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Social Science & Medicine 59 (2004) 573583

Social thinking and cultural images: teenagers notions of

tobacco use

Marie-Louise Stjernaa,*, Sonja Olin Lauritzena, Per Tillgrenb,c

aDepartment of Education, University of Stockholm, Stockholm S-106 91, SwedenbDepartment of Public Health Science, Division of Social Medicine, Karolinska Institutet, Norrbacka, SE-171 76 Stockholm, Sweden

cDepartment of Caring and Public Health Sciences, M.alardalen University, Box 883, 721 23 V.aster (as, Sweden

Abstract

The health hazards of tobacco use are well-known, and it is considered particularly important to prevent tobacco use

among teenagers. New generations of teenagers still start using tobacco. To develop a more profound understanding of

tobacco use among teenagers, the purpose of this study is to explore representations of tobacco use, smoking as well as

snuffing, at the age when young people often start using tobacco. Focus-group interviews were carried out with 14-15

year olds in two schools in the Stockholm area. The analysis reveals that teenagers are well informed about the health-

hazards of tobacco use. At the same time they hold complex and conflicting ideas concerning the relationship between

tobacco use, risk, the body and human nature. At the most general level of social thinking there is a dynamic

relation between the three main representations of tobacco use related to: (1) notions of risk, (2) human nature and;

(3) societys efforts to discipline its citizens, which together can be seen as the social representation of tobacco use. These

representations of tobacco use are discussed as related to the teenagers identity-work and gender identities.

r 2004 Elsevier Ltd. All rights reserved.

Keywords: Teenagers; Tobacco use; Social representations; Gender; Social identity; Focus-groups interviews

Introduction

In contemporary society, efforts are made to restrict

tobacco use and particularly to prevent tobacco use

among teenagers. Despite preventive activities, health

education about tobacco at school and the fact that

health-hazards related to tobacco use are well-known,

new generations of teenagers start using tobacco. InSweden, as in several West European countries, cigarette

smoking is more common among girls (Wold, Aasen,

Aaro,&Samdal, 1995;WHO, 2000) while oral snuffing1

(smokeless tobacco) is almost exclusively a male habit.

The prevalence of snuffing among teenagers has

increased since the early 1970s, whereas smoking has

decreased slightly during the last decade (Andersson,

Gr .onberg, & Hibell, 1999). Today, the prevalence of

tobacco use is fairly equal in girls and boys: 38 percent

of the boys and 36 percent of the girls, aged 1415, used

tobacco (smoking and/or snuff) in Sweden in 2000.

Among the tobacco users 10 percent of the boys and 15percent of the girls were daily smokers. 30 percent of the

boys and 3 percent of the girls used snuff ( CAN, 2001).

In this study we address smoking as well as snuffing as

both forms of tobacco use are addictive, and one can

serve as an introduction to the other (Tillgren, Haglund,

Lundberg, & Romelsj .o, 1996).2 A multi-disciplinary

ARTICLE IN PRESS

*Corresponding author. Tel.: +46-8-16-31-58; fax: +46-8-

15-83-54.

E-mail address: [email protected]

(M.-L. Stjerna).1Sweden has one of the highest prevalence of smokeless

tobacco use (mainly moist snuff; snus) per capita in the world,

whereas the sale of moist snuff is prohibited since 1992 in other

countries in the European Union (Bolinder, 1997).

2 In pre-adolescence (1112 years) there is an earlier initiation

of tobacco use among boys, and a more rapid transition to

regular smokers among girls (Galanti et al., 2001). Of particular

interest is that experimentation with snuffing among boys also

marks the transition to cigarette smoking (ibid).

0277-9536/$- see front matterr 2004 Elsevier Ltd. All rights reserved.

doi:10.1016/j.socscimed.2003.11.003


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project was carried out in collaboration between the

Department of Public Health at the Karolinska In-

stitutet (Stjerna, Marttila, & Tillgren, 2000) and the

Department of Education, Stockholm University (Stjer-

na, 2001). Of particular interest is how tobacco use is

described and dealt with in the local socio-cultural

context, where cigarettes and snuff are consumer goodsloaded with symbolic meanings. The purpose of this

paper is to explore teenagers notions of tobacco use,

their shared ideas and images, how these notions are

reflected in their accounts about their own and other

peoples tobacco use and also the ways understandings

of tobacco use are related to the teenagers development

of a gender identity.

Social representation theory

To explore teenagers notions of tobacco use, we takeour point of departure in social representations theory,

where social representations are defined as a system of

thinking that affects our perceptions of and acting in

the world (Moscovici, 1988). Within a group of people,

social representations contribute to a shared image of

reality, at the same time as conflicting ideas can exist and

be debated at a discursive level (Rose et al., 1995). The

focus is on human beings as social and cultural beings,

and on the vital function of this system of thinking to

both shape and maintain social identity (Jodelet, 1991).

Social representations are seen as socio-cultural phe-

nomena which are formed in interaction between people

and thus differ from a purely cognitive perspective.

The understanding of peoples ideas of tobacco use

can be informed by studies of social representations of

health and illness. Herzlich (1973) found that when

people talked about health and illness, their reflections

were phrased in terms of the individuals relation to

society. Illness is to a great extent understood as caused

by the lifestyle of modern society, and the threat to the

individuals health emanating from outside. However,

the individual can act in order to maintain his or her

natural state of health. The relationship between

health and illness, and between the individual and

society, is thus characterised by conflict. In this sense,representations of health and illness relate biology to

social life. Today, the concept of health is imbued with

far reaching implications, sometimes perceived as

synonymous with success and fortune (Herzlich, 1995).

