This study explored influences on adoption, maintenance and cessation of smoking among young women as they experienced life transitions: Standardized, open-ended telephone interviews were conducted with 80 women including never smokers, continuing smokers, recent adopters and quitters aged 24—29 years, recruited from participants in Women who enjoy smoking Australian Longitudinal Women who enjoy smoking on Women's Health.
The context of smoking socializing with other smokers, drinking alcohol and going to pubs and clubs was perceived to be a predominant influence on smoking from the time young women left home until they settled into a committed relationship or started their own family.
Stress was identified as an important factor as they experienced lifestyle changes. An increased sensitivity to the negative aspects of smoking after turning 21 was reported, and around the mids the women became concerned about the addictive nature of cigarettes.
Women who enjoy smoking was seen to carry Women who enjoy smoking responsibilities to protect children from passive smoking there was a perceived importance of positive role modelling to protect children from becoming smokers themselves.
This Women who enjoy smoking highlights the need for public health campaigns to address the social role that smoking plays in young women's lives, and the perceived use of cigarettes for stress relief. Life changes such as settling down with a partner and the contemplation of motherhood provide Women who enjoy smoking for targeted interventions to quitting. Tobacco smoking a well-recognized risk factor for coronary heart disease, stroke, lung cancer and a range of other diseases 1—3 ].
For women, smoking is also related to difficulties becoming pregnant, and risk of miscarriage, menstrual symptoms and early Women who enjoy smoking [ 4 ]. In developed countries, such as Australia, female smoking prevalence peaks among women of childbearing age. Most young women
Women who enjoy smoking smoke start before they are 18 [ 6 ], however, smoking uptake continues into the young adult years [ 7, 8 ]. While a great deal is known about adolescent smoking initiation and the socio-demographic and psychological characteristics of smokers in general, very little is known about the smoking patterns of young adult women and the influences on women's Women Women who enjoy smoking enjoy smoking behaviour during young adulthood.
Women who enjoy smoking is a time when life changes and transitions are occurring, including new freedoms, rights, responsibilities and pressures [ 9 ], and when progression to regular, addicted smoking often takes place [ 10 ]. Moving out of the parental home marks one of the first major life transitions from being a child to being an independent adult.
It is a time that provides young people with increased opportunity to experiment with different lifestyles and behaviours and to make their own decisions about many aspects of their life [ 11, 12 ]. Graduating from high school and gaining employment or pursuing further education is another important transition, as is marriage or forming a partnership and becoming a parent [ 13 ].
Each of these
Women who enjoy smoking transitions includes major changes in social roles, social contexts, responsibilities and expectations, which can either positively or negatively influence health behaviour [ 12, 14 ].
For instance, leaving the parental home has been found to be significantly associated with smoking adoption [ 15, 16 ].
Becoming Women who enjoy smoking has a positive influence on smoking cessation [ 17 Women who enjoy smoking, as does getting married and having children [ 16, 18 ]. In-depth exploration of factors associated with such life changes is necessary to understand how they influence smoking behaviour at different stages of young Women who enjoy smoking lives. This is important in order to design interventions for both the prevention of cigarette smoking and to enhance quitting.
The use of qualitative methods provides researchers with the opportunity to develop an in-depth understanding of behaviours and motivations to inform the development of such interventions.
Qualitative investigations specific to women's experiences of smoking have provided an understanding of the role of pregnancy as an important trigger for quitting [ 19, 20 ] and, insights into the reasons women resume smoking post-partum [ 21 ].
Women who enjoy smoking this life transition has received considerable attention in tobacco control research, there has been very little qualitative inquiry into the potential influences of other life transitions on women's smoking behaviour. We used standardized, open-ended telephone interviews to explore the possible influences on smoking adoption, maintenance of smoking and smoking cessation among young adult women as they experienced different life transitions.
Life transitions were defined using a framework described by Greene et al. The ALSWH aims are to examine the relationships between biological, psychological, social and lifestyle factors and women's physical and emotional health, as well as their use of and satisfaction with health services [ 24 ].
The study aimed to recruit 20 participants each from a range of smoking behaviour categories, including shorter- and longer-term smokers. These categories were selected from the results of the baseline survey in and follow-up survey in At the time of recruitment inthe eligible women were aged between 24 and 29 years. Letters were sent to young women from random samples of the four smoking categories. The letters invited them to participate in a telephone interview to explore how different stages of life may influence cigarette smoking and why some women become smokers while others do not.
Recruitment telephone calls, which also set up appointment times for the interviews, were then made over a period of 4 months. The interview schedule was developed following two focus group discussions on cigarette smoking
Women who enjoy smoking different life stages with young women aged 25—33 years who were not members of Women who enjoy smoking ALSWH cohort.
A revised interview schedule was individually piloted by telephone with five women from the young cohort of ALSWH three were ex-smokers, one was a current smoker and one had never smoked. No further changes were required to the interview schedule.
The standardized, open-ended telephone interviews commenced with an explanation of the process of the interview and issues of confidentiality. Participants' consent to proceed with the interview and to have the interview recorded was obtained. The interviews began by asking general questions about the participants' smoking history, current smoking status and cigarette consumption, and progressed to questions relating to their smoking behaviour, and factors that may have influenced them to smoke or not to smoke between leaving high school and turning 21 years of age; and after they turned 21 to the present.
These time periods were chosen, as in Australia, the 21st birthday is an important celebration and marker of young adulthood. This significant milestone was Women who enjoy smoking to help the young women
Women who enjoy smoking on experiences before and after this occasion. Questions on factors influencing smoking in relation to first leaving home, employment or attending college or university, romantic relationships or marriage and motherhood were asked.
