Starting smoking: girls' explanations of the influence of peers

Journal of Adolescence 1999, 22, 647±655Article No. jado.1999.0260, available online at http://www.idealibrary.com on

Starting smoking: girls' explanations of the influenceof peers

KEVIN LUCAS AND BARBARA LLOYD

A questionnaire survey of cigarette smoking completed in six secondary schools by4773 pupils aged 11±16 years included five items concerning the circumstances ofsmoking initiation: (1) age at first cigarette; (2) source of supply; (3) location of firstsmoke; (4) persons present; and (5) perceived degree of coercion. Although there wasa highly significant gender difference on the item concerning age at first cigarette, withthe average for boys lower than that for girls, the remaining items showed no gendereffects. In order to explore further the reasons for the observed higher prevalence ofcigarette smoking among teenage girls compared to boys, 33 focus groups wereundertaken with girls in Years 7 and 9. These qualitative data provide evidence of thesocial representations of different groups and of smoking and non-smoking identities.Any understanding of smoking among girls needs to take account the dynamics of girls'membership in groups of never, experimental and regular smokers in determiningsubsequent smoking behaviour.

# 1999 The Association for Professionals in Services for Adolescents

Introduction

Demographic, personality and social variables have all been linked to adolescent smokinginitiation. The first of these includes age, gender and social class (Santi et al., 1990±91;Ashby, 1995; Balding, 1995; DeVries, 1995). The second involves traits such as sociabilityand depression. A wide range of social influences including family, friends and peer groupshave also been studied (Chassin et al., 1986; Santi et al., 1990±1991; Aloise-Young et al.,1994; Urberg et al., 1997). The place at which the first cigarette was smoked, the peoplepresent at that time, the smoking behaviour of significant others and how cigarettes wereacquired have also been studied (Lloyd and Lucas, 1998).

Boys smoke their first cigarette at an earlier age than do girls, but more girls go on tobecome regular smokers. Adolescent smoking in the U.K. is inversely related to social class;girls from working class families are more likely and girls from the highest social class are leastlikely to be smokers (Balding, 1995).

Personality has not been studied extensively among adolescents although Killen et al.(1997) have reported that girls with higher sociability scores are more likely to try smoking.

Santi et al. (1990±1991) have linked initiation to sibling and peer influence. Aloise-Younget al. (1994) have shown that cigarette smoking is viewed as an entry strategy for thoseadolescents whose initial friendship choices were unreciprocated.

A useful approach to describing the nature of adolescent groups and the demands theyplace upon their members is through the identification of their social representations.Relatively few studies have sought specifically to describe adolescents' social representationsof young cigarette smokers and non-smokers. Joffe (1996) has suggested that this lack

Reprint requests and correspondence should be addressed to Dr Kevin Lucas, East Sussex, Brighton and HoveHealth Authority, 36±38 Friar's Walk, Lewes, BN7 2PB, U.K.

0140-1971/99/050647+09 $30�00/0 # 1999 The Association for Professionals in Services for Adolescents

648 K. Lucas and B. Lloyd

reflects the focus of health professionals on the prediction of behaviour using social cognitionmodels. However, she has asserted that

the ability to predict behaviour is not the central contribution that social science canmake to theconcerns of health professionals; ecological validity is often sacri¢ced for a health belief modelwhich explains the maximum possible amount of variance ( Jo¡e,1997, p. 81).

In our study social representations and social identities of smokers and non-smokers weremeasured both by questionnaire and in focus group discussions (Lloyd et al., 1996).Questionnaire data provided a quantitative assessment of age when trying first cigarette,location of first episode, supplier, social setting and perceived pressure to smoke. We examinethese data briefly, but concentrate our attention on the differing perceptions of initialsmoking episodes as described in discussion by homogeneous focus groups of girls who werenever, experimental and regular smokers.

Methods

This report is based on a study of English secondary school pupils in Years 7±11 (11±16 yearsold) from six mixed-gender, state secondary schools in East Sussex. Questionnaires wereadministered to all pupils at school by teachers according to a standard set of instructions.Participants provided 4771 usable questionnaires from a total of 4943 collected.

Charlton et al. (1985) have argued that self-reports of smoking behaviour can be asaccurate as those obtained through the use of cotinine assays if anonymity and confiden-tiality can be established. Pupils were assured of anonymity and confidentiality by the useof a self-created personal code number and of unmarked, sealable envelopes.

The focus groups were formed from girls recruited in friendship groups in Years 7 and 9.These ranged in size from two to six girls and included girls almost 14 years old. Informationabout their smoking behaviour was recorded during discussion.