To actively strive for health has become an imperative

(Lupton, 1995). Also, asRadley and Billig (1996)argue,

notions of health and illness are ideological. They are

related to wider discourses in society that affect not only

the way individuals think, but also how they feel they

should think. Definitions of a healthy way of life include

judgements and values and is therefore ideological. As

smoking is without doubt hazardous to health, the

moral imperative to strive for health is of particular

interest in relation to smoking.

Tobacco use from a gender perspective

The attitude teenagers adopt towards cigarette smok-ing and snuffing can be seen as related to the young

persons position in the social order, as a young man or

woman approaching adult hood. Our point of departure

is thus a gender perspective on teenagers search for an

identity. Gender is here primarily understood as what we

do in interaction with other people, not what we are

(West & Zimmerman, 1991). Doing gender means

that differences between men, women, boys and girls are

socially constructed and not considered simply natur-

al or biological. Gender is thus to be understood as an

ongoing process in womens and mens lives, which

children are incorporated into when they learn toobserve these differences regarding their own and other

peoples behaviour (ibid.).

At a cultural level these differences can be described

as notions of masculinity and femininity and are

reflected in ideas of typical male and female

characteristics, interest and behaviors. At the same time,

the youth of today have possibilities to choose as norms

and traditions that put a pressure on former generations

may have lost its meaning for generations of today

(Holstein-Beck, 1995), even if such choices are circum-

scribed by ideas of what is considered feminine in

local socio-cultural contexts. Jones (1993) argues that

young women no longer have to be viewed as socialised

into appropriate gender roles, but create their own

positions in the social order, and consequently girls can

take different positions in different situations. The

search for an identity could thus be described as a

central project, and young people find themselves right

in the middle of identity-work. As the question of

taking up smoking or snuffing is most urgent during the

teen years, the young persons attitudes towards tobacco

use could be seen as a part of his or her identity-work.

Earlier work on the meaning of tobacco use from a

gender-perspective has addressed the meaning of smok-

ing in motherhood and in the transition towards adult-life. In her study of English womens experience of

smoking in the context of motherhood, poverty and low

social support, Graham (1987) found that smoking

serves a contradictory function in the womens lives.

Although undermining their own and their childrens

health, smoking helps the women to cope with caring for

their families. Cigarette smoking offered them a short

break from the routines and strains of family life,

cigarettes were often the only consumption women

allowed solely to themselves. The meaning of smoking

for young women has also been studied in relation to the

transition between school and work life. Daykin (1993)

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found that for young women smoking could offer a

symbolic adult status and serve the purpose of balancing

their subordinated position both at home and at work,

as they struggled for independence.

To date, research on tobacco use from young peoples

perspective is still limited (Allbutt, Amos, & Cunning-

ham-Burley, 1995), and more knowledge is neededabout contexts that promote smoking or non-smoking.

Michell and Amos (1997) have demonstrated the

importance of the gendered peer-group structure for

smoking. Lloyd, Lucas, and Fernbach (1997) and

Moffat and Johnson (2001)have explored teenage girls

smoking identities and the meaning of nicotine addic-

tion, andPlumridge, Fitzgerald, and Abel (2002)looked

at the implication of smoking refusal on personal

identity. However, teenagers own notions should be

explored to further the understanding of tobacco use in

the teens, which also may have implications for health

promotion as suggested by Frankowiak (1987).

Method

To capture teenagers notions of tobacco use, a

qualitative approach with focus group interviews was

used (Krueger, 1994). Lunt and Livingstone (1996)

argue that focus-group interviews stimulate everyday

communication and thus allow for the analysis of social

representations. Furthermore, as Farr points out:

Group discussions is a useful way of sampling thestock of arguments available within a particular

culture where the researcher is interested in the

arguments produced rather than in the individuals

producing the arguments (Farr, 1995:6)

Focus groups differ from individual interviews in that

they capture the social interaction among participants

and can provide knowledge about peoples shared

understanding of everyday life (Krueger, 1994). Frank-

land and Bloor (1999) argue that the method is

particularly suitable in studies of group norms, espe-

cially if participants know each other, which was the

case in this study. It is then possible to gain insight intoconflicting views as well as consensus in the groups

regarding a phenomenon.

Nine focus groups were carried out with 43 ninth-

grade students, 1415-year- old, at two schools in inner

Stockholm, in areas with an average socio-economic

structure. The first author (M-L.S.) moderated all nine

groups and another member of the research team made

close observations of the discussions and interactions in

the groups (Stjerna et al., 2000). Girls and boys were

interviewed in separate groups, as is recommended in

studies of gender issues (Debus, 1990; Krueger, 1994).

Tobacco users and non-tobacco users, according to their

own presentation of their tobacco habits, were also

placed in different groups to stimulate discussions and

avoid a polarization between teenagers with differentexperiences of tobacco use: Table 1.