For smokers and ex-smokers, questions surrounding motherhood also explored: For never smokers, the questions surrounding motherhood explored: Personal views about women who smoke during pregnancy, and parents Women who enjoy smoking smoke around their children were also explored. The telephone interviews were conducted Women who enjoy smoking October to February by ALSWH research assistants trained in the delivery of telephone recruitment procedures and personal telephone interviews.
An in-depth analysis of the response rate and of these young ALSWH participants has been reported elsewhere [ 25 ]. Eighty interviews were transcribed verbatim and transcripts of the interviews were used for the analysis. Participants were categorized into one of three smoking groups: These groups were established from their current smoking status at the time of the interview. Thematic content analysis techniques were used to identify patterns and recurrent themes [ 26 ].
Initial coding categories were developed with the first author reading a number of transcripts from each of the
Women who enjoy smoking groups, until no new themes emerged. This initial analysis began with open coding by locating themes and assigning initial codes to segments of text. Coding
Women who enjoy smoking were then discussed and revised by the research team and definitions for each code were written.
All transcripts were read individually and coded. Matrices of codes across the different life transitions for each of
Women who enjoy smoking smoking groups were created to Women who enjoy smoking and compare the common themes.
All the young women in this study except one, who was still living at home, first left their parents' home between the ages of 16 and 25 years Table I. Other life transitions and socio-economic characteristics of the participants are shown in Women who enjoy smoking I. At the time of the telephone interviews, 26 of the 80 participants reported being never smokers, 27 were ex-smokers and 27 were current smokers. All but two had tried at least one puff Women who enjoy smoking a cigarette.
They were aged between 7 and Women who enjoy smoking years when they tried cigarette smoking for the first time. Most of them experimented with smoking purely out of curiosity and commonly it was an experience prompted by their peers' smoking and a desire for social The ex- and current smokers first started regular smoking between 11 years of age and their mids.
Their reasons for starting smoking typically related to their social environment;
Women who enjoy smoking is, having friends who smoked and going out to pubs and clubs. Social acceptance and social image were also common underlying motivators for starting to smoke. The common themes surrounding the influences on smoking behaviour as the three groups of women different life transitions are summarized and illustrated in the next sections.
The names used are not those of study
Women who enjoy smoking, and the quotes are edited versions of the primary information, presented so as to reduce some of the multiple repetitions and redundancies that characterize normal speech.
Those who were non-smokers reported not taking up smoking because of their awareness of the health risks, and negative aspects such as the smell of cigarette smoke. An unpleasant first-time experience with smoking such as feeling sick or disliking the taste or smell of the cigarette led to an early decision not to smoke. Kylie never smoker, aged 26 years explained: When I was 12 and I was drunk … I was fine with the alcohol but as soon as I had a cigarette I spent the rest of the night throwing up and I had total major head spins so I was like no, Women who enjoy smoking never doing this again.
I was totally freaked out by it really. An increased personal awareness of the negative aspects of smoking emerged among ex-smokers, especially after they turned While quitting for pregnancy was a predominant reason motivating them to quit after this time, for some women, like Mandy ex-smoker, aged 27 yearsthere was an increasing distaste for their smoking habit which led them to quit: I started to really hate the smell of it and the smell of it on your clothes … your hair, having to wash your hair every time you went out because it stunk and the difference in your skin, like I didn't like how my skin felt all the Women who enjoy smoking, it just felt like crap.
Fear of addiction was a further motivating factor to quit after turning 21, particularly among ex-smokers. While some current smokers reported trying
Women who Women who enjoy smoking smoking quit smoking after this time, their attempts were unsuccessful due to their addiction and inability to cope with withdrawal symptoms, or their social environment which triggered a return to smoking.
Nevertheless, some current smokers reported decreasing the amount they smoked as they became more conscious of the addictive nature of cigarettes, their own health and preparing for pregnancy.
As Vanessa current smoker, aged 26 years explained: It's toned down a lot now.
Concern about the addictive nature of smoking was also highlighted among never smokers as they matured,
Women who enjoy smoking an important factor in remaining a non-smoker. Anita never smoker, aged 29 years highlighted: The thought of that really bothered me. The only apparent threat to the never smokers'
Women who enjoy smoking not to smoke was the influence of alcohol in social settings, as Tonya never smoker, aged 26 years explains: Just being in a environment and out drinking I suppose.
The only time I've ever smoked is when I've been a bit tipsy, or probably more than a bit tipsy, quite drunk actually. This Women who enjoy smoking context of smoking was the most salient factor influencing the ex- and current smokers to smoke from the time between leaving the parental home and not yet establishing their own family.
Christine current smoker, aged 26 years highlighted the Women who enjoy smoking among nightclubs, alcohol and smoking: It was probably when I was smoking the most. It was just from drinking and going out in kind of environment.
For those who attended
Women who enjoy smoking or university, this aspect of Women who enjoy smoking extended to their study environments.
As ex-smoker, aged 27 years expressed: It was just a party environment I suppose.
Everyone smoked, there were ashtrays everywhere. It was not much of an issue really. The work environment was also an important influence on smoking behaviour.
The ex- and current smokers felt their jobs or work environments would increase or decrease the amount they smoked, depending on how conducive their workplace was to smoking that is, having colleagues who smoked, being able to smoke at work and having cigarette breaks. Tami aged 29 yearsa regular smoker, highlighted the impact of smoking policies at her workplace: