Smoking’s Shrinking Geographies

Smoking’s Shrinking Geographies

Damian Collins* and Amy ProcterDepartment of Earth & Atmospheric Sciences, University of Alberta

Abstract

Smoking bans are the most geographical aspect of contemporary tobacco control policy, and areeliminating smoke from many of the spaces of everyday life, particularly in high-income countries.In this paper, we emphasize that the adoption of bans both reflects, and reinforces, changing socialnorms around smoking and exposure to environmental tobacco smoke. Specifically, as understand-ings of the health consequences of environmental tobacco smoke have developed, social accep-tance of smoking has declined. Bans cement this norm shift by making the behaviour moredifficult to perform, relocating smokers to marginal places, and contributing to stigmatization. Wedraw upon a diverse, multi-disciplinary scholarship examining contemporary trends in the spatialregulation of smoking. While its focus is on the formal, large-scale bans implemented by publicauthorities, increasing attention is now being paid to the myriad small-scale, voluntary decisions ofprivate actors to limit smoking. As smoking is permitted in ever fewer places, the behaviour isdenormalized and its social status markedly eroded.

Introduction

In 2006, Poland et al. called for the development of avowedly social and contextual per-spectives on smoking, to expand conventional concerns for the health of the individualsmoker. They proposed drawing on insights from across the social sciences about theoperation of power, scale and collective influence, in order to envision smoking as aninherently social behaviour, generated at the intersection of structure and agency, andrendered concrete ‘‘in specific places (e.g. neighbourhoods)’’ (Poland et al. 2006, 60).Five years on, this paper surveys socio-spatial perspectives on smoking and tobaccocontrol, with a focus on the advance of smoking bans. Our central contention is thatincreasingly widespread restrictions on where smoking may occur both reflect, and rein-force, the denormalization of smoking and exposure to environmental tobacco smoke(ETS).

The elimination of smoke from many everyday spaces – particularly but not exclusivelyin high-income countries (WHO 2008) – entails profound changes to the struc-ture ⁄ agency ⁄place dynamic. In the first instance, a ban is a structure that delimits opportu-nities for smoking – most often, a legal structure which sets out formal penalties fornon-compliance with a spatial rule. However, increasing numbers of private (non-governmental) actors are also exercising agency in prohibiting smoking in spaces undertheir control (e.g. campuses, houses, vehicles), in the absence of any legal requirement todo so. In combination, these formal and private bans are rapidly shrinking smoking’sgeographies; accordingly we rework Poland et al.’s (2006, 61) call for smoking to bereconceptualized as ‘‘a social activity rooted in place’’, emphasizing instead that as it ispermitted in ever fewer places, smoking’s social status and normality are markedly eroded.

In many high-income countries, contemporary social meanings associate smoking withaddiction, despair and low socio-economic status (Chapman and Freeman 2008; Poland

Geography Compass 5/12 (2011): 918–931, 10.1111/j.1749-8198.2011.00463.x

ª 2011 The AuthorsGeography Compass ª 2011 Blackwell Publishing Ltd

2000). These countries are experiencing ‘‘an increasingly pronounced socio-economicgradient in smoking as a result of higher rates of cessation among more affluent groups’’(Pearce et al. forthcoming, 3), as well as a marked clustering of smokers in deprivedneighbourhoods (Stead et al. 2001; Thompson et al. 2007). Our contention is that theincreasing social marginality of smoking recursively produces, and is produced by,expanding spatial restrictions on where the behaviour may take place. We elucidate thisrelationship with reference to the concept of social norms, and conceptualize the contri-bution of smoking bans to the broader denormalization of tobacco. In so doing, wereflect – in particular – on four decades of regulatory action to delimit ETS exposure in abroad array of publicly- and privately-owned spaces.

The meanings and significance of this socio-spatial transformation have attracted atten-tion across the health and social sciences. Within the associated literatures are myriad con-ceptual and empirical concerns that speak powerfully to core social geographic issues,such as the interconnectedness of place and identity, and the spatial constitution of sociallife. However, little of this work has been situated within social geography per se, asopposed to public health, epidemiology and social psychology. This is changing, with theemergence of overtly geographical analyses of the contexts of smoking behaviour (Ritchieet al. 2010), ETS exposure in homes (Phillips et al. 2007; Robinson and Kirkcaldy 2007),and associations between smoking and spatial inequality (Barnett et al. 2004; Thompsonet al. 2007).

Nevertheless, smoking retains a lower profile within social geography than alcohol (seeDeVerteuil and Wilton 2009; Jayne et al. 2006, 2008). This is likely due in large part totobacco’s low potential for intoxication (Nutt et al. 2007), which means it lacks the sameassociations with street disorder, crime and acute harm. Yet in other ways, smoking bansconnect to long-standing disciplinary concerns for spatial regulation, inclusion ⁄exclusionand the construction of social order. As we emphasize in this review, smoking bans havebecome particularly far-reaching, have transformed behaviours and experiences in manyof the spaces of everyday life, and have complex social consequences related to marginali-zation, stigmatization and inequality.

The biomedical risks of smoking, and the health benefits of smoking bans, are well-documented – particularly by the US Surgeon General (USDHHS 1986, 2006), WHO(2008), and IARC (2009) – and need not be rehearsed here. Instead, our purposes are asfollows. First, we outline the development of smoking bans, highlighting their intendedfunctions and expansion over time. Second, we highlight the interplay of changing socialnorms around smoking, and evolving spatial rules determining where it can ⁄ cannot takeplace. Third, we detail the contribution of bans to the stigmatization of smokers. Fourth,we consider the existence of local norms that insulate residents of deprived areas fromnormative shifts away from tobacco. Our final substantive section examines the enactmentof bans as a social process, with a focus on diminishing opportunities for (and toleranceof) smoking even in the most private spaces.

The Spatial Regulation of Tobacco Smoke

Contemporary tobacco control, centred on biomedical risk, has its origins in two largereview studies published in the 1960s. The reports of the Royal College of Physicians(1962) and the US Surgeon General (USDHHS 1964) highlighted the direct associationof smoking with lung cancer and chronic bronchitis. Smoking – at the time enjoyingrecord popularity of around 60% of men and 30% of women in high-income nations(Chapman 2007a) – was reconceived as a behaviour that put smokers’ health at risk

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(Berridge 1999). Initial policy responses centred on personal behaviour, seeking to dis-courage uptake and encourage quitting via the introduction of mandatory health warningson packets, restrictions on tobacco marketing (including prohibitions on radio and televi-sion advertising), and the first mass media campaigns drawing public attention to thehealth harms of smoking (Brandt 2007; Jacobson et al. 1997).

A decade later came recognition that smokers were also harming the health of thosenear them (Feldman and Bayer 2004). Evidence mounted in the 1980s, culminating in aUS Surgeon General report linking ETS to the development of lung cancer in non-smokers (USDHHS 1986). At this time, tobacco control policy took on a broader pro-tective – and explicitly geographical – mission, concerned with limiting the exposure ofnon-smokers to ETS via restrictions on where smoking could occur. Until this point,ETS had been effectively ubiquitous and impossible to avoid in shared spaces (Chapman2007a).

Public transport was often the first environment to be made smoke-free, in the early-mid 1970s, followed by government buildings and then privately owned office spaces.Smoking in airports and on planes was prohibited from the late 1980s, followed by res-taurants in the 1990s (see Chapman 2007a; USDHHS 2006). Bars and pubs commonlyremained ‘last bastions’ for indoor public smoking, due in large part to hospitality andtobacco industry predictions of economic ruin precipitated by bans (Champion andChapman 2005). However, the tide has clearly turned, with comprehensive indoor bansimplemented by an increasing number of countries and (where applicable) second-tierjurisdictions – including all Canadian provinces, Australian states and component nationsof the UK (IARC 2009).

Achieving this level of restriction has involved decades of policy-making across allscales of government. In the Canadian context, where municipalities often took the leadin establishing smoke-free spaces, the adoption of bylaws broadly followed geographicalmodels of hierarchical and expansion diffusion (Nykiforuk et al. 2008). With increasednational and international attention on smoking bans (reflected, e.g. in the WHO Frame-work Convention on Tobacco Control), there is the potential to examine the transfer of policyinnovation at the global level (see McCann 2008).

Smoking ban policy continues to evolve, with outdoor environments a recent focus ofattention. ‘Buffer zone’ restrictions prohibiting smoking within a certain distance of door-ways and windows are becoming increasingly widespread, and serve primarily to maintainthe efficacy of indoor bans (Kaufman et al. 2010). Outdoor spaces associated with chil-dren – such as playgrounds, and the grounds of daycare centres and schools – are com-monly being declared smoke-free by regulatory authorities. Bans are also reaching intosome outdoor workplaces (e.g. restaurant patios) and public spaces in general (e.g. beachesand parks). Alongside these government-mandated restrictions are decisions by large insti-tutions – particularly those with health- or education-related functions – to prohibitsmoking on their grounds (see USDHHS 2006). Accordingly, smoking is increasinglyrestricted to homes and a diminishing number of outdoor environments.