The non-tobacco users did not smoke or use snuff at

all. Tobacco use varied from occasional smoking/

snuffing to regular smoking of 1020 cigarettes a day

or snuffing on a daily basis.3 The discussions4 revolved

around the teenagers views on boys and girls tobacco

use at home, at school and in their leisure time, and on

how tobacco use is represented in the media, with a

focus on what they saw as its advantages or disadvan-

tages. All nine groups were tape-recorded and tran-

scribed verbatim. The analysis was conducted in three

steps (Stjerna, 2001). First, the teenagers talk about

tobacco use was described according to the strategy of

analytic induction or deviant case analysis (Frankland&

Bloor, 1999). Starting with one interview, eight themes

were identified; (1) health and tobacco use, (2) the age-

limit of tobacco purchase, (3) school and tobacco use,

(4) media and tobacco use, (5) the aesthetics of tobacco

use (6) the pointless tobacco use, (7) presentation of

self, peers and adults as tobacco-users, (8) presentation

of self and peers who do not use tobacco. The

description of each theme was then modified, with

openness to new themes and sub-categories, in the

process of including more material from all groups. The

focus was here directed towards conflicting views andconcordances in the groups. The second step was to

identify notions of tobacco use which were shared

among the teenagers. At this level, the focus was on the

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Table 1

The number of participants in the focus groups

Group no. Tobacco habit Sex Abbr. Participants

1 Tobacco users Boys T-B 5

2 Tobacco users Boys T-B 3

3 Tobacco users Girls T-G 44 Tobacco users Girls T-G 6

5 Non-users Boys N-B 6

6 Non-users Boys N-B 4

7 Non-users Girls N-G 6



Total 43

3The majority of the 25 non-tobacco-users had tried smoking

earlier, 12 boys and one girl had tried snuffing. Among the 18

tobacco users more girls than boys use tobacco on a daily basis.4A topic guide was used to stimulate to discussions among

the focus groups participants and to cover certain topics of

interest: tobacco use related to (1) the age-limit of tobacco

purchase, (2) school (3) family (4) leisure time (5) advantages

and disadvantages of tobacco use (6) media and (7) gender.

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teenagers ways of understanding the world, for example

their assumptions about male, female, the body,

generation and tobacco use. The final step was to

identify the most general themes constituting the social

representation of tobacco use and to develop a deeper

understanding of the teenagers cultural repertoire of

identities.

The social representation of tobacco use

The analysis revealed that the teenagers shared

understandings of tobacco use revolve around notions

of risk, human nature and societys efforts to

discipline its citizens. At the most general level of social

thinking, there is a dynamic interplay between these

notions.

Tobacco use as risk

The teenagers talk about the risk of tobacco use in

relation to physical health and addiction to tobacco.

Smoking is related to negative social development, such

as drug abuse, primarily among non-users, and to

images of the problematic smoker. According to the

teenagers, smoking will eventually lead to the break-

down of the whole body. Notions of the body as inner

and outer, or invisible and visible emerge in the ways the

girls and boys talk about the absorption of oxygen and

the functioning of lungs when smoking. They describe

that the invisible process inside the body, when smoking,

will gradually be visible on the outside of the body. This

implies a way of thinking ofrisk as a process, which also

is related to a dimension of time. Pictures of the

smokers lungs which have been shown in tobacco

education sessions at school, are described in terms of

how smoking destroys lungs and makes them dis-

gusting. When talking about the outside of the body, a

non-smoking girl (group 9) says: Maybe they look

good now (others of the same age who smoke), but if

you wait, if you, like, look, all our parents who smoke,

they dont really have nice teeth.

Snuffing is not associated with illness and death thesame way as smoking, but more with the health and

hygiene of the mouth. Among the boys, there is an idea

that snuffing could have positive effects, such as

increasing their sports performance. To this degree

snuffing is attributed a health value, but if one wants to

avoid risk all together one should not use snuff. There

seems to be a close relationship between smoking, illness

and ugliness. For example, a boy who does not use

tobacco (group 6) thinks that it is the cells in the face

that will be destroyed by smoking and that a person

does not have to become ugly provided he or she

abstains from smoking. The bodily processes are also

related to aesthetic values. Some girls refer to tobacco

information they have read in girls magazines:

* Like, there are models who appear in magazines and

tell you that smoking is bad. That it gives you a bad

complexion and then you think y*

Ill never be Miss Sweden. (Group 3, T-G)

Some of the aesthetic effects of tobacco use show

immediately. Cigarette smoke smells and the snuffer

looks ugly as the snuff changes the shape of the lip:

* And moist snuff is disgusting when it hangs outside

the lip (laugh).* Then when it is spit out there is some left between the

teeth (laugh). Then it is so damned disgusting when

they laugh. (Group 5, N-B)

Furthermore, in the long run the smoker runs the risk

of becoming seriously ill as a result of smoking.However, the teenagers stress that it will take a long

time before the more serious consequences of smoking

occur (if they ever do). This means that ill-health due to

tobacco use does not have to be a reality until the distant

future. This indicates different notions of risk related to

the young and the adult smoker as well as a risk

dimension, spanning from almost no harm to serious

danger. At one end of this continuum is the teenager

who has been using tobacco for a short while, and at the

other, the adult who has been a smoker for almost a

lifetime.

