Perceived non-smoking norms and motivation to stop smoking, quit attempts, and cessation: a cross-sectional study in England

This study examined the prevalence of non-smoking norms in England and their associations with motivation to stop smoking, quit attempts, and cessation. Data were from a representative cross-sectional survey of 1,521 adults (301 combustible tobacco smokers). Descriptive non-smoking norms were endorsed, with just 16% of adults (12% of smokers) believing smoking was uncommon. Injunctive non-smoking norms were more prevalent, with 60–77% of adults (17–48% of smokers) viewing smoking as something of which others disapproved. Personal non-smoking norms were also prevalent among all adults (73% indicated they would prefer to live with a non-smoker) but not smokers (69% had no preference). Smokers who endorsed stronger descriptive non-smoking norms had increased odds of reporting high motivation to stop smoking (OR(adj) = 1.63, 95%CI 1.06–2.52). Female (but not male) past-year smokers who endorsed stronger injunctive (OR(adj) = 2.19, 95%CI 1.41–3.42) and personal (OR(adj) = 1.90, 95%CI 1.29–2.82) non-smoking norms had increased odds of having made a past-year quit attempt. In conclusion, perceived descriptive non-smoking norms are not held by the majority of adults in England. Injunctive and personal non-smoking norms are prevalent among all adults but lower among smokers. There is some evidence that smokers – in particular, women – who endorse stronger non-smoking norms are more likely to be motivated to stop smoking and to make a quit attempt.