Smoking and drinking often go hand in hand. Therefore extending the smoking ban outside bars could help curb “social smoking”, a qualitative study published online in the journal Tobacco Control suggests.

The international evidence indicates that, while the prevalence of smoking per se has decreased, social smoking— smoking intermittently or only in given situations—has increased among young adults, say the authors.

The authors carried out in-depth interviews in 2011 with 13 “social smokers,” aged between 19 and 25, who were recruited through the online social network Facebook, via posters in cafes, supermarkets, and on community notice boards.

Analysis of the interview transcripts identified that social smokers often had conflicted identities. Participants found it very difficult to reconcile their stated identity as non-smokers…..who smoke. They managed this conflict by limiting where and when they smoked, and by sharply differentiating themselves from smokers, to whom, by and large, they felt superior.

Their demarcation strategies included claiming they never smoke alone; asserting that they controlled when, where, and how much they smoked, and defining smoking as “a temporary phase”.

More particularly, they defined themselves as other than a “smoker” by rationalising and justifying their smoking as something that had occurred only because they had been drinking.

Participants described smoking and drinking as going “hand in hand”. Some indicated that alcohol prompted cravings for a cigarette, something they did not otherwise experience. More fundamentally, alcohol enabled them to absolve themselves of responsibility for their actions, which they inevitably regretted. Drinking thus supported and even induced “binge smoking” and yet also distanced them from this behaviour, enabling them to maintain their “non-smoker” persona.

One respondent commented: “Some nights I can smoke 14/15 ciggies or a pack while I’m drinking but I can never do that without alcohol.”

When asked their thoughts on mandating smoke-free areas outside bars, which could help decouple smoking and drinking, all but one participant strongly backed this proposal and indicated they would reduce or stop smoking.

“Introducing smoke-free outdoors bars could reduce social smoking by removing cues that stimulate this behaviour and changing the environment that facilitates it,” suggested Professor Janet Hoek, the lead author.

“Such a policy would eliminate the current intersection between smoke-free and smoking spaces and create a physical barrier that, for some, would make accessing the smoking zone too difficult,” concluded Dr Ninya Maubach, a co-researcher on the project.