The teenagers seldom question tobacco facts. Such

facts are understood as valid on a general level, but the

teenagers sometimes wonder if information about

smoking is exaggerated:

* Except, the information you get, you dont really

know if its true. But, it most probably is. I dont

know.* Most often you think that they only want to scare

you and, like, exaggerate about things. Thats what I

think they do. (Group 1, T-B)

The meaning of these facts is sometimes renegotiated

at thelevel of the individual, making smoking or snuffing

seem appropriate for some individuals. The teenagersstress that people differ in bodily constitution as well as

values. Some people may never experience illness due to

smoking. A boy who smokes puts it this way:

* I dont feel the need to quit smoking. I dont know

why. I havent noticed that Im less fit, than I need to

be, because I dont feel less fit. I still ride my

skateboard and, like, play floor ball and stuff like

that. I can still do it just as well. (Group 2, T-B)

The teenagers assume that people evaluate what is

important to them. It is not possible to smoke if you

want to be a successful sportsman or woman, but if you

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are just an ordinary jogger, the issue of smoking is not as

important. Also there is the idea that some people are

attracted to danger, and see a value in risk-taking, which

is one reason for them to choose to smoke. The

teenagers are thus informed about the risks of tobacco

use. However, an underlying dimension in their reason-

ing is the assumption that it is possible to be healthy andsmoke. At the same time a constant danger, a health

hazard, is lurking in the background. Lupton (1995)

refers to the function of cigarettes as an expression of

beauty, pleasure and death: Cigarettes are negative

pleasure; they risk death even as they fulfil desire

(Lupton, 1995:153). The smokers caring for ones own

health has been described as subordinated to other

concerns (Graham, 1987; Lupton, 1995). What is

indicated in this study is that tobacco use and health

are not always seen as contradictory at the level of the

individual, and smoking during teen years is not

necessarily thought of as turning away from health.

Tobacco use and human nature

The teenagers express the idea that human nature

makes people susceptible to tobacco use. This idea is

related to the view of the teens and is closely associated

to teenagers identity work. Smoking is sometimes

described as part of teenage lifestyle; such as being

together with friends, going out and enjoying oneself.

The girls who smoke talk about growing older when

they will quit smoking:

* When youre like 30 years old, you dont go out withyour friends in the same way. Maybe, you just sit at

home and watch TV with your husband and kids

(laugh).* God, that sounds boring.* Yeah, I know but then you dont really have the need

to smoke. (Group 4, T-G)

Family life is thought to put adults under the

obligation not to smoke. Parents should not smoke in

front of their children or allow them to smoke:

* One person in our class is allowed to smoke at home.

Her dad lets her. But I think it isy* Thats no good. I dont think that is taking their

responsibility as parents if they let their kids smoke a

home. (Group 9, N-G)

Also, it looks bad if mothers smoke: she sat with her

little baby over her shoulder. The baby was like, two

weeks. She sat and smoked over her kid (Group 4, T-

G). At the same time, there is an opinion that adults

have limited possibilities of controlling teenagers. For

example, a boy (group 2) says that his mum doesnt

approve of him smoking, but there isnt much she can

do about it. There is some acceptance ofadult smoking,

as adults are supposed to do what they want and are

considered more responsible than teenagers. Some

boys who use tobacco (group 1) say it is okay if their

parents smoke, but only if they try to stop. Less

common are explicitly expressed worries about a

smoking parent He smokes lots and lots, an awful

lot. And that is, like, and I become sad, because you

know that, what the risks are, that he can get cancer andall that stuff. (Group 8, N-G). The overwhelming

reason why adults smoke, according to teenagers, is

because they are addicted to tobacco. The idea is that

parents and grandparents started to smoke at a time

when they didnt know much about the health-hazards.

This is seen as a legitimate reason for adult smoking but

less legitimate for teenagers, who smoke just in order to

be cool: Its idiotic to start smoking now, but it

wasnt back then. No one knew that you could get

cancer then and the thing with nicotine, you just cant

quit later on. (Group 6, N-B).Smoking is thus seen as a

symbol of adult life, but thought of as loosing itsattractiveness after the age of 18, when one is officially

grown-up.

When it comes to their own tobacco use, the teenagers

describe the meaning of peer-pressuredifferently accord-

ing to their experiences of tobacco. The non-users argue

that smoking gives young people access to social life,

and peer pressure is about belonging to a certain group:

This thing with smoking. Its just a status thing with

wanting to belong to a group and stuff like that, I think.

You want to be cool (Group 6, N-B). The peer-

pressure is then seen as the smokers desire to attain a

certain image. Everybody has a dream of being popular

and some people do anything to achieve this. Suscept-

ibility towards smoking could in this sense be under-

stood as a deeply human need to belong to others. As

rational beings, smokers act in order to fulfil their needs,

for instance to achieve high status or belong to a social

group. Among boys who smoke, the credo is that it is

wrong to expose others to pressure to smoke, but

everybody has the right to make ones own choice:

* I think every one should do as they wish.* Yeah, I do too.* I guess thats how it is with everything. Only if it

doesnt directly affect others.* You get so much information. You know that its

dangerous. It you want to smoke, you can do it

anyway. (Group 1, T-B)

All but one of the smoking girls emphasise it was their

own choice to smoke. When they started, smoking was a

fun thing to do. These girls focus on the pleasure, the

new and the excitement of smoking, but stress they

dont smoke in order to be cool: if I dont smoke or

drink then Im still cool, Im still noticed, no but heard,

noticed, everything, just the same in school (Group 3,

T-G). From this point of view smoking is seen as an

offer, possible to realise through friends who smoke.

