular responses to this question are given in Table 32 and it should be noted that no other substance received more than a 5 percent response by any group. TABLE 32 SUBSTANCES IN CIGARETTES ALL TOT NICOTINE 65 TAR 46 SALT PETRE 16 SMOKERS CON SONANCE/D ISSONA NCE SM0 HIC CON DIS HID 69 66 68 68 71 48 so 46 46 49 21 21 22 16 21 EX-SMOKERS NEVER SMOKERSI WHEN QUIT EXS <2Y >2Y NEV 67 73 65 61 52 57 50 41 24 23 24 6 DON'T KNOW 21 19 20 18 25 17 17 11 18 26 c::) BATCO document for Province Of Brifth COIUMbia 29 October 1999 -137- If these data are interpreted as an index of awareness, it is consistent with expectation that recent ex-smokers are most aware of the presence of nicotine and tar in cigarettes. Thus, those smokers who have attempted to quit (the consonant and highly dissonant), are least likely to be ignorant of the presence of nicotine and tar in cigarettes. The difference between smokers' and ex-smokers' awareness is more marked in respect of tar than nicotine, further suggesting perhaps that the health motivation to quit included a perception of tar as an undesirable constituent of cigarettes. This hypothesis is not clearly supported, however, when the data in Table 33 are considered. Here, respondents were asked: "Which of the substances that you have mentioned do you think are harmful to health?" It is clear that for all respondents, regardless of category, nicotine is more often than tar seen to be harmful to health. TABLE 33 ALL TOT NICOTINE 59 TAR 51 SALT PETRE 5 DON'T KNOW 9 SMOKERS EX-SMOKERS CO NSONANCE/ DISSONANCE WHEN QUIT SMO HIC CON DIS HID EXS <2Y >2Y 57 53 48 60 64 57 60 56 50 49 48 48 52 54 54 53 6 7 3 2 7 7 7 7 8 10 10 7 6 11 11 12 NEVER SMOKERS NEV 64 49 3 8 cz:> c0 110 BATCo document for Province of BritiSh Columbia 29 October 1999 . . r, ~ - ( i - I I CD (-71 L.n co CrII BATCo document for Province of British Columbia 29 October 1999 -138- Of the total sample of 2018, 1594 mentioned at least one substance w~Lich, apart from tobacco and paper, they believed to be in cigarettes. C'aly 470 respondents mentioned more than one substance and these were subsequently asked: "Which one substance in cigarettes or cigarette smoke --:a you think is most harmful to health?" The results are summarised in -able 34. TABLE 34 NEVER ALL SMOKERS EX-SMOKERS SMOKERS CON SONANCE/D ISSONANCE WHEN QUIT TOT SMO HIC CON DIS HID EXS <2Y >2Y NEV N I C 0--',-E 26 20 14 29 9 20 20 29 16 38 T&R 60 65 68 60 73 66 66 58 70 50 SALT ?ETRE 1 3 4 6 - 2 - - - 1 DON': ILNOW 11 10 14 6 18 9 12 11 12 11 Clearly, for the more sophisticated respondent who is able to provide more than one constituent, tar is far more often perceived as the substance most harmful to health. Again, it is those who have made unsuccessful attempts to quit (the consonant and highly dissonant smokers) who are least likely to be unable to answer the question. All respondents were asked if they had seen the government tables showing tar and nicotine content of all brands of cigarettes. The percentage of each category of respondent answering "yes" is shown in Figure 25. c0 BATCO document for Province of BritiSh C01urnbia 29 October 1999 0 RGURE 25 ;/0 "'0' HAVE SEEN GOVT TABLES OF TAR NICOTINE CONTENT 50 0 HIC CON D15 HID EX5 NEV % FIGURE 26 10 D, DO NOT KNOW THE TAR BAND CATEGORIES 50- 0 HIC CON DIS HID EX5 NEV c0 BATCo document for Province of British Columbia 29 October 1999 -139- FIGURE 25 0/0 FIGURE: 26 0 '00 HAVE SEEN GOVT TABLES OF 100. DO NOT KNOW THE TAR TAR & NICOTINE CONTENT - BAND CATEGORIES 50- 50- 0 0 HIC CON D15 HID EXS NEV HIC CON DIS HID EXS NEY The two smoker groups who have attempted to quit and the ex-smokers have a greater level of awareness than the other two smoker groups and the irrelevance of the tables for the never smoker is reflected accordingiy. Surprisingly, it is the consonant and highly dissonant smoker groups who are relatively more ignorant of the tar band categories used on cigarette packs (Figure 26). The established ex-smoker and the never smoker clearly separate from the other groups in this regard. When asked "What are the tar band