This advance of smoking bans was (and is) by no means uncontested. For example, inrelatively recent Australian debates over extending smoke-free laws to bars and pubs,objections encompassed claims that denied or downplayed the health effects of ETSexposure, warned of far-reaching economic losses, and represented bans as culturally andideologically inappropriate (e.g. ‘unAustralian’) (Champion and Chapman 2005). Includedin the cultural ⁄ ideological rhetoric was the contention that smoking bans restricted free-dom of choice – a rights-based objection heard with great frequency internationally. In acompelling account of the rights issues inherent in tobacco control policies, Katz (2005)

920 Smoking’s shrinking geographies


observes that opponents of regulation (including the tobacco industry) have selectivelychampioned the individual right to liberty, and to use property as the owner sees fit.1

While smoking bans impede these freedoms, they do so to uphold higher-order rights tolife, health and unpolluted air: ‘‘Non-smokers’ rights to be free of harmful interferencetrumps the rights of others to be at liberty to smoke’’ (Katz 2005, ii33).

Spatial Rules, Social Norms

The principal goal of smoking bans is to restrict where smoking can occur in order to pro-tect non-smokers from exposure to ETS, and its attendant health consequences. That bans areeffective in reducing (or eliminating) exposure, and in protecting health, is certain (IARC2009). They also contribute to eroding the social acceptability of smoking (Chapman2007a; USDHHS 2006; Wakefield et al. 2000). This highlights a broader connectionbetween spatial rules and social norms – the latter a concept developed within social psy-chology, with particular reference to health-related behaviours (see Blanton et al. 2008).

In this section, we argue for the utility of a social norms approach to exploring the socialgeographic significance of smoking bans. It provides valuable insight into the evolving con-texts in which decisions about smoking and its regulation are made, and thus a conceptualtool for linking structure and agency. It also points to the influence of scale on smokingbehaviour. Social norms consist of broadly shared customs, standards and rules that definean acceptable range of behaviours and beliefs. They are guided by perceptions of typicalbehaviours (descriptive norms) and prevailing attitudes (injunctive norms) within groups(Blanton et al. 2008). At the micro-scale, social norms influence the conduct and beliefs ofindividuals; at the macro-scale they contribute to maintenance of social order (Campbell1964; Kendall et al. 2004). Departure from social norms is met with informal and ⁄or formalsanctions, including marginalization, stigmatization and legal penalties.

While social norms are powerful structures, individuals retain agency in decidingwhether or not to adhere to them. The likelihood of adherence to a norm is influencedby a number of factors, including the strength of an individual’s attachment and proxim-ity (both spatial and temporal) to the group that holds it (Aronson et al. 2010). For thesereasons, local norms (shared by family, peers and friends) are more influential than globalnorms (held by distant others) (Blanton et al. 2008). With respect to smoking, the inti-mate scale of the household has a strong effect on behaviour. Thus, parental smoking is apowerful predictor of smoking initiation by adolescents (Otten et al. 2005). Conversely,in-home bans reduce both uptake and transition from ‘experimental’ to ‘established’smoking among young people (Wakefield et al. 2000).

One of the ways that norms may shift is through minority influence. This is often mosteffective in changing dominant standards of thought and behaviour when supported bynew forms of information (Aronson et al. 2010). Smoking ban advocacy presents anexample of this; while concern about exposure to ETS was socially and politically mar-ginal into the 1970s and 1980s (Chapman 2007a), the viewpoint gathered strength asmore information on biomedical risk emerged (USDHHS 2006). It is at this point thatthe productive interplay of spatial restrictions, and the decreasing social acceptability ofsmoking, began to take effect. Specifically, incremental shifts in individual attitudestowards smoking and ETS, prompted by new information and advocacy, increased sup-port for more formal spatial rules (i.e. bans), which in turn brought about new behavioursand attitudes (cf. Young 2008).