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This is in line with other studies suggesting that girls

who smoke are more socially skilled, self confident and

rebellious than their non-smoking peers (Clayton 1991;

Michell & Amos, 1997). The point is that girls who

smoke are not unable to refuse cigarettes, but actively

choose to smoke.

Both boys and girls who smoke stress that one reasonthey smoke is because it is a social thing to do. When

smoking, they spend time together with friends during

breaks in school or after school hours and at parties,

which means that smoking functions both as an activity

and a way to make friends:

* But you smoke because its sociable.* Yeah, you make new friends, can stop a good-

looking guy in town and ask for light (laugh)* Yeah, exactly, its terrific.* So I mean, when I came to this class, then it was, I

got to know her just because we went out and smoke

at recess, like. Like, what would we otherwise have

done? (Group 3, T-G)

According to the teenagers, there is a difference

between smoking as a social act and being addicted to

tobacco. The smoking girls are not sure they want to give

up smoking. When they have tried to quit they get

irritated and in a bad mood and some describe

physical cravings for smoking, such as cramps in the

stomach. The boys who use tobacco say they are able

to stop whenever they want to, thus locating themselves

in a phase of invincibility, which can be seen as a

paradoxical standpoint I smoke, but I am not a

smoker (Moffat & Johnsons, 2001, p. 673). At the

same time it is perceived as risky to continue smoking:

But what I think is that I know that I can quit right

now, but then maybe you keep on thinking that youve

only just begun, so maybe some months pass by without

thinking about it, then maybe suddenly, you cant quit

(Group 1, T-B). Compared to the boys, the girls present

a smoking identity which recognises their addiction to

tobacco, which similar to Moffat and Johnsons (2001)

study of American girls. Smoking gives you pleasure

(you dont really want to quit) and at the same time it is

out of control (it is difficult to quit). From this point

of view, addiction to tobacco is seen as the inevitableresult of continuous use.

Among non-users, the disposition to develop an

addiction is also understood as a human weakness. At

the same time there is an understanding that individuals

are different. For example, non-users, like themselves,

have the mental strength to resist the pressure to smoke.

The boys who do not smoke (group 6) suggest that to

refuse smoking at their age proves a certain maturity,

strength of character or self-confidence. The non-

smoking girls argue that it feels good not to do as

everyone else: I think is an advantage in being able

to say that you dont smoke. Youre not like others. You

dont have to be like others. You dont have to, like,

follow theirsy (Group no 9, N-G).

To conclude, it is not human nature, the suscept-

ibility to tobacco use, that varies, but the individuals

ability to handle the consequences. Furthermore, the

human ability to deal with tobacco use is seen as related

to the phases of the life-cycle. Teenagers differ fromadults in terms of maturity, which determines their

different abilities and obligations to take responsibility

for their own and others behaviour.

Tobacco use and societys efforts to discipline its citizens

The third theme in the representation of tobacco use is

the role of society. The teenagers opinions about the

role society ought to take, actively or passively, is related

to their view on tobacco use and human nature, in

particular the ways tobacco use is perceived as normal

or not normal. The teenagers who use tobacco arguethat frequent smoking among adults makes it normal.

They (smokers) are a part of society. They are

everywhere so, like, I mean its not really anything you

think about, much. Oh no, that person is smoking, who

cares (Group 2, T-B). The idea that tobacco use is an

artificial need, which makes it not normal, is most

strongly articulated among the non-users. However, the

scientific evidence of the health hazards is used as a

strong argument why society should act among both

users and non-users. This evidence is often presented as

a moral imperative to abstain from tobacco, and in the

focus group discussions it is apparent that the respon-sibility for ones own health and the responsibility

towards others is closely associated to guilt; tobacco

use is perceived as non-hygienic and causing illness.

Snuffing, however, is more at ones own risk and is

mostly related to aesthetic values: But I think its

better, because the ones who use snuff just affect

themselves. Its nothing that affects anyone else. But if

someone is standing smoking and blows smoke in your

face, then you also breath it in and that affects you.

(Group no 8, N-G).

In this study, the teenagers present themselves as the

informed generation, who are well aware of the health

hazards of smoking. There is a strong consensus amongboys and girls that there is no new information about

smoking. However, the case of snuffing is less clear. The

teenagers stress that they do not know as much about

snuffing compared to smoking, but snuffing is viewed as

less hazardous to health than smoking:

* They should remove the sign (health information on

snuff package), because it isnt known whether its as

harmful in that way (the boy is referring to the cancer

risk). The only thing is that, like, its eats away your

lip, the underside of the lip.*

You get cancer, you can get cancer.

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* But its not like, its, you cant die from using snuff. Or

anyway, they havent found that yet. (Group 5, N-B)

Also, there is an understanding that society has

possibilities and obligations in the restriction of teenage

use of tobacco. However, the teenagers nature makes

it difficult, as teenagers are thought of as living here andnow and also stretching rules. The teenagers attitudes

towards societys right to intervene are related to the

question of whom the measures are directed to. Children

are considered incapable if taking responsibility for their

actions and should therefore be protected from tobacco

use. In addition, tobacco use is viewed as inconsistent

with the idea of childhood. The age-limit of tobacco

purchase (18 years) is worthwhile because it could

prevent young children from smoking:

* But then these little kids who see the cool people

standing back here smoking (at school). Then they

think that it is okay, because there isnt any age limitor anything. Then no one talks about it. Then,

maybe, like, hash begins to be like this, likey* Smoking.* Yeah, right and then it just gets worse and worse. I

dont think that you can, you cant just cant just go

ahead and allow it. (Group 6, N-B)

The majority of teenagers who use tobacco argue that

at 1516, the teenager has attained the awareness to

handle tobacco use. The non-users present a rival idea;

smoking during the teens could be described as

youthful foolishness, even though the psychologically

mature teenager is able to decide about his or her own

life. The teenagers think that most adults want to quit

smoking, but are unable to, andsmoking in middle age is

thus described as a cul-de-sac: Then I think (the girl is

referring to adults who smoke) poor, poor person, like,

that is stuck and has smoked their whole life, type of

thing. (Group 3, T-G).To summarise, teenage smoking

and adult smoking are viewed as separate phenomena.

