Smoking experimentation and initiation among adolescent girls: qualitative and quantitative findings

OBJECTIVE: To use qualitative and quantitative findings to describe patterns of smoking experimentation and initiation among adolescent girls. DESIGN: Ethnographic in-person interviews, focus groups, telephone interviews, and a survey questionnaire were used over a one-year period. The paper reports on cross-sectional data drawn from a three-year longitudinal study. SUBJECTS AND SETTING: 205 girls participated in the survey and interviews during year 3 of the study. Girls were drawn from two urban high schools in Tucson, Arizona (USA), and were in grades 10 and 11 (mean ages 16 and 17, respectively) during year 3. RESULTS: Overall, 30% (n = 61) of informants reported that they currently smoked, 7% (n = 15) were ex-smokers, and 63% (n = 129) were "non-smokers". The most frequently cited reasons for smoking were stress reduction and relaxation. Several stress-inducing situations, including family environment, social relations with classmates, and schoolwork, are discussed. The notion of peer pressure is re-examined in the light of teenagers' experience that there is little overt pressure to initiate smoking. Consonant with notions of adolescent autonomy, the theme of independence in smoking initiation and continuation permeated girls' narratives about their smoking behaviour. Girls projected the image that they could control their cigarettes rather than have their cigarettes control them. CONCLUSIONS: Smoking prevention and cessation programmes need to address and counter the smoking/relaxation association, which was identified as an important reason for smoking among adolescent girls. Questions typically used in surveys to measure smoking behaviour do not adequately define the smoking experience as described by teenagers.