Elsevier

Social Science & Medicine

Volume 53, Issue 5, September 2001, Pages 593-602
Social Science & Medicine

Anxious adults vs. cool children: children's views on smoking and addiction

https://doi.org/10.1016/S0277-9536(00)00367-1Get rights and content

Abstract

Tobacco addiction represents a major public health problem, and most addicted smokers take up the habit during adolescence. We need to know why. With the aim of gaining a better understanding of the meanings smoking and tobacco addiction hold for young people, 85 focused interviews were conducted with adolescent children from economically deprived areas of Northern Ireland. Through adopting a qualitative approach within the community rather than the school context, the adolescent children were given the opportunity to freely express their views in confidence. Children seem to differentiate conceptually between child smoking and adult smoking. Whereas adults smoke to cope with life and are thus perceived by children as lacking control over their consumption, child smoking is motivated by attempts to achieve the status of cool and hard, and to gain group membership. Adults have personal reasons for smoking, while child smoking is profoundly social. Adults are perceived as dependent on nicotine, and addiction is at the core of the children's understanding of adult smoking. Child smoking, on the other hand, is seen as oriented around social relations so that addiction is less relevant. These ideas leave young people vulnerable to nicotine addiction. It is clearly important that health promotion efforts seek to understand and take into account the actions of children within the context of their own world-view to secure their health.

Introduction

Cigarette smoking is the most researched health risk factor in the history of medicine (Brigham, 1999). It has been proven beyond doubt that nicotine is highly addictive (Royal College of Physicians, 2000), and the detrimental effects of smoking upon health are well known. Recently, a wide range of publications have enhanced our understanding of the pharmaceutical and neurological manifestations of addiction (e.g. Leshner, 1996; Le Houezec, 1999; Stoleman, 1999). This knowledge has been incorporated into research on smoking cessation (Raw, McNeill, & West, 1999; West, 1999), involving Nicotine Replacement Therapy (Stapleton, Lowin, & Russel, 1999; Fagerstom, Tejding, Westin, & Lunell, 1997) and, more recently, other drugs such as bupropion (Jorensby et al., 1999; Jarvis, 1999). These contributions emphasise that stopping smoking is extremely difficult. Smoking clinics report low success rates (Sutherland, 1999), and those who try to quit without any help appear to be no more successful (Irish Times, 1999). Indeed, it has been claimed that nicotine is more difficult to give up than heroin or cocaine (Royal College of Physicians, 2000).

Of course, addiction can only occur following a decision to smoke. Up to 91% of adult smokers started smoking in adolescence (Hampl & Betts, 1999). If we are to reduce tobacco addiction, it is therefore crucial that we gain a fuller understanding of how young people conceptualise smoking and addiction before they are actually trapped, so that appropriate health promotion measures can be put in place. We need to know why so many young people choose to smoke and why their knowledge of health risks seem to have little effect on their behaviour. Something is known about who is most likely to start smoking (Sutton, 1992), although it has been claimed that predictions to a significant degree depend on the particular research design (Rutger, Engels, Knibbe, & Drop, 1999). We do not, however, know much about why people take up smoking (Sutton, 1992). Moreover, we know very little about the meanings that smoking has for young people (Allbutt, Amos, & Cunningham-Burley, 1995; Michell, 1997: Michell & Amos, 1997). For the present study, a qualitative approach has been adopted in order to acquire more in-depth knowledge and understanding in this area. If we wish to construct theoretical frameworks about children, then we must pay close attention to their views and experiences so that our theories resonate with actual experiences (Mayall, 1996).

This study explores the understanding that 10–11 year old children have of tobacco addiction at an age where experimentation with cigarettes often begins. Pilot focus group discussions held among 16 year olds are also briefly reported. The interviews form part of a larger study being carried out longitudinally (involving the same children being interviewed at yearly intervals), with parallel studies underway in Spain and the Republic of Ireland (see Hyde, Treacy, Abaunza, & Knox, 2000). The aims are to define the subjective rationale associated with smoking uptake; gain deeper insight into the social and cultural factors underpinning adolescent smoking; map longitudinally the early smoking ‘career’ of young people; determine the nature of any associated beliefs and attitudes; and finally, to compare the findings cross-culturally. The research was conducted within community youth clubs rather than schools and focused upon economically deprived areas because it has been established that smoking is increasingly associated with socio-economic deprivation (Marsh & McKay, 1994). The research team includes interdisciplinary expertise from Psychology, Social Anthropology and Health Sciences. The present paper presents mainly a sociological interpretation, investigating socio-cultural dimensions of nicotine addiction. It is tentatively suggested that for young adolescents, addiction may be related to the socially constructed identity of a ‘smoker’, which is linked to being adult-like.