Risk, the possibilities of society to intervene and to a

certain degree the human nature is thought of as varying

in relation to different phases of the life span. The

teenagers also stress the differences between smoking

and snuffing. The risks of using tobacco are thus seen asvarying. The teenagers representations of tobacco use

can thus be seen as characterised by a dynamic relation-

ship between, on the one hand, notions of the suscept-

ibility of human beings towards the risky smoking and on

the other hand, the opportunities and obligations of

society to intervene in this course of events.

A cultural repertoire of identities

To understand the gender aspects of tobacco use, we

looked more closely into the different cultural images

of tobacco use. Part of identity-work consists of

developing a gender identity (Forn.as, 1995), we examine

the meaning of collective identities that are used by the

teenagers to develop an understanding of social life.

Such cultural images, in turn, say something about

values and ideals in our culture.

The identity of the young smoker, snuffer and non-user

One characteristic of teenage culture which emerges in

this study, is that smokers are largely portrayed in a

positive manner. It is the cool ones with high status in

the teenagers hierarchy who smoke. The popular

ones go to parties, drink alcohol and smoke. The idea

of peer-pressure is intertwined with this positive image

of those smoking. Also, according to the teenagers,

those who begin smoking widen their circle of friends:

But if you start smoking, then you start drinking, then

you get to know everyone, the ones who are so-called

popular and cool. (Group 9, N-G).This is in line with

other studies of the structure of young peoples social

networks. Urberg, Degirmencioglu, and Pilgrim (1997)

showed that when young people tried smoking or

drinking alcohol, they often started to socialise with

peers who smoked or drank alcohol. A limited use of

tobacco or alcohol could lead to positive changes in the

relationship to peers, as found in a study of German

teenagers (Maggs & Hurrleman, 1998): for example,

more occasions when peers spent time with each other

and increased experiences of having a central role in the

circle of friends.In a Scottish focus-group study, teenagers described

their relations as formed within a hierarchic structure

(Michell & Amos, 1997). Girls at the top, who were

cool and good-looking, were the ones smoking.

These girls can be more vulnerable to smoking as they

could use cigarettes to form a certain image of

themselves. For boys with high social status, smoking

did not seem to have the same social significance.

Participation in sports activities and other interests, such

as computers and music, seemed to protect them from

smoking, as in this study. However, a substantial

proportion of the young Scottish female smokers alsohad sophisticated social skills, which makes the image of

their smoking behaviour more complex. In our study, we

have seen that both girls and boys who use tobacco

stress that it is a personal choice to start smoking.

Although smoking has a gender loading towards the

feminine, it is also perceived as gender neutral:

* I dont think it matters if they are girls or boys. Its

just the ones who, like, want to meet others instead of

sit at home and study.* I think that its probably those ones that start

smoking. (Group1, T-B)

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According toMichell and Amos (1997)smoking does

not seem to be an issue for girls positioned in the middle

of the teenagers hierarchy. Those girls who were doing

well at school and had positive aspirations for the future

did not feel a pressure to smoke and were safe from

smoking. Plumridge et al. (2002), on the other hand,

argue that smoking as well as smoking refusal areimportant identity statements, which means that non-

smoking teenagers are always faced with the problem

of accrediting themselves against superior smokers cool

group (2002 p. 167). In our study, the non-users

present positive images of non-smokers and negative of

their smoking peers, which could be described as

rivals to the positive image of the smoking teenager.

This implies that smoking could always be understood

as a topic of interest in the teenagers culture. Although

images of smoking and non-smoking youths seem to

circulate in teenager culture, this does not necessarily

mean that the non-smoking individual always will findhim or herself having to struggle against their inferior

status compared to peers who smoke. Rather, these

images could be understood as a repertoire of different

values and ideals among teenagers, with implications for

smoking uptake or refusal.

This reasoning gets some support in a British focus

group study of girls construction of non-smoking and

smoking identities which demonstrated that girls not

only have different tobacco habits, but also different

ideals (Lloyd et al., 1997). The non-smokers identity

was rated more sensible than the smokers, by non-

smoker as well as smokers, whereas the smokers

identity was rated more fun-loving. On the other

hand, being mature was desirable to smoking as well

as non-smoking girls, but may be constructed differently

as both groups claim to be mature. If we assume that

different groups of teenagers accept different ideals, this

can be problematic for the non-smokers as well as the

smokers. Individuals are not free to fashion their

identity as they choose, but have to do so under

conditions of others readings of their competence. Each

has to make a claim to some identity, but lacks the

power to ensure the claim (Plumridge et al., 2002, p.

