Saying "no" to environmental tobacco smoke: determinants of assertiveness among nonsmoking employees.
BACKGROUND
Nonsmokers' assertiveness can help regulate smoking in worksites by enhancing the salience of nonsmoking social norms. This study examined determinants of employees' assertiveness toward smoking colleagues.


METHODS
Cross-sectional data were collected from 898 nonsmoking Dutch employees. Potential determinants were chosen using the attitude-social influence-efficacy model.


RESULTS
Fifty-one percent of nonsmoking employees asked co-workers not to smoke. Assertive respondents had colleagues who more often acted assertively toward smokers at work, had a more positive attitude to asking colleagues not to smoke, and had a higher perceived self-efficacy. Moreover, assertive employees more often perceived hindrance from environmental tobacco smoke (ETS) and had more negative beliefs about ETS at work.


CONCLUSIONS
What matters is whether ETS is perceived as bothersome and harmful. It is likely that both conditions must be met for nonsmokers to behave assertively. Worksite educational programs could focus more on increasing nonsmokers' awareness of the harmfulness of regular exposure to ETS at work to increase social pressure on employees who smoke in places that are shared by smokers and nonsmokers. However, the effectiveness of such strategies is yet unknown.
Department of Health Education, University of Limburg, Maastricht, The Netherlands. m.willemsen@gvo.rulimburg.nl
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D000328:Adult; D001242:Assertiveness; D001290:Attitude; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016272:Occupational Health; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012649:Self Concept; D012945:Social Values; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*; D017132:Workplace
D014028:Tobacco Smoke Pollution