Section snippets

The sample

This paper reports data from 85 initial depth interviews with 10–11 year old children in Northern Ireland. The participants were approached and interviewed in 18 different youth clubs based within economically deprived areas. Approximately, one-third of the parents were unemployed, and nearly one-third of the children lived in single parent families. More than two-thirds of the children lived in urban areas, many on housing estates marked by poverty and social unrest. The study population

Results and discussion

Taken together, the data implies that children's conceptualisations of nicotine addiction are linked to the notion that tobacco consumption is something that symbolically belongs to the world of adults (Porcellato, Dugdill, Springlett, & Sanerson, 1999). Whereas adult smokers are perceived as dependent on nicotine, child smokers are perceived in terms of social relations. This distinction is important in that adult smokers seem to be viewed as passive, while child smokers are viewed as actively

General discussion

The children participating in our research do have knowledge about the addictiveness of tobacco, and how addiction manifests itself socially, psychologically and physiologically. Much of this knowledge comes from observing the smoking behaviour of their own parents or other adults, and also through health promotion and the media. They associate addiction with certain positive and negative psychological and social effects, and they have learned that adult addiction affects family life and

Acknowledgements

This study is part of a project funded by the European Commission Directorate General V (Contract No. DGV 96/I.T./36) entitled “Children Talking: Why do they Smoke?” involving the University of Ulster, University College Dublin, and Universidad de Cantabria who are conducting parallel longitudinal studies. An earlier version of this paper was presented at the 2nd European Conference of the Society for Research on Tobacco and Nicotine (SRNT) in London, November 1999, and we wish to thank

References (43)

  • P. Burnard

    A method for analysing interview transcripts in qualitative research

    Nurse Education Today

    (1991)
  • L. Michell et al.

    Girls, pecking order and smoking

    Social Science and Medicine

    (1997)
  • J.A. Stapleton et al.

    Prescription of transdermal nicotine patches for smoking cessation in general practiceevaluation of cost-effectiveness

    The Lancet

    (1999)
  • H. Allbutt et al.

    The social image of smoking among young people in Scotland

    Health Education Research

    (1995)
  • Barton, M., Sittlington, J., Rugkåsa, J., & Knox, B. (1999). Unlocking child smoking: do peers hold the key?...
  • L.H. Bearinger et al.

    The utility of locus of control for predicting adolescent substance use

    Research in Nursing and Health

    (1997)
  • Brigham, J. (1999). Statistics, scientists under fire. Those findings we frequently cite –are they accurate? SRNT...
  • L. Chassin et al.

    Changes in peer and parent influence during adolescenceLongitudinal versus cross-sectional perspectives on smoking initiation

    Developmental Psychology

    (1986)
  • W.A. Corsaro

    The sociology of childhood

    (1997)
  • J. Cotterell

    Social networks and social influences in adolescence

    (1996)
  • J.R. Eiser

    SmokingThe learning of an addiction

    Journal of Social and Clinical Psychology

    (1985)
  • J.R. Eiser et al.

    Adolescent health behaviour and similarity-attractionFriends share smoking habits (really), but much else besides

    British Journal of Social Psychology

    (1991)
  • European Commission. (2000). Report of the state of young people's health in the European Union. Brussels: European...
  • K.O. Fagerstom et al.

    Aiding reduction of smoking with nicotine replacement medicationHope for the recalcitrant smoker

    Tobacco Control

    (1997)
  • J. Hampl et al.

    Cigarette use during adolescenceeffect of nutritional status

    Nutrition Review,

    (1999)
  • Hyde, A., Treacy, M., Abaunza, P., Knox, B. (2000). Young people's perception of and experiences with drugs: Findings...
  • Irish Times (1999), Wednesday, December...
  • A. James et al.

    Theorizing childhood

    (1998)
  • Jarvis, M. (1999). Review of the clinical efficacy of Bupropion in smoking cessation. Paper presented at the Second...
  • D. Jorensby et al.

    A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation

    The New England Journal of Medicine

    (1999)
  • Lazenbatt, A. (1997). Protecting young people from tobacco. An evaluation of the Ulster Cancer Foudation's...
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