These new rules, and the social norm shift they reflected, were not initially supportedby those attached to older conventions of thought and behaviour around tobacco use,



but relatively high levels of compliance were achieved via formal and informal sanctions(Jacobson et al. 1997; Ritchie et al. 2010). In such cases, social psychology suggests that acompelled behaviour change (e.g. the discontinuation of indoor smoking) often promptsan attitudinal change (e.g. an acceptance that smoking indoors is injurious to others) inorder to reduce cognitive dissonance (Aronson et al. 2010). Moreover, the nature ofnorms is that they ‘‘become routinely embedded’’ by virtue of ‘‘people working, individ-ually and collectively, to enact them’’ (May et al. 2009, 30). The ability to smoke inshared offices, for example, reinforced the normality of indoor smoking, irrespective ofthe views of non-smoking colleagues. The introduction of bans to the office environment– often accompanied by official signage and the social empowerment of non-smokers (seePoland 2000) – signalled a fundamental norm change, subsequently reinscribed by day-to-day respect for, and enforcement of, the new spatial rule.

Denormalization

Alongside the quotidian normalization of smoke-free environments, which renders materialan emerging social commitment to eliminating ETS, is a corresponding denormalization ofsmoking. Broadly put, this is the process by which tobacco use, tobacco products and thetobacco industry are portrayed as abnormal and undesirable (Jacques et al. 2004). Tobaccocontrol strategies that contribute to denormalization include legislated pack warnings –which detract from corporate branding and re-position the product as ‘‘exceptionally dan-gerous’’ (Chapman and Freeman 2008, 28) – prohibitions on advertising and sponsorship,restrictions on where and to whom tobacco may be sold, and social marketing campaignsemphasizing the health consequences of smoking and ETS exposure, as well as thetobacco industry’s culpability for these. Some recent initiatives, such as bans on point-of-sale display (e.g. colourful ‘powerwalls’ of tobacco products) are principally about denor-malization, and breaking the symbolic association of tobacco with normal consumergoods, such as groceries (Hastings 2009).

Spatial restrictions make significant contributions to denormalization. When smoking isprohibited in everyday environments, particularly workplaces, smokers are compelled toseek out more distant locations, and the behaviour becomes harder to perform. In sodoing, they may be isolated – socially and spatially – from friends and colleagues (Ritchieet al. 2010). The fact that the ‘alternative locations’ are typically ‘‘less socially valuedspaces’’ (Poland 2000, 7) – from windswept alleyways to desolate corners of snow-cov-ered parking lots (see Figure 1) – sends a further message about smoking’s declining socialstatus. For these reasons, bans contribute to decreasing rates of tobacco consumption,reduced smoking uptake, and promote successful cessation attempts (Chapman andFreeman 2008; Eisenberg and Forster 2003; Fichtenberg and Glantz 2002).

The role-modelling justification for bans highlights that their communicative valueextends beyond smokers themselves. Here, the focus shifts to reducing opportunities forpeople to observe smoking, and perceive it as normal behaviour. Restrictions on smokingin child- and youth-oriented outdoor environments are typically grounded in role-modelling justifications. In addition, some institutions seek to act as role-models byvoluntarily extending bans to their outdoor grounds. For a growing number of hospitalsand universities, adopting an outdoor ban is a means

to project a positive institutional image, convey a consistent pro-health message, undercut theperception that smoking is socially acceptable, discourage tobacco use initiation among students,



and encourage and support tobacco use cessation among students, patients and employees.(USDHHS 2006, 634)

Studies reporting high concentrations of ETS in outdoor public places (Cameron et al.2009; Klepeis et al. 2007; Parry et al. 2011; Wilson et al. 2011) lend further support tobans in such contexts. Their findings undercut contentions that outdoor bans are moti-vated by social intolerance (for smoking and smokers) rather than health per se (see, e.g.Bell et al. 2010; Chapman 2007a; Poland 2000). While the protective function of suchbans is becoming increasingly clear, the reconceptualization of ETS as a pollutant thatviolates the personal space of the body also contributes to demands for ‘‘zero exposure’’,irrespective of evidence of harm (Chapman 2007a, 163).

Smoking bans help to construct smoke-free environments as normative, indoors andout. In so doing, they contribute to the denormalization of smoking, which in turn lendsfurther support to spatial restrictions. Increasing social marginality and expanding spatialrestrictions have diminished not only opportunities for smoking (an embodied behaviourthat must occur somewhere), but also the status of smokers.

