title: Behavioural and psychological responses of lower educated smokers to the smoke-free legislation in Dutch hospitality venues: a qualitative study.
abstract: OBJECTIVE
  In 2008, smoke-free legislation was implemented in hospitality venues (HV) in the Netherlands. We investigated how continuing smokers with a lower educational background respond behaviourally and psychologically to the legislation and the norm it communicates.
  
  
  METHODS
  In 2010, 18 lower-educated daily smokers were interviewed. Transcripts were analysed with MAXQDA software. Theories of self-awareness and social in- and exclusion were applied to interpret findings.
  
  
  RESULTS
  Smokers had become more self-aware and the experience of a more negative norm surrounding smoking had made them reevaluate their smoking. Smokers had also become more self-aware of their own smoking, both in HV and in general. Feelings of increased social exclusion were reported. Participants dealt with the increased awareness and feelings of social exclusion in different ways depending on their evaluation of the smoking ban, changes in attitude towards own smoking, changes in HV patronage and changes in smoking behaviour.
  
  
  CONCLUSIONS
  Theories of self-awareness and social in- and exclusion were useful in understanding consequences of a HV smoking ban on continuing smokers. Four different types of responses were identified, i.e. (1) actively trying to quit, (2) socially conscious smoking, (3) feeling victimised and (4) rejecting the norm. Implications for future smoke-free legislation are discussed.
authors.affiliation: Department of Clinical, Health and Neuropsychology, Leiden University, Leiden, The Netherlands.
authors.forename: Sander
authors.initials: S
authors.lastname: Van der Heiden
authors.forename: Winifred A
authors.initials: WA
authors.lastname: Gebhardt
authors.forename: Marc C
authors.initials: MC
authors.lastname: Willemsen
authors.forename: Gera E
authors.initials: GE
authors.lastname: Nagelhout
authors.forename: Arie
authors.initials: A
authors.lastname: Dijkstra
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001364:Awareness; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D036301:Qualitative Research; D012147:Restaurants; D012907:Smoking / Q000331:legislation & jurisprudence* / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D012933:Social Identification; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution