Dunbar, Michael S.
(2015)
Workplace Smoking Bans and Daily Smoking Patterns: Implications for Nicotine Maintenance and Determinants of Smoking in Restricted Environments.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Background: Daily smokers are thought to strive to maintain blood nicotine levels above a certain threshold. Workplace smoking bans pose a substantial barrier to nicotine maintenance. Individuals may compensate for time spent in smoking-restricted environments by smoking more before (“anticipatory”) or after work (“make-up” compensation), but this has not been quantitatively examined. Methods: 124 smokers documented smoking occasions over 3 weeks using ecological momentary assessment (EMA), and provided information on nicotine dependence and stringency of workplace smoking policy (full, partial, or no bans). Hierarchical linear modeling examined effects of workplace policy, time of day block, and weekday vs weekend on mean cigarettes per hour (CPH) and simulated nicotine levels based upon EMA smoking data. Nicotine levels were assessed relative to two subject-specific standards of comparison: 1) “optimal maintenance,” levels achieved through evenly-spaced smoking (ΔEvenNL); and 2) “preferred” nicotine levels achieved at comparable times on weekends (%WeekendNL). Moderating effects of dependence, nicotine clearance rate, and home smoking restrictions were examined. Results: Individuals were most likely to change locations to smoke during work hours, regardless of work policy, and frequency of EMA reports of restrictions at work was associated with increased likelihood of changing locations to smoke (OR=1.14, 95% CI 1.08 – 1.21; p=0.0002). Workplace smoking policy, time block, and weekday/weekend interacted to predict CPH (p<0.01), and %WeekendNL (policy*time on weekdays, p<0.05), such that individuals with partial work bans –but not those with full bans - smoked more and had higher nicotine levels at Night (9 pm – bed) on weekdays compared to weekends. There was little evidence for interference with nicotine maintenance, although individuals with full or partial bans demonstrated more frequent low-nicotine (<50%WeekendNL) ‘trough’ events (p=0.04). Conclusion: Smokers may largely compensate for exposure to workplace smoking bans by escaping restrictions. However, full bans may suppress smoking even after they are lifted, perhaps by extinguishing stimulus associations or denormalization of smoking, whereas partial bans may not have these effects. This may suggest a stronger role for contextual factors in driving temporal variations in smoking. There was little evidence of true compensatory smoking to maintain nicotine levels in the face of smoking restrictions.
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| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
14 September 2015 |
| Date Type: |
Publication |
| Defense Date: |
14 November 2014 |
| Approval Date: |
14 September 2015 |
| Submission Date: |
24 July 2015 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
129 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
Dietrich School of Arts and Sciences > Psychology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Cigarettes, Smoking, Smoking Bans, Tobacco Control Policy |
| Date Deposited: |
14 Sep 2015 15:55 |
| Last Modified: |
15 Nov 2016 14:29 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/25741 |
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