Multi-ethnic adolescents' attitudes toward smoking: a focus group analysis

PURPOSE: To explore young, multi-ethnic adolescents' attitudes and influences related to cigarette smoking for the purpose of developing and producing a youth-led, tobacco prevention drama. DESIGN: Focus groups and demographic surveys. SETTING: Island of Oahu, Hawaii. PARTICIPANTS: Fifty-four multi-ethnic youth, ranging in age from 10 to 14 years, participated. The study was promoted in schools with a large representation of Hawaiian, Filipino, and Pacific Islander students. METHODS: Each of five focus groups was audio-recorded, and an observer recorded extensive notes throughout the sessions. Content analysis consisted of coding focus group notes for recurrent themes and using the audio recording as confirmation. RESULTS: Just more than one quarter (n = 15) of the youth had tried smoking, and two-thirds (n = 35) currently lived with someone who smoked. Participants expressed the feeling of being surrounded by smoking influences at home, in their communities, and at school. Youth were negatively affected by family members' tobacco use, and they desired skills that could enable them to help family members stop using tobacco. CONCLUSION: Family influences may play an important role in youth attitudes toward tobacco use, especially given the cultural significance of extended family and of filial piety that are reflected in many traditional, Asian and Pacific Islander families. Interventions targeting youth in Asian and Pacific Islander communities should incorporate key cultural references to the extended family and to a respect for elders to establish relevance in the life experiences of young people in these population groups.