Stigmatization

The denormalization of smoking carries with it potentially significant social consequencesfor those who continue to smoke. The thorough-going reconstruction of smoking asunhealthy is particularly relevant, given the emergence of ‘health’ as ‘‘a pre-eminentsocial value in Western society’’ (Farrimond and Joffe 2006, 482). For Thompson et al.(2009, 566) health concerns have ‘‘substantially reconfigure[d] the discursive field withinwhich smoking is practiced and smokers construct identities’’. Other discursive shiftsassociating smoking with dirt, addiction and despair are also relevant (Stuber et al. 2008),and may be internalized by smokers (Bell et al. 2010). Importantly, social intolerance forsmoking extends beyond the discursive to material spatial practices – most obviouslyformal bans, but also myriad private restrictions on smoking (Burgess et al. 2009; Gillespieet al. 2005) – which literally locate smokers outside of many social spaces, therebyreinforcing their ‘‘desultory, exiled status’’ (Chapman 2007a, 154).

Fig. 1. A designated smoking area on an otherwise smoke-free campus (Lakehead University, Ontario, Canada).



This process evokes Goffman’s (1963) concept of stigmatization. He theorized that fail-ure to meet normative expectations of behaviour prompts negative social responses,which ‘‘spoil’’ identity, transforming the non-compliant individual from ‘‘a whole andusual person to a tainted, discounted one’’ (Goffman 1963, 3). Stigma has two sets ofeffects: psychologically, the individual feels guilt, shame, and distancing; socially, he orshe experiences discrimination, sanctions and even formal punishment (Stuber et al.2008). Although smoking was not stigmatized at the time of Goffman’s writing, it is nowcommonly understood in this way (Burgess et al. 2009; Chapman and Freeman 2008;Poland 1998; Thompson et al. 2007).

A key debate in the literature concerns whether the stigmatization of smoking encour-ages cessation. Stigma is understood to encourage adherence to social norms, and giventhe extent to which these have shifted to become intolerant of smoking, it is seen bysome as a powerful tobacco control tool. It signals a social cost associated with maintain-ing a ‘smoker’ identity, as well as a social reward for quitting (Thompson et al. 2009).Alternatively, it may undermine tobacco control goals, generating feelings of low self-efficacy, helplessness or despair in some smokers, and active resistance in others(Thompson et al. 2007). The morality of policies that lead to smokers being ‘‘devalued,discriminated against, and viewed as ‘blemished’ and different’’ has also been questioned(Burgess et al. 2009, S155). Bans, in displacing those who smoke from valued sites ofsocial interaction, and relegating them to marginal spaces (such as that shown inFigure 1), contribute to this stigmatization.

Indeed, several accounts suggest smoking bans are rendered problematic by the way inwhich they humiliate and disempower smokers, and exacerbate inequalities by impactingdisproportionately on those relatively disadvantaged groups in which smoking rates arehighest (Bell et al. 2010; Poland 1998). These studies correctly identify the way in whichefforts intended, in the first instance, to regulate a behaviour (smoking), also have impli-cations for the identities of those who practice it (smokers) (see Burgess et al. 2009).However, their critiques downplay the welfare-enhancing role of smoking bans inboth protecting non-smokers from ETS, and in assisting cessation in smokers. They alsosidestep the question of whether those who put others’ health at risk with ETS areacting unethically (Jarvie and Malone 2008) – and whether this may warrant theirstigmatization.

Local Norms

In the relatively deprived neighbourhoods in which smoking remains most common inhigh-income countries, residents may be doubly stigmatized through the coincidence ofplace of residence and smoking status (Thompson et al. 2007). This said, within thesecontexts local norms can be supportive of smoking, or at least accepting of it as ‘‘a sanc-tioned form of respite’’ (Burgess et al. 2009, S154). Underpinning these values are local-ized understandings of smoking as ‘‘a means of coping with living and caring indisadvantaged circumstances’’ (Ritchie et al. 2010, 462) and a source of ‘‘stress-releaseand pleasure [amid] structural disadvantage’’ (Farrimond and Joffe 2006, 482). Suchunderstandings provide a buffer against global anti-tobacco norms, while also helping toreproduce the association of smoking with both personal and area-level deprivation.

Stead et al. (2001) provide a compelling qualitative account of the effect that residingin a disadvantaged area can have on smoking behaviour. In low-income neighbourhoodsof Glasgow, Scotland characterized by residents as isolated, stressful and unrewarding,smoking was both prevalent and integral to socialization. It was seen to compensate for



hardship and exclusion from the wider society, and to reinforce identity and companion-ship within the communities. Accordingly, smoking remained normal and there were fewnon-smoking role-models, as well as ‘‘little motivation to quit’’ (Stead et al. 2001, 339).In these contexts, effective support for cessation must extend beyond conventionaltobacco control initiatives (including bans) to encompass interventions that address disad-vantage.

