Article | A qualitative analysis of ‘informed choice’ among young adult smokers
Flaws in the tobacco industry’s argument that smokers exercise “informed adult choice” when they start smoking have been highlighted in a new study led by ASPIRE2025 researcher Rebecca Gray.
Her research among 18-25 year olds who had started smoking since turning 18 showed that, despite a general awareness that tobacco causes harm, it is difficult for young adults to make an informed choice. At the time they started smoking they tended to be thinking of immediate social priorities rather than considering health risk information, and rarely imagined that risks might apply to them personally.
Participants’ poor understanding of addiction also meant most regarded smoking as a short-term phase they could stop at will.
Policy interventions that could help young adults avoid becoming smokers without making a conscious choice include decoupling smoking from drinking in young adult’s social environments, and ensuring that risk messages aimed at young adults recognise their short term focus and desire for control over their lives.
This study was authored by Ms Gray, Professor Janet Hoek and Professor Richard Edwards from Otago University’s Public Health and Marketing departments. It has been published online in Tobacco Control, and was supported by funding from the Marsden Fund, administered by the Royal Society of New Zealand.
The tobacco industry often relies on the assertion that smokers make ‘informed adult choices’. We tested this argument by exploring how young adults initiate smoking.
Fifteen in-depth interviews with young adults who had started smoking since turning 18, the legal age of adulthood and tobacco purchase in New Zealand. We undertook a thematic analysis of the interview transcripts.
Although participants had a general awareness that smoking is harmful and knew some specific risks, they rarely saw these as personally relevant when they started smoking, and few had made a deliberate decision to smoke. Participants’ poor understanding of addiction meant most regarded smoking as a short-term phase they could stop at will. Initiation contexts discouraged the exercise of informed choice, as smoking onset often occurred when participants were influenced by alcohol or located in socially-pressured situations that fostered spur of the moment decisions.
Young adults’ ability to exercise ‘informed choice’ at the time of smoking uptake is constrained by cognitive and contextual factors. We propose an updated informed choice framework that recognises these factors; we outline environmental changes that could make default adoption of smoking less common while promoting more ‘informed choices’.
Gray, R., Hoek, J., Edwards, R. (2014) A qualitative analysis of ‘informed choice’ among young adult smokers. Tobacco Control doi:10.1136/tobaccocontrol-2014-051793
The full article can be viewed here.
The media release can be viewed here.
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University of Otago, Wellington