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Title: Understanding non-compliance with smoke-free policies in public places in Albania
Author: Melonashi, Erika
Awarding Body: University of Sheffield
Current Institution: University of Sheffield
Date of Award: 2012
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Aim of the research Smoke-free policies have only recently been introduced in the Balkans. These countries are characterized by high smoking prevalence and research evidence has suggested problems at the level of compliance with smoking bans. The aim of the present research was to provide an understanding of non-compliance with smoke-free policies in one of these countries, Albania. Methods The theoretical frameworks guiding the investigation included the reactance and normative approaches (used across all studies) and the general theory of deterrence (Study 4 only). Hence, four studies were conducted, investigating constructs informed by the reactance approach (age, gender, and attitudes), the normative approach (descriptive and injunctive norms), and empirical research in the area (smoking status, type of ban, health risk beliefs). Study 4 additionally assessed legal, moral, and social deterrents to non-compliance and non-smokers' self-efficacy to be assertive. Participants included 140 teachers (Study 1), 203 healthcare workers (Study 2), 295 adults (Study 3), and 944 university students (Study 4). The measures used were self-report questionnaires. Results showed that Albanian smokers had an overall positive attitude towards the ban and good awareness of the health consequences of passive smoking. Nonetheless, they were not very well informed as regards smoke- free policies and reported strong social norms favouring non-compliance. As regards the general predictors of non-compliance, they included reactance variables (gender and attitude), normative variables (descriptive norms), and smoking-specific variables (smoking status). Study 4 showed that this predictive model additionally contributed to the explanation of non-compliance, beyond the general model of compliance with the law (the deterrence model). Furthermore, findings from Study 4 also found weak legal, moral, and social deterrents to non-compliance as reported by both smokers and non-smokers. Moreover, non-smokers reporting weak deterrents to non-compliance behaviour (of smokers) also reported lower self-efficacy to be assertive. Discussion Findings suggested that non-compliance with smoke-free policies in Albania might be explicable in terms of the pro-smoking normative influences, attitudinal variables, and individual characteristic (gender, smoking status). Furthermore, smokers do not seem to expect much in terms of either legal, moral, or social consequences to noncompliance behaviour. Finally, the low self- efficacy and weak descriptive norms of assertiveness among non-smokers represent additional factors related to higher non-compliance rates among smokers. These findings suggest the need for practical enforcement of tobacco control policies in Albania as well as further efforts towards promoting non-smokers assertiveness behaviour. Importance of research Despite the several limitations, the present research represents the first systematic attempt to provide feedback on the implementation of the smoking ban in public places in Albania. As such, it has important practical implications for policy makers and suggests several directions for future research.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available