Thompson et al. (2007) have coined the term ‘smoking islands’ to characterize thoseneighbourhoods in which smoking remains normal, while the societies of which they arepart become increasingly smoke-free. However, respondents in Thompson et al.’s (2007)study reported that local attitudes towards smoking, while generally accepting, were byno means immune to external forces, including anti-tobacco social marketing campaignsand formal bans. Moreover, many residents were internalizing norms that required limitingchildren’s exposure to ETS in the home. The last point is significant, as it points to pri-vately enacted spatial restrictions, even in a context otherwise tolerant of tobacco use.

Enacting Spatial Restrictions

Research into the enactment of smoking bans has contributed significantly to the evi-dence base for tobacco control advocacy and policy. One line of inquiry centres onmeasurement of changes in atmospheric quality, and in levels of human biomarkers thatindicate exposure to nicotine, following the implementation of bans (e.g. Akhtar et al.2007; Klepeis et al. 2007). A second focuses on observations of compliance, surveys ofpublic opinion, and assessments of economic impacts (e.g. Ludbrook et al. 2005; WHO2008). Broadly put, the former approach has established the technical efficacy of smok-ing bans, and the latter their social acceptability. However, by virtue of their policy-minded focus on large-scale formal bans, and quantitative methods, they say relativelylittle about issues of structure ⁄ agency, or the changing social geographic context ofsmoking.

Ritchie et al. (2010) provide a rare qualitative exploration of the implementation of aformal ban – the introduction of comprehensive indoor restrictions in Scotland in 2006.Post-legislation levels of compliance were universally high. Significantly, and in keepingwith the social psychology literature on responses to forced behavioural changes (seeAronson et al. 2010), smokers reported adopting new attitudes consistent with the indoorban. In particular, the identity of the ‘considerate smoker’ was re-constructed as one whodid not smoke indoors, so as not to inconvenience both non-smokers and venue staff(Ritchie et al. 2010).

The key change in the meaning of smoking in Scotland was directly related to its spa-tial separation from normal social interaction. First, smoking was transformed from a rou-tinized habit into a behaviour that required a conscious decision to step outside, whichrepresented a physical as well as social inconvenience. Second, some smokers reportedthat once outside, their isolation led them to feel self-conscious and uncomfortable –indicators of stigmatization. These effects encouraged decreases in consumption as well asquit attempts, and also point to the role of bans in constructing ‘smoker’ and ‘non-smoker’ as increasingly distinct identities (see Poland 2000; Thompson et al. 2009).

The Privatization of Smoking

With the extension of formal smoking bans into bars ⁄pubs and other previously exemptedindoor workplaces, many high-income jurisdictions now offer ‘comprehensive’ protection



against ETS in enclosed public places. In this context, public places are defined by acces-sibility and function, not ownership; as Bryan-Jones and Chapman (2006, 2) put it, theyconsist of all indoor environments ‘‘where a duty-of-care towards employees, patrons orthe visiting public can be demonstrated to exist’’. Indeed, private ownership per se hasnot been a significant impediment to government regulation of ETS, as bans have longapplied to privately owned transport, theatres, shops and office buildings. This speaks inpart to acceptance of public jurisdiction over matters of workplace safety (Katz 2005),although the manner in which ETS regulation appears to have elided the distinctionbetween public and private ownership merits further investigation.

What remains significant to the geographies of smoking and ETS exposure are theexpectations of autonomy in spaces with strongly private functions – such as residential useand personal transport. Thus, private homes – and, until recently, vehicles – haveremained outside the regulatory gaze. Smoke-free laws have often been late to apply evento institutional spaces with residential functions – including prisons and psychiatric facili-ties (USDHHS 2006). With the constriction of smoking opportunities elsewhere, quintes-sentially private spaces have increased in relative significance as sites of ETS exposure,Thus, while parents cannot smoke on buses, on school property or at restaurants (etc.),‘‘their freedom to expose their children to high concentrations of tobacco smoke in set-tings assumed to be private’’ has been largely unfettered (Freeman et al. 2008, 63).

