Grant: Travel Awards - Institute Community Support

Background. Despite significant declines in smoking prevalence in Scotland, 34% of people living in the most deprived areas smoked in 2014, compared to 9% of those living in the least deprived areas. Few studies have examined tobacco control's effects on smoking inequalities and their findings are inconsistent. Some studies found that certain tobacco control policies have had the unforeseen effect of increasing social exclusion and stigmatization among deprived smokers. This issue is challenging for the Scottish government, which aims to design policies to reduce smoking prevalence and smoking inequalities. To better understand how tobacco control affects inequalities, we sought the perspectives of those involved in its design. We asked: How do tobacco control stakeholders perceive future Scottish tobacco control policies as affecting smoking inequalities? Methods. We conducted a qualitative thematic document analysis of 92 Scottish government consultations completed by tobacco control stakeholders in 2014. We analysed 12 questions that addressed future tobacco control (i.e. smoke-free NHS grounds and children's outdoor areas) and their effects on inequalities. Results. Many stakeholders agreed that further de-normalised smoking with national smoke-free policies was key to reducing smoking inequalities. A few stakeholders were concerned of the stigmatizing and exclusionary effects of smoke-free policies on deprived groups. They suggested that community groups be involved in future policy design to reduce inequalities. Conclusions. Scarce research examines tobacco control stakeholders' perspectives although they are critical in policy design. Results suggest that their perceptions of the effects of tobacco control on smoking inequalities vary, with many failing to consider tobacco control's potential effects on increases in inequalities. Researchers and stakeholders need to consider how smoking inequalities are perceived to design future equitable tobacco control.