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