Questionnaire data

Smoking group membership. Three categories of smoking group membership wereidentified from responses to three questions: self-reports of smoking status, lifetime consump-tion, and time elapsed since last smoking a cigarette.

. Never smokers: adolescents who reported that they had never smoked.

. Regular smokers: adolescents who reported smoking at least one cigarette a weekand who had smoked over 20 cigarettes in their lives.

. Experimental smokers: adolescents who had smoked in the past, but who did notcurrently smoke one or more cigarettes per week.

Smoking initiation. Individuals who reported having had at least a puff of a cigarette(experimental and regular smokers) completed five smoking initiation items:

. age at first cigarette;

. source of supply;

. location of first smoke;

Starting smoking 649

. persons present;

. perceived degree of coercion.

Year in school was employed in statistical analyses of these variables in addition to age,since pupils often report not knowing people in other years.

Focus group dataAudio recordings of the group discussions were transcribed by a commercial agency andcorrected by a researcher present during data collection. The computer program NUD*IST(Non-numerical Unstructured Data Indexing, Searching and Theorising, 1985±1994) wasused in qualitative analyses. It has three major functions:

. it facilitates the organization of qualitative data in a structured form;

. it enables the researcher to explore the data and to view it in many differentcombinations;

. it has a hypothesis testing and theory building function whereby co-occurring oroverlapping coding within text units or whole documents or groupings of documentsmay be juxtaposed according to differing logical functions.

Almost 22,000 individual speech turns were coded. Inter-rater reliability varied withdomain from 85% to virtually 100% agreement. Disagreements were resolved throughdiscussion.

Results

Questionnaire dataThe five smoking initiation variables were analysed by gender for experimental and regularsmokers (n� 2045). Only age revealed a significant gender difference.

Age at first cigarette. Boys were approximately 4 months younger than were girls whenthey smoked their first cigarette (mean for boys� 11?1 years; mean for girls� 11.5 years).This difference is highly significant (p� 0?009).

Source of supply. Approximately 70% of pupils claimed that the first cigarette theysmoked had been offered to them by another person and 30% reported obtaining one forthemselves. Regular smokers were more likely to have obtained cigarettes for themselves(Kendall tau 0?12, p50?001).

Location of first smoke. There were no statistically significant differences between boysand girls in where they first tried cigarettes.

Persons present. Approximately two-thirds of both girls and boys first tried a cigarette inthe presence of one or two friends; only 10% smoked their first cigarette alone.

Perceived degree of coercion. Perceived degree of coercion was rated on a six-pointscale. In an ANOVA with school Year as a covariate, there was a highly significant main effectfor smoking group membership (p� 0?003). Experimental smokers reported having felt morepressured to try a cigarette by others than did regular smokers. Individuals who felt greaterpressure to smoke also reported that others had provided them with cigarettes. The highly


significant negative correlation (r� 0?25; p50?001) between perceived degree of coercionand the source of supply attests to the validity of these items.

Focus group dataThese analyses are based only on data from 13 groups homogeneous in their smokingbehaviour:

. never smoked: none of the members had tried smoking (10 groups);

. experimental smokers: all members had tried smoking, but none were regularsmokers (two groups);

. regular smokers: all members were regular smokers (one group).

Age was strongly related to membership: girls who described themselves as experimentaland regular smokers were older than never smokers. All girls who participated in focus groupswere aware of the serious health risks of smoking.

Never-smoked groups. Girls who belonged to never-smoked groups construed theonset of smoking largely in terms of group identity and behaviour. These girls easily identifiedgroups of smokers, and their social representations of them consistently included threedimensions:

. active;

. predatory;

. demanding conformity to their smoking behaviour.

The active nature of groups of smokers was summarized in three observations:

. smoking occurs in places and at times which are unregulated, e.g. on the way toschool, or near youth clubs, where smoking is not allowed;

. attracting boys is one of the main reasons for smoking;

. the first experience of smokers involves going somewhere out of doors, specificallyto smoke.

By contrast, these girls represented themselves as quiet, sensible and preferring to stay in:

Interviewer Can you tell me why she's not the type to smoke?I think she's too sensible.Interviewer Too sensible. Does that mean people who smoke are stupid then?Yeah [laughs]Interviewer Okay. So F's sensible. What else about her?She's quite quiet as well.I think 'cos she's a bit like me would rather just stay home watch the telly or laughs do something likethat.

The predatory nature of groups of smokers is described below.

These other people are quite wimps and they [smokers] actually get them and like [say]: `Òh come on,come and join us'', and you can try it [smoking] and all that and they make you like it.

Demands for conformity were described in terms of aggressive behaviour which alsocontributed to the predatory image of smokers. These girls believed that groups of regular


smokers did not tolerate non-smoking members for long, even when they initially acceptedthem as new members.