169). However, smoking alone is no guarantee for being

accepted as cool, the right clothes and being seenwith the right people was just as important (ibid). The

conclusion is that there seem to be continuos ongoing

negotiations concerning identity claims in the social

space of teenagers.

In our study, the teenagers speak about non-smokers

as associated with psychological strength and willpower

to make ones own choices. The boys who represents

themselves as athletes (group 6) say it is a natural

thing not to smoke, but snuffing is possible for a

hockey or football guy. Also, their smoking peers can

claim that those who do not smoke are smart or are

impressed by their non-smoking status. This is in line

with Michell and Amos (1997) findings that an interest

in sports or computers can protect from a mean-

ingless life, which could be the breeding ground for

smoking. The dreary character of the swot also

changes when the school is presented as an interest

which prevents you from smoking, as found in a British

study where the non-smoker was portrayed as interestedin school life. Girls who adopted this identity were likely

to refer to girls who smoke as stupid (Lloyd et al.,

1997). At times, the non-users talk about tobacco use as

problematic behaviour. For example, the smokers hang

around, consume alcohol and are potential trouble-

makers. By the use of tobacco they take risks which

could lead to drug abuse:

* If I think back to when I was in elementary school,

its like, when you look at the photos: everyone was

so little, no one is going to smoke. Then, there they

stand with a cigarette in their hand or lying some-where in a ditch drunk. Its like, its almost sad to

think about. Such little children: you sit and you look

at the pictures. In that picture they didnt know that

they would begin smoking and drinking. (Group 9,

N-G)

Images of female and male tobacco use

The teenagers assume that girls and boys are brought

u p t o a female and male identity, respectively.

According to this view, upbringing in the family and the

commercial market are important socialising agents.The reason why girls and boys, act differently in some

respects, is associated with different ideals and the

different expectationsthey are confronted with: I think

that girls are more into their appearance and stuff like

that. Because they are more used to that role, they put

on makeup and stuff like that. And its like, smoking is a

little more like, the appearance like, how you

look(Group 6, N-B). One idea, put forward by the

non-smoking girls (group 9), is that girls smoke in order

to avoid eating candy and putting on weight, based on

the assumption that girls learn to pay great attention

to their appearance. Smoking is also understood as an

attribute that girls can use in order to create a specialimage of themselves. The entertainment business is given

a prominent role in this process, as a creator of

images. Boys are also presented as anxious about their

appearance, but boys and girls are thought of as having

different ways of expressing themselves. Boys and girls

deal with smoking in different ways, even if there are

exceptions:

* Girls are more discreet about smoking. When they

come into the classroom they breath more through

their nose. They try to avoid their fingers, and they

ask: Like, do I smell of smoke? When boys come into

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the classroom they couldnt care less if they smell of

smoke. Right (laugh)?* Thats exactly right. Most of themy* Well, take Maria, for instance. This is how she is (the

boys inhales and exhales) then she enters like this.

But, like, she doesnt give a damn about anything.

(Group 2, T-B)

The teenagers argue that girls shouldnt snuff.

Snuffing is considered un-feminine and thus a typical

male thing; If girls smoke, if boys smoke, no there is no

difference. They can smoke as much as they want to, as

we want to. But no snuffing. (Group 1, T-B). They

stress that it is not common for girls to snuff, but if they

do, they snuff in a more tasteful and discrete

manner than boys. It is more acceptable for a man to

snuff. The girls who use tobacco (group 3) say that

although snuffing is disgusting, boys who snuff can be

friendly and very sweet. But in any case boys

shouldnt snuff for aesthetic reasons: I dont think that

boys should use snuff either, because its so unattractive.

I mean, God, just putting it in like that, no you cant do

that, like making your face uglier. (Group 3, T-G) .

Furthermore, for the teenagers the meanings of

certain fields, contexts and clich!es are associated with

female or male significance. Different types of

tobaccos have male or female connotations, which

in turn are associated with different contexts. Pipes and

cigars are male. Cigarettes are both male and

female with domination towards the female.

Snuffing is considered male. Further, snuffing is

associated to male fields such as hockey, football,hunting and construction work:

* Snuff, yeah, its likey* Yeah, its manly or men in their 30s.* Like, construction workers. Yeah, like with check-

ered shirts.* Who hunt. (Group 9, N-G)

When associated to glamour, smoking is consistent

with a feminine style: Yeah, but like, they (the boys

is referring to girls his age), they want to look so bloody

good and go around with their cigarette trying to look

glamorous. (Group 2, T-B). The teenagers also reflecton smoking heroes (men) in action movies:

* when we saw a movie at the cinema. It starred Bruce

Willis and what the hell he is calledy* Die hard?* No, but never mind about that. In it he smoked so

damned much and he was really mean, really

shooting down every last person and stuff like that.

(Group no 6, N-B)

If it is a tough cowboy who smokes, the gender-

loading is male, the strong man. This male stereo-

type could be compared to a female clich!

e; the glamour

woman, a seductive and slightly dangerous femme

fatale. These images could be related to smoking

women earlier in the 1900s, who were not considered

respectable (Waldron, 1991). Also, the feminine

and masculine can be reflected in the way one smokes

and holds the cigarette. The girls who smoke (group 4)

think it is charming and smart if boys smoke in acertain manner, which is relaxed and cool.

