Elsevier

Addictive Behaviors

Volume 36, Issues 1–2, January–February 2011, Pages 110-115
Addictive Behaviors

Differences in the smoking identities of adolescent boys and girls

https://doi.org/10.1016/j.addbeh.2010.09.004Get rights and content

Abstract

Objective

To assess sex-disaggregated differences in youths' characterizations of their own smoking behavior.

Method

Cross-sectional data including demographics (sex, age, and grade level), perceived addiction to tobacco, Dimensions of Tobacco Dependence Scale (DTDS) scores, the Modified Fagerström Tolerance Questionnaire (M-FTQ) scores, smoking history, and self-reported smoking identity were collected from questionnaires administered to 7246 students in British Columbia, Canada. Differences in tobacco dependence by sex and by smoking identity were examined.

Results

Girls were more likely to report being ex-, social, irregular, or regular smokers than were boys; and were more likely to select more than one smoking identity to describe their smoking behavior. Among the current smokers, the boys smoked more cigarettes each day, on average, and had significantly higher scores on the social and sensation dependence dimensions of the DTDS, and the M-FTQ, compared with the girls. Girls in each smoking identity group had lower scores on every tobacco dependence measure, except the emotional dependence dimension of the DTDS.

Conclusion

Adolescent boys and girls appear to understand and subscribe to ‘smoking identity’ groups in similar patterns. However, there may be differences in the ways boys and girls conceptualize, describe, and endorse smoking identities. Researchers should examine the consistency between adolescents' smoking identities and researcher-derived categorizations of their smoking in planning and selecting appropriate interventions. Future research should explore qualitative gender differences in the smoking identities of adolescents.

Research Highlights

►Significant differences in single smoking identity were found between boys and girls. ►Heavy smoker boys had higher perceived physical and mental addiction than girls. ►Regular smoker girls scored higher on emotional dependence to tobacco than boys.

Introduction

Studies of adolescents have shown that several important intrapersonal (Martin et al., 2002, Skara et al., 2001), interpersonal (Kobus, 2003), and environmental (Pucci and Siegel, 1999, Wayne and Connolly, 2002) factors are associated with tobacco use, and particularly smoking behavior. The complex interactions of these factors are hypothesized to influence individuals' engagement with tobacco use and their perceptions or construals of their own smoking behavior. Understanding how these factors affect the development of self-identity as a smoker may be particularly salient in adolescence because this is a time in which youth confront the task of defining their social identities as they make the transition to adulthood (Denscombe, 2001). For example, researchers have shown that youth who find the image of adult smokers appealing or desirable generally have greater intentions to smoke in the future (Burton, Sussman, Hansen, Johnson & Flay, 1989).

“Smoking identities” (i.e., self-identification as a non-smoker, former smoker, or regular smoker) characterize commonly employed psychosocial understandings of how tobacco users and non-users perceive themselves in relation to their ‘cigarette’ smoking behavior (Lloyd et al., 1997, Wakefield et al., 2004). Yet, how these smoking identities are associated with actual smoking behavior in adolescence has not been studied extensively. Some researchers have noted that young current ‘cigarette users’ do not necessarily identify themselves as smokers (Harris et al., 2008, Leatherdale and McDonald, 2006). For example, in a sample of 1401 college students who reported smoking cigarettes within the previous 30 days, 57% did not consider themselves to be “smokers” (Levinson et al., 2007). Such results suggest that smoking cessation activities may be unsuitably targeted towards, or unaddressed for, adolescent tobacco users who may identify as non-smokers, and point to the need for specific smoking prevention and intervention programs, targeted to these smoker subtypes (Leatherdale & McDonald, 2006). Researchers have recognized a need to further examine adolescents' self-perceptions of their smoking status, self-labels, and intentions, and to examine how these self-labels and intentions correlate with other behavioral measures (Mermelstein et al., 2002).

To better understand the development of substance use and related behavior it is recommended that researchers adopt sex- and gender-sensitive methods and data analysis processes (Johnson, Greaves & Repta, 2009). This recommendation encourages the consideration of both biologically- and socially-based factors that might affect girls' and boys' behavior and identity formation in different ways. As a multi-dimensional construction, “gender” refers to socio-cultural norms and expectations regarding individuals' roles, relations, and identities (Johnson et al., 2009). Although various tobacco consumption patterns, irregular smoking, and high rates of transition to and from smoking are common among youth (Mayhew, Flay & Mott, 2000), the gender differences in these transitions are not clear. Several studies have demonstrated a progression from occasional to daily smoking among adolescents (Patton et al., 1998); where some studies suggest that girls progress faster than do boys (Ariza-Cardenal & Nebot-Adell, 2002), others have found that boys are more likely than girls to progress in the frequency or regularity of their smoking behavior (Wetter et al., 2004). In addition, there is some evidence to suggest that the development of nicotine dependence symptoms during the early stages of intermittent tobacco use is more rapid among adolescent girls (DiFranza et al., 2002). Yet, few researchers have assessed differences between boys and girls in their self-defined smoking behavior.

