Etiology of Smoking Tendency: A Qualitative Examination of the Experiences of Young Smokers

Extended Abstract
Background and Objectives
Youth is the most special period of human life that is full of new experiences and of course sensitive and challenging risks. It is essential that, in their critical period which is full of choices to be made, the young generation go through this stage successfully and make it to an integrated identity. However, the young living in the current stressful and risky conditions, with few contacts and often experiencing lack of trust and confidence in their social environment can end up a failure, imposing serious challenges on society. The ubiquitous presence of the young in the society at large, including the family, labor market, universities, etc. reinforces their social bases, which in turn leads to their increasing focus on adopting risky behaviors. One of these deviant behaviors is smoking, which is always lurking in the youth. Thus, understanding the driving forces of smoking, from the perspective of young people, in a qualitative and conversational format is needed to be able to better understand their mental world in this regard with the ultimate goal of hindering the process or preventing them from picking up the habit.
Material and Methods
The present study adopted qualitative research approach and phenomenological method in order to enter the depths of the minds and lived experiences of young people about smoking and thus, get to know their inner world better. In this regard, the interview (semi-structured) was conducted with 14 young girls and boys living in Tehran, who were at the age range of 20 to 35 years in 1399, through a dialogue and narrative method. Participants in this study were selected, using purposive sampling. Sampling was continued until the saturation stage in order to obtain the data, and then the collected data were analyzed by coding method. Necessary criteria for entering the study included satisfaction and willingness to participate in the study, being at the age bracket of 20 to 35 years, and finally, continuous and daily dependence on smoking. Also, the lack of conscious satisfaction or unwillingness to continue cooperation for any reason and lack of smoking experience were among the criteria for exclusion from the study. Then a list of questions was prepared with the approval of the supervisors on the subject. The youth were then asked in a separate, quiet room to freely and narratively express their views on smoking. The interview sessions lasted between 60 and 90 minutes, and the focus of the conversations was on the etiology of smoking tendencies from the perspective of the young participants in the study. Finally, after 14 interviews, the content of the conversations was carefully implemented and the data coding process began. This process started from grouping and classification at low levels in the form of concepts and ended with reclassifying themes at the highest abstract level until finally a report of primary codes, subcategories, subclasses and the main categories was obtained. Finally, the validity of the data was proved to the researcher by the participants’ confirmation and reviewing of the expert colleagues.

Results

Careful analysis of the participants' interview texts led to the identification of 113 primary codes, 19 subcategories, 8 subcategories, and finally 2 main categories. One of the main categories of the tendency to smoke was the Intrapersonal dimension, such as cognitive falsification of the effects of smoking, use of cigarettes to reduce psychological problems, smoking to compensate for feelings of inferiority, and the desire to smoke when in low spirits. In this direction, young people focused on expressing their desire to smoke more to themselves and the perceptions and problems that existed around their personality and behavioral dimensions. In fact, young people considered things that were a kind of defect or shortage in life, such as lack of peace or problems such as depression and anxiety, as the cause of their desire to smoke. Of course, in addition to these cases, young people, through smoking, also strengthened the characteristics that were necessary during when facing serious challenges in society, such as focusing more during workload or daring to get into difficult situations. Thus, part of the drive for the young smokers was related to their attempt to cover up or, justifying their actions in their minds. Another major category extracted from interviews with young people was the interpersonal, extrapersonal dimensions of the tendency to smoke, which included feeling of being different when consuming, a desire to consume in response to art-influenced emotions, easy access to cigarettes and the opposite effect of negative advertising. Young people in this category of reasons for smoking pointed to the systems around them from family and friends to educational environments and the macro level, i.e. society. Film and cinema, advertising and the bedrock of society in the field of access to smoking are in the macro-social sphere that directly and indirectly lead young people to smoking. On the other hand, young people use smoking to neutralize the feeling of lack in society, in such a way that smoking induces them to feel different, which is considered valuable in the heart of society. This feeling, under normal circumstances, requires activities that are beyond their means. Therefore, from this perspective, smoking is the means through which one gets access to communication and interaction channels in youth systems, which is considered a significant privilege for the young.
Conclusion
Young people today have more winding paths than generations of recent decades and are more likely to become smokers. Therefore, identifying important components in beginning to smoke requires paying attention to the views and experiences of young people in this field. Due to the fact that smoking is very popular among young people, it should be considered comprehensively and multi-dimensionally in terms of individual and context. Because, in recent decades, cigarette smoking has become a symbol of self-centeredness for young people and a factor of self-expression in social terms. Therefore, smoking has been affected by both the individual and social structures, which have caused young people to adapt in different situations. As a result, conducting an inclusive or comprehensive analysis of smoking tendencies can help consider all the facts and needs, and do away with the narrower, one dimensional view of smoking at the same time.
Practical Implications of Research
It is hoped that the topics of the present study will be on the agenda of health promotion programs in the field of prevention in organizations, universities and youth-related entertainment centers, and given that the topics are derived from the young people’s words, they are realistic. The categories of the present research in the form of a workshop and in the form of roundtables and conversations with young smokers have led to more depth and richness of conversations so that their points of view in this direction are better identified.
Ethical considerations
In the present study, informed consent to participate in the study was fully observed and all participants were given the authority to leave the research process if they did not wish to continue.
Conflict of interest
The process of the present study is done independently and does not involve any conflict of interest in terms of organization.

Acknowledgment

The present study is extracted from a doctoral dissertation with the code of ethics IR.ATU.REC.1398.011 from the National System of Ethics in Biomedical Research, which was approved by Allameh Tabatabai University.