The teenagers reasoning reflect roles and identities

divided by gender. At the same time it is possible to

break gender norms and expand conventional gender

roles. AsJones (1993)argues, there are several positions

for a female subject. In the group of boys who use

tobacco (group 2) suggest that it is alright if tough

birds use moist snuff compared to mini catch which

is seen as a more feminine snuff. However, to break

norms can be risky. A boy who smokes in a feminine

manner runs the risk of being seen as sissy. A girl who

snuffs could be viewed as mannish. The teenagersusually do not explain gender differences in terms of

biology, but snuffing is a less clear case since it is

considered to be a male practice given by nature; men

have for a long time practised the habit. Consequently,

the ways snuffing is reserved for men is not viewed as

discrimination of women. However, girls can break into

this male field if they do it in a way that is consistent

with what is accepted as feminine in the culture.

To sum up, the repertoire of possible identities to

some extent reflects the cultural images that teenagers

face and have to deal with as part of their identity-work.

The analysis shows that the teenagers cultural images of

female, male and youth identities and behaviour

are fairly stereotyped. However, the tension between

different types of images, such as the cool or the

problematic smoker, as well as the possibilities of

crossing gender barriers and expanding traditional

gender identities, indicates that what should be con-

sidered feminine, masculine and the identity of the

young smoker is continuously negotiated in different

social situations. At the level of the individual the

teenager can draw on these cultural images in different

ways in different social contexts. The cultural images

could thus be seen as offers and allow for different

ways of expressing gender identities.

Conclusion

What conclusions can be drawn from the analysis of

the teenagers social representation of tobacco use? The

fact that the notion of the cool smoker emerges in this

study, limited to urban Sweden, as it does in other

European studies (Michell & Amos, 1997; Plumridge

et al., 2002) indicates a more general notion of the

tobacco user in Western teenage culture. However,

the analysis reveals a more complex pattern. First, the

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tradition of snuffing adds another dimension to tobacco

use in Sweden, which is presented as less harmful than

smoking and goes well with a traditional male identity.

Secondly, the teenagers are informed about tobacco

facts and do not question the health hazards at a general

level, even if the correctness of these facts are discussed.

At the same time, the risk of tobacco use is re-interpreted at the individual level. The individual has a

responsibility for her own and others health, but this is

open to be negotiated within the local socio-cultural

contexts of teenage life. Most importantly, smoking

during teenage years and adult life are viewed as

separate phenomena. The teens are viewed as a phase

in life characterised by certain conditions, and tobacco

use in this phase is not necessarily thought of as turning

away from health. In these ways, the teenagers

challenge a more fundamental imperative of health

(Lupton, 1995) and cultural understandings of health as

a symbol of happiness (Herzlich, 1995) in contemporaryWestern societies. The conclusion is that, although well

informed about the health-hazards, the teenagers

notions of tobacco use forms a paradox; although

considered risky, smoking is thought of as possible during

the teenage years, since the most alarming dangers are

attributed to the adult smoker.

This pattern, in turn, seems to be intertwined with

certain youth and gender identities. The teenagers see

the individual as shaping her own destiny, as an

individual acting within a social context. This takes

place in a rapid stream of different influences, such as

upbringing in the family, teenage culture, market forces

and societys efforts to discipline its citizens. Part of this

influence is the possibility of tobacco use. When

confronted with the offer of tobacco use, loaded with

symbolic meaning, teenagers are thought to differ in

psychical strength and capacity to handle this offer in

the context of identity-work. Here, the notion of

human nature is important, and the finding that

teenagers separate the childs nature from the teenagers,

but not male from female. However, even if the

teenagers nature creates a common platform for

identity-work, to be a boy or a girl, weak or strong is

seen as making a difference. We would argue that

teenagers notions of tobacco use should be understoodwithin this context of identity-work, reflecting the

fundamental condition of modern man to be obliged

to form an identity (Giddens, 1991;Smart, 1999).

This study has shown that the teenagers hold complex

and conflicting ideas concerning the relationship be-

tween tobacco-use, risk, the body and human nature.

These results may have implications for preventing

tobacco use among teenagers. Of particular importance

are the ways images of tobacco use are intertwined with

ideas of different identities that the teenager could strive

for or try to avoid. We have seen that boys and girls

tobacco use are described as related to different values

and gender loadings. Also, some teenagers, mostly girls,

articulated an identity as smokers whereas others were

more likely to view themselves as social smokers.

Other researchers (Michell & Amos, 1997, Plumridge

et al., 2002:169) have stressed that girls seem to be more

vulnerable to smoking uptake due to different peer

pressure and have more limited possibilities of formingalternative identities to the cool smoker, whereas boys

seem to be more protected as they can establish

themselves as physical beings. In other words, there

are gendered solutions to the problem of being a non-

smoker. We agree with Wearing, Wearing, and Kelly

(1994)argument, that to prevent smoking in girls, there

is a need to provide enriching experiences in the leisure

field, which can extend the repertoire of female identities

beyond the traditional. To do this, we think it is

important to take teenagers social representation of

tobacco use as a point of departure.

Acknowledgements

We would like to thank the teenage girls and boys

who participated in the focus groups discussions and

Dulcinia Da Costa for her translations from Swedish of

the teenagers vividly described views on smoking and

snuffing. We would also like to thank the anonymous

referees for constructive comments on an earlier version

on this paper, as well as the Swedish Cancer Society for

funding the initial phase of this study.

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