Further differences between male and female smokers relate to differences in their smoking motives. In a study of adults, Berlin et al. (2003) found that women were more likely to report smoking for relaxation, stimulation, and social interactions. In a cross-sectional study of adolescent high school students, girls were more likely than boys to report expectancies about dysphoria reduction associated with smoking (Vidrine, Anderson, Pollak & Wetter, 2006). Other studies, however, have found that girls, compared with boys, are no more likely to smoke to reduce stress (Dugan et al., 1999, Mermelstein, 1999). Differences may also occur in the extent of nicotine dependence experienced by boys and girls; some authors, employing the Modified Fagerström Tolerance Questionnaire (M-FTQ), have reported that boys are more likely to be nicotine dependent compared with girls (Kandel et al., 2005). Other researchers, however, have not found sex differences in nicotine dependence (Breslau, Kilbey & Andreski, 1994), and still others have found that girls have higher nicotine dependence scores compared with boys (Panday, Reddy, Ruiter, Bergström & de Vries, 2007).

To assess the validity of adolescents' smoking identities, Okoli et al. (Okoli, Richardson, Ratner & Johnson, 2008) compared self-selected smoking identities (i.e., selected from cigarette smoking identity choices: “I am a non-smoker,” “I am an occasional smoker,” “I am an irregular smoker,” “I am a regular smoker,” “I am a heavy smoker,” “I am a social smoker,” “I am an ex-smoker”) with existing literature-based classifications of adolescents' smoking behavior (i.e., non-smoker vs. smoker) and adolescents' perceived tobacco dependence. The study found that the adolescents' selected smoking identities were modestly associated with both the literature-based classifications of adolescents' smoking behavior and their perceived tobacco dependence (Okoli et al., 2008). However, the study did not assess the potential for differences in boys' and girls' smoking identities. Understanding the gender-related factors or differences in the ways adolescents formulate and describe their smoking behavior is salient for tobacco addiction prevention and smoking cessation efforts. If differences exist in the ways in which adolescent boys and girls identify or conceive of their behavior, conventional efforts employed for smoking cessation may be construed as non-salient or inappropriate by the target audience (Leatherdale & McDonald, 2006). Hence, smoking cessation activities may be unsuitably targeted towards boys and girls, for example, who identify themselves as non-smokers because they infrequently use tobacco.

The purpose of the present study is to examine gender differences in youths' smoking identities by: (a) describing differences in the reported smoking identities of adolescent boys and girls, and (b) examining differences in the tobacco dependence of adolescent female and male current smokers (i.e., individuals who have smoked in the past 30 days) stratified by smoking identity.

Section snippets

Participants and sampling

The data for this secondary analysis were obtained from responses to a self-administered cross-sectional survey from the British Columbia Youth Survey on Smoking and Health II (BCYSOSH-II) (Tu, Ratner & Johnson, 2008), which was administered to 8225 students (grades 7 to 12) in schools in British Columbia (BC), Canada. Of the 86 eligible schools located in the 14 districts which consented to the study, 49 (57%) agreed to participate with an average response rate of 84% (student absenteeism

Sample characteristics

The participants were evenly distributed by sex (51.6% were girls) with a median age of 15.0 years (range = 12–19 years). The majority of students were in the 10th grade and were non-smokers. The girls were significantly more likely than the boys to report smoking a cigarette in the past 30 days (see Table 1). The girls were also more likely to report being ex-, social, irregular, or regular smokers than were the boys. Overall, the girls were more likely to select more than one smoking identity

Discussion

The current study describes differences in smoking identities among adolescent boys and girls by examining differences in tobacco dependence among self-defined smoking identity categories. Although studies have used adolescents' self-defined smoking behavior as inclusion criteria for participation in studies and to assess youths' smoking behavior, few have questioned the validity of such self-reported smoking behavior identities (Aveyard et al., 2003, Leatherdale and McDonald, 2006, Okoli et

Role of Funding Sources

This research was supported, in part, by the Canadian Institutes of Health Research (CIHR) operating grant (grant #62980). The funding source had no role in the study design, collection, analysis, or interpretation of data, writing the manuscript, and the decision to submit the manuscript for publication.

Contributors

Dr. J. L. Johnson and Dr. P. A. Ratner designed the original study and wrote the protocol. Dr. Chizimuzo Okoli conducted literature searches and provided summaries of previous research studies. Chizimuzo Okoli and Iris Torchalla conducted the statistical analysis and contributed to the analysis and results section of the manuscript. Drs. J.L. Johnson and P. A Ratner contributed to the introduction and discussion sections and overall editing of the manuscript. Chizimuzo Okoli wrote the first

Conflict of Interest

None declared.

Acknowledgements

Dr Chizimuzo Okoli was supported by the CIHR Strategic Training Program in Tobacco Research Postdoctoral Fellowship through the Integrated Mentor Program in Addictions Research Training (IMPART). Dr Iris Torchalla was supported by the CIHR Strategic Training Program in Tobacco Research Postdoctoral Fellowship through the Integrated Mentor Program in Addictions Research Training (IMPART). Dr Pamela A. Ratner is a Senior Scholar funded by the Michael Smith Foundation for Health Research. Dr Joy

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