British researchers are spearheading a 2-year project focused on understanding why smoking rates are so high in certain communities and why they aren’t following the national trend of reducing smoking levels. The findings will be used to target resources to provide community-based anti-smoking and quitting support.
The city of Nottingham has the third highest rate of smoking in England, and more than half the people who live in the community of Aspley smoke—53%, compared to the national average of 21%. Smoking is a key reason why people in living in Aspley die, on average, 10 years younger than people in wealthier parts of the city.
The researchers examined why so many people in Aspley smoke and what effect social challenges, including high unemployment and low incomes were having on the community’s smoking rates. They found that smoking was very much the social norm in the community and was strongly associated with unemployment, boredom, and stress. Moreover, smoking was often seen as a shared activity, creating a sense of belonging and identity with the rest of the community.
Researchers found that there was an acceptance of the dangers of passive smoking, especially to children, but government warnings on the dangers of smoking were viewed by some with suspicion and hostility. In addition, children in smoking families had little to counteract the strong pressure to smoke.
In the community, many smokers still regarded cigarettes as a ‘little luxury’ that disadvantaged people could enjoy—a view often shared by nonsmokers. While stopping smoking was an aspiration among most smokers, the researchers found that it was often ‘put on hold’ until the time or mental state was perceived to be right.
The researchers also identified a strong sense of community within the area and believe this could be used to promote antismoking initiatives.
"This kind of research is crucial to understanding why smoking is so high in certain communities and why they aren’t following the national trend of reducing smoking levels,” said Jeanelle de Gruchy, MD, MPH, deputy director of public health at NHS Nottingham City. “Once we know that, we can more effectively target our resources to support community actions to provide an environment which prevents young people starting to smoke and supports people wanting to quit."
The project is an example of ‘action research,’ where researchers address issues and solve social problems in tandem with the local community.