Groups of regular smokers were believed to use three methods to encourage eventualcompliance among potential and new members:

. persuasion: smokers were reported to deny the addictive potential of cigarettes whenoffering them to non-smokers but there was some belief that good friends would nottry to encourage one to smoke;

. physical intimidation: these girls often said they were in fear of future beatings fornot smoking:

There's one girl, she hangs with one of my friends, and he's in another form, and my friend doesn't smokebut she says she doesn't actually like being with the others that smoke because she feels that one day she'sgoing to actually start smoking. And she also says ``what if I don't smoke? I am going to get beaten upwhen I'm older''.

. social ostracism: consistent non-smoking is seen as likely to lead to being removedfrom the smoking friendship group:

I think they'd be really sly about it and they would get you thinking that you're their friend and if youdon't smoke later on they'll chuck you out their group.

These tactics suggest that never smokers viewed smoking as a defining socialrepresentation of the smoking group identity.

Smoking and social contagion. Smoking itself was represented by non-smokers asanalogous to a highly contagious disease that challenged loyalty to friends and group identity.A smoking `òutbreak'' is described below.

It was then they started, in year eight I think, that they started going to [night clubs] and then more girlsstarted. Just recently, a couple of weeks ago, more girls started smoking 'cos a big group of them go downto [leisure centre], and then one started smoking who came to this school just recently, and then they allstarted smoking.

The dynamics of group `ìnfection'' and resistance were linked, and two routes to`ìnfection'' were described by the never-smoked groups. The first involved anexperimental episode, resulting from curiosity and enjoying lighting matches. The secondand more likely route was predation by a smoking group. The methods of `ìnfection'' werebelieved to include the tactics described above, but also an effect associated with asmoking context.

My friends smoke and they're in year seven, they're in [school name], and I went round to their houseand she goes: ``Do you want a cigarette?'' And I go: ``No''. And they were all smoking and then all theirfriends came and they were all smoking, but I just went home early because then I didn't want to gethooked on it or anything.

The dynamics of group resistance to smoking challenged loyalty to friends. Girls reportedthat they would react very unfavourably to a group member who started to smoke. Although


they would initially stay friends with the new smoker, they would try to persuade her notsmoke:

I think I'd be their friend during school because they wouldn't be allowed to smoke, but after school, youknow, at clubs and that we go to, I think I'd be where she doesn't, where you're not allowed to smoke.

Many reasons are given by the never-smoked groups for the necessity of avoiding smokers,although all are understood in terms of the smoker having ``gone bad'', and that this``badness'' becomes a threat to a never-smoked group identity and to the individual groupmembers.

I would stay away from her . . . because she would have bad breath all the time, and I don't really likepeople that smoke. . . Just every time you say something that they don't like they just lash out at you allthe time.

Discussions frequently involved efforts to mark off the new smoking part of a friend fromthe rest, in order to banish smoking behaviour from the group, while not losing a friend andgroup member. Some girls said they would remain friends with new smokers if they did notsmoke around them, or if they did not offer cigarettes to never smokers. When a neversmoker took up smoking, friendship and group membership became unstable.

The onset of smoking. Even in never-smoked groups there was consistent affirmation ofthe individual's freedom of choice to begin smoking, despite strong evidence of negativegroup-oriented consequences and implications for group membership. Personal choice wasalways invoked in the context of a new smoker deciding to ignore her friends' advice and tocontinue to smoke. Nevertheless, this affirmation served as a boundary:

. as the point in time at which the new smoker ceased to be a concern of the never-smoked friendship group;

. as the boundary in social space between the friendship group and its environment;and

. as a marker within the friendship group, delimiting acceptable behaviours andmarking off the unacceptable.

The demand for conformity that the never-smoked group attributed to groups of smokerswas also a feature of their own groups. Most girls from the never-smoked groups agreed that ifa girl took up smoking, she would almost inevitably leave their group to join other smokers.They explained this as a consequence of the girl's behaviour which was not part of theidentity of their group, and which could not be tolerated.

No they try and hang round with us but we don't really like them.

However, if a group member tried smoking only once and concluded, independently, thatshe did not wish to continue, then her membership of the ``never-smoked'' group was notthreatened.

We're best friends, but she has tried smoking, but it hasn't really changed her 'cos I think she's only doneit once.


Experimental smokers groupsCompared with never-smoked group members, experimental smokers had qualitativelydifferent representations of smoking initiation. Their descriptions were based in part onmemories of their own experiences as well as on observation and imagination. From theirperspective, the clear distinction between smoking and non-smoking friendship groupsoffered by the never-smoked groups was less stable, although it was still present sometimesimportant. The affirmation of individual choice that had formed a key element in the self-definition of the never-smoked groups was much less obvious among experimentalsmokers.