Yet this exposure is increasingly problematized, with growing recognition of both chil-dren’s physiological vulnerability to ETS, and their limited ability to avoid ETS in privatespaces not subject to formal bans (Ashley and Ferrence 1998; Jarvie and Malone 2008;Thomson et al. 2005).2 Formal regulatory attention is now turning to private vehicles –confined spaces in which ETS can reach grossly excessive levels (Sendzik et al. 2008).Bans on smoking in cars in which children are present – pioneered in Arkansas in 2006 –are rapidly becoming widespread (Saltman et al. 2010; Thomson and Wilson 2009). Thisrepresents a key development in the geographies of tobacco control, in that formal regu-lation is for the first time extending to a space that is (generally) neither a workplace, norpublicly accessible. Public opinion surveys consistently report high levels of support forvehicular smoking bans, particularly when these are framed as protecting children fromharm (Thomson and Wilson 2009).3

Self-Regulation in Private Spaces

The case of ETS in cars is also noteworthy for evidence of widespread self-regulation. Ina US study, 90% of respondents, including 65% of smokers, reported choosing to prohibitsmoking in their vehicle when children were present (McMillen et al. 2005). While thisis a socially desirable response, it is consistent with increasing public awareness of thehealth risks of ETS (Burgess et al. 2009). Legislative intervention offers a level of protec-tion to children whose exposure to ETS in cars would be otherwise left to the discretionof individual parents ⁄drivers (Akhtar et al. 2007; Leatherdale et al. 2008). Its effectivenessin this regard likely depends less on enforcement than on reinforcing the normative unaccept-ability of such exposure (Saltman et al. 2010).

Self-regulation is also becoming prevalent in homes, which have to date been largelyprotected from formal smoking ban policy by virtue of their cultural status as bastions ofprivacy and individual freedom (Ashley and Ferrence 1998; Freeman et al. 2008). Thenotion of smokers refraining from smoking in their own homes is gaining momentumout of concerns to protect children from physical harm and negative role-modelling,respect non-smoking adults, and reduce the smell of smoke (IARC 2009; Phillips et al.



2007). Particularly influential here are pervasive representations of children as the inno-cent victims of ETS (Stuber et al. 2008). In Scotland, Phillips et al. (2007) reported thatthe likelihood of indoor restrictions being implemented, and enforced, was stronglylinked to the presence of children.

Robinson and Kirkcaldy (2007) highlight the complex reality of ‘partial restrictions’ inhomes that allow for smoking in particular spaces and ⁄or under certain circumstances.Specifically, focus groups with smoking mothers living in disadvantaged areas of Liver-pool, England revealed complex geographical arrangements that ‘‘did not conform toconventional definitions of ‘smoking’ and ‘smoke-free’ homes’’ (Robinson and Kirkcaldy2007, 901). While no home was free of self-restriction, nor was any home entirelysmoke-free in practice. Instead, norms of responsible mothering required an intent to limitchildren’s exposure to ETS, via physical distancing and ⁄or ventilation, tempered by needsto supervise children, maintain security and care for the self.

The increasing normative status of restricting children’s exposure to ETS in domesticspace raises the question of whether formal prohibitions in this context are becomingsocially and politically acceptable (Borland et al. 1999). Several studies identify a strongethical foundation for such action (Ashley and Ferrence 1998; Jarvie and Malone 2008),but the more general tendency – even among strong advocates of tobacco control – hasbeen to dismiss legislative intervention as an unwarranted invasion of privacy (ASH UK2006; Chapman 2007b; IARC 2009). From this perspective, the issue is framed as onebest left to ‘‘agreement among household adults’’ (IARC 2009, 234) – a voluntarist aswell as ageist logic that, increasingly, is no longer extended to any other indoor environ-ment.

Conclusion

With expanding knowledge of the health risks of ETS exposure, many public authoritiesand an increasing number of private actors have mandated smoke-free environments. Inso doing, they have drastically diminished the space available for smoking. Our conten-tion is that the significance of spatial restrictions extends beyond their direct effects – theremoval of smoking from routine interactions and settings, and corresponding reductionsin ETS exposure – to a broader social process: denormalization. Bans reflect the decreas-ing social acceptability of smoking, but also strengthen this norm shift. They do so bymandating changes in everyday practices around smoking, making the behaviour moredifficult to perform, relocating smokers to marginal places, and contributing to ‘spoiling’their identity.

