Heterogeneity among smokers and non-smokers in attitudes and behaviour regarding smoking and smoking restrictions

Objective-To determine if smokers and non-smokers cluster into meaningful, discrete subgroups with distinguishable attitudes and behaviours regarding smoking and smoking restrictions. Design-Qualitative research with 45 smokers guided development of questionn aire items applied in a population based telephone survey of 432 current sm okers and 1332 non-smokers in Ontario, Canada. Methods-Cluster analysis of questionnaire items used to categorise adult sm okers and non-smokers; comparison of clusters on sociodemographic character istics and composite knowledge and attitude scores. Results-Smokers clustered in three groups. "Reluctant" smokers (16%) show m ore concern about other people discovering that they smoke, but parallel "e asygoing" smokers (42%) in supporting restrictions on smoking and not smoki ng around others. "Adamant" smokers (42%) feel restrictions have gone too f ar, and are less likely to accommodate non-smokers. Significant gradients a cross categories in the expected direction were observed with respect to sm oking status, stage of change, knowledge, and attitude scores, and predicte d compliance with restrictions, validating the proposed typology. Non-smoke rs also clustered into three groups, of which the "adamant" non-smokers (45 %) are the least favourably disposed to smoking. "Unempowered" non-smokers (34%) also oppose smoking, but tend not to act on it. "Laissez-faire" non-s mokers (21%) are less opposed to smoking in both attitude and behaviour. A significant gradient across categories in the expected direction was observ ed with respect to composite scores regarding knowledge of the health effec ts of active and passive smoking and a composite score on support for restr ictions on smoking in public places. Conclusion-Recognition and consideration of the types of smokers and non-sm okers in the population and their distinguishing characteristics could info rm the development of tobacco control policies and programmes and suggest s trategies to assist implementation.