Views of smoking initiation. Three elements commonly appeared in experimentalsmokers' accounts of their own smoking initiation.

. An instigator, often an older person, was always known to the new smoker, but thisperson was not always among the new smoker's closest existing friends.

. A sense of place was always associated with the first experience of smoking. Theinstigator usually accompanied one or two people to an outside location for thespecific purpose of smoking, although in one case they were both in a night-club.This sense of going somewhere to smoke is consistent with the never-smoked groups'descriptions of smoking groups as active in the world. This sense of place, and thepresence of an acknowledged instigator, give the event some of the attributes ofritual or initiation, especially since the first cigarette is often passed around a numberof girls. Cigarettes may have a symbolic significance, indicating daring (access tocigarettes for girls of this age usually requires some nerve), or of fearlessness (in theface of a known killer).

. Claims by smokers included that smoking just one cigarette would not hurt, that thenew smoker would not get addicted, and that smoking was pleasant once you gotused to it. These claims are consistent with the predatory description of smokersoffered by never-smokers. Experimental smokers appeared to be girls who had haddifficulty in producing counter-arguments.

Issues arising from smoking initiation. Girls' reports of their friends' reactions to theirsmoking were consistent with those provided by never-smoked groups. Non-smoking friendsput pressure on the new smoker not to smoke, as smoking represented a threat to theintegrity of their group. At first, this pressure involved offering reasons for not smoking thatwere oriented toward the short term. Later it led to suggestions that the new smoker couldno longer be part of the group.

[To new smoker] ``'Cos I said that you'll be stupid. Even though other people are doing it doesn't meanthat you have to. You're not going to be any different. You'll still be my friend if you try it, but I said,it's just for you that I'm telling you. So it's up to you. But, I said I wouldn't if I was you, but it's upto you''.

All the experimental smokers claimed to have chosen to remain within their non-smokingfriendship groups. However, experimental smokers' loyalty to those groups could no longer betaken for granted.


The regular smokers groupBefore they began smoking, individuals in the group of regular smokers reported being veryanti-smoking. One of these girls recalled being close to a relative who died from lung cancer.Regular smokers described three phases in their smoking careers.

. Initiation. Regular smokers confirmed the suspicions of never-smoked groups thatthere are two routes to smoking initiation. Some described a curiosity-drivenexperiment (involving either just themselves, or a small group of non-smokers).Others described being pressured into smoking by a friendship group of smokers. Therole of the instigator described by experimental smokers was given less emphasis.The sense of place was as strong for regular smokers as it had been for experimentalsmokers. Although adolescents are often told that smoking for the first time isunpleasant, girls in the group of regular smokers did not always describe theexperience as such.

. Experimental smoking. One girl emphasized the difficulty in saying ``no'' after she hadbeen seen smoking. Others noted the desire to be active and out in the world withtheir friends rather than being bored. Smoking gave them an opportunity to ``go offto the woods and have a laugh''. Finally, one girl said that the second cigarette hadbeen less unpleasant than she remembered the first one to have been, lendingcredence to smokers' claims that smoking is pleasant `ònce you get used to it''.

. Regular smoking. Most of the girls said they continued to smoke experimentally untilone day they realized they were addicted. However, one girl, pressured into smokingby her friendship group, reported that she suddenly realized she was a smoker:

. . . before I went round with you lot [smoking friendship group] I never smoked, and everyone's going:``You're going to smoke in a year, I bet you next year you're going to be smoking.'' . . . And then afterthat I thought, `Ì'm going to smoke,'' and like something happened, I can't remember what. . .

This was the only mention in the regular smoking group of exclusion from non-smokingfriendship groups, or of any reaction from non-smoking (ex)-friends.

Discussion and conclusions

Results from the focus group discussion support and amplify quantitative findings from thequestionnaire. Smoking initiation generally takes place outside usual locations, with one ortwo friends, and does not lead immediately to regular smoking. Despite concern about theone-third of adolescent girls who smoke regularly by the time they are 17 years old, girls whonever smoke have incorporated and accepted the representations of smoking and of non-smoking which interventions have offered them since primary school.

It is useful to consider some of the alternative representations which smoking offersadolescents in order to understand better the limited success of conventional interventionswith this age group. Smokers are seen by their peers as fun-loving and non-conformist andcigarettes as a passport to an exciting and popular lifestyle. Although there can be littledoubt that any new intervention needs to be specifically targeted at regular smokers, it mayprove difficult to create an alternative that has the same appeal as the social representationsof the smoker identity.


References

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Starting smoking: girls' explanations of the influence of peers