The framing of smoking as an environmental (and not merely personal) health issue hasbeen central to the dramatic progress of smoking ban policy from the first tentativehealth-related restrictions of the 1970s. Specifically, ETS has come to be envisioned as athreat to ultimate social values – health, life and the wellbeing of children – that is prob-lematic wherever it occurs. Accordingly, counter-arguments grounded in economic andcultural claims, and selective appeals to individual rights, have limited purchase. For thosewho continue to smoke, experiences of constricting spatial opportunities and increasingsocial opprobrium for ‘‘posing peril to others’’ (Burgess et al. 2009, S152) often amountto stigmatization.

Formal spatial regulation of ETS is significant for its expanding reach, large-scaleeffects, and ability to reinforce changing social norms via legal sanctions for non-compliance. Moreover, new spaces are continually appearing under the tobacco controlgaze – as the recent extension of bans to private vehicles and outdoor public spaces



highlights. This article has also emphasized the contribution of private actors to shrink-ing the geographies of smoking by implementing punctiform spatial restrictions of theirown. Qualitative social research is playing a key role in articulating the extent of, andmotivations for, such voluntary initiatives (Phillips et al. 2007; Robinson and Kirkcaldy2007; Thompson et al. 2009).

Future research might usefully adopt a larger-scale view, examining the contribution ofsmoke-free laws to the broader ‘‘hardening of public space’’, which encompasses policycrackdowns on use(r)s of alcohol and illegal drugs, as well as other efforts to targetand control socially marginal groups (DeVerteuil and Wilton 2009, 480). The legal-geographic lens often applied to this phenomenon could readily be extended to theexample of smoking restrictions, which – as this article has highlighted – raise ‘familiar’concerns about rights, the public–private distinction and marginalization. Yet, at the sametime, smoking bans can be distinguished from this literature by the fact that public space(as conventionally defined) has never been the sole, or even predominant, focus of regu-lation: rather, the overarching concern has been to prevent ETS exposure in enclosedenvironments accessible to workers and ⁄ or members of the public, largely irrespective ofownership. While the distinction between public- and privately owned space is alreadyacknowledged as blurred, socially as well as legally (Blomley 2005; Collins 2009), the par-ticularly far-reaching qualities of this public health intervention can appear to elide it alto-gether. Nonetheless, the private home remains a principal (legal) site of ETS exposure formany. The ultimate test of how far social norms around ETS have shifted will bewhether public authorities are willing to extend formal bans to the final frontier of thehome, and thus complete the eradication of ETS from indoor space.

Acknowledgement

Research for this article was supported by the Social Sciences and Humanities ResearchCouncil of Canada.

Short Biography

Damian Collins is Associate Professor of Human Geography in the Department of Earthand Atmospheric Sciences, University of Alberta. He has an MA from the University ofAuckland, and a PhD from Simon Fraser University. His research interests centre on therelationship between health and place, and on the geographical dimensions of social,political and land use conflict. Children and young people are a focus for both types ofinquiry.

Amy Procter has recently completed an MA in Human Geography in the Departmentof Earth and Atmospheric Sciences, University of Alberta. Her thesis research consideredthe spatial regulation of smoking on University campuses in Canada, and linked the rapidexpansion of smoking bans to the declining social acceptability of smoking. This worknoted that with smoking now entirely prohibited indoors at Canadian universities,increasing regulatory attention is turning to outdoor spaces, and several campuses havemade the decision to go entirely smoke-free.

Notes

* Correspondence address: Damian Collins, 1-26 Earth Sciences Building, Edmonton, AB, Canada T6G 2E3.E-mail: [email protected].



1 Katz also records that the epithet ‘‘Health Nazi’’ was coined by the tobacco industry in order to portray tobaccocontrol advocates as rights-deniers and enemies of the freedom of choice. Given this origin, and the ‘‘[r]eprehensi-ble’’ nature of the term (Katz 2005, ii33), we suggest that scholars may have an obligation to challenge its use (cf.Bell et al. 2010, 918).2 Ashley and Ferrence (1998, 61) suggest children’s agency in this area is extremely limited: ‘‘Infants and veryyoung children cannot complain; older children who are bothered by ETS may not complain, or may be ignoredor reprimanded when they do. Further, children often cannot remove themselves from exposure and, therefore, aredependent on other measures for protection’’.3 The definition of a ‘child’ for the purposes of such laws is inconsistent, with age cut-offs ranging between 6 and19 years (Saltman et al. 2010; USDHHS 2006).

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Smoking’s Shrinking Geographies