Exploring the role of social, cultural and environmental factors in adolescent girls’ tendency to smoke based on qualitative content analysis | BMC Women’s Health

First subcategory: Friends role model

Participants reported that factors such as the role model of friends/peers, the importance of the role of friends, having friends who smoke, imitation of friends, and interaction with smokers were effective in the tendency of adolescents to smoke.

A teenager said that “…My friends who use a cigarette to tell me that smoking calms them down when they’re upset. Then when I was upset, I decided to try smoking once, which has the effect of smoking”. Another teenager said that “…I became a smoker in the group of my friends, they taught me to smoke and when I tried, I liked to smoke cigarettes”.

Second subcategory

Membership in groups

In this context, participants consider factors such as becoming famous in cyberspace, proving oneself to others, gaining social popularity, being accepted in groups, attracting attention from others, being under the influence of friends , stimulating and encouraging friends were effective against the tendency of adolescents to smoke .

One participant said that “…It was very important to me to be socially popular and to be approved by my friends, and that’s why I smoked”. Another teenager explained the role of persuading friends to start smoking by saying “…The first time I smoked, my friend encouraged me to smoke and I did”.

Third sub-category: parental models

Participants reported that factors such as family problems, parental divorce, stressful home environment, inappropriate role model of mothers, parents’ use of hookah, lack of adequate communication between parents and caregivers. adolescent, inappropriate parenting style and parental neglect of their child’s smoking were effective in adolescent smoking tendency.

One of the teenagers about the effect of parental divorce on the tendency to smoke cigarettes mentioned that“… My parents’ divorce played a big role in my tendency to smoke. Sometimes I thought that if my parents hadn’t separated, I wouldn’t have met many of my friends and I wouldn’t have had the freedom that I have now”.

A teenager about the wrong parenting style said that “… My parents’ upbringing style was not at all the same between them, for example, my mother said not to do this, but my father said that there was no problem and we always took refuge with my father because he gave us more freedom and the parenting style was effective in my smoking”.

Fourth subcategory

Family modeling.

In this regard, participants said that factors such as the role model of smoking parents, exposure to smoking in the family, cigarette and alcohol consumption by fathers, and hookah use by parents were effective in the tendency of adolescents to smoke.

Exploring the role model of parents, one of the teenagers said that “…Well, we always saw my father smoking and always smoking in front of us, and it created a positive attitude towards smoking in me and it was effective in my tendency to smoke”.

Another participant said that “…I’ve been using hookah since I was a kid. Hookah is a normal thing in my family. My parents use the hookah, I use it too and they don’t forbid me to do it. Well, smoking hookah has been effective in encouraging me to smoke.”

Fifth sub-category: the predisposing community

In exploring the community predisposing to the tendency of adolescents to smoke, participants mentioned that factors such as the non-banning of smoking in the community, the availability of cigarettes everywhere, the low price of cigarettes, the normalization of women’s smoking in the society, the unfavorable economic situation of society, the lack of proper recreational facilities to vent the excitement, the high cost of other entertainment compared to cigarettes, and the sale of cigarettes to any age group were effective in the tendency of adolescents to smoke.

A participant said that “…Well, the availability of cigarettes everywhere has affected my consumption, and I probably wouldn’t have come a long way to buy a cigarette if it wasn’t so readily available”.

Exploring the lack of cheap entertainment, one of the teenagers said that “…we couldn’t play sports, go to tennis, go to pool or places like this, or they are very expensive and cost more than smoking a cigarette. I think smoking was easier and cheaper entertainment, and I think that influenced my tendency to smoke.”

Sixth sub-category: the negative impact of the media

In exploring the negative impact of media, factors such as media encouragement of smoking, media portrayal of smoking instead of presenting facts, negative role of social media, celebrity normalization of smoking and the advertising of smoking in movies to attract more audiences and sell more cigarettes have influenced the attraction and tendency of adolescents to smoke.

Exploring the negative role of media and social networks, one teenager said “…We’ve always seen celebrities smoking on social media and telling me why I shouldn’t smoke, and that encourages me to ‘Smoking was effective’.

Exploring the pattern of the role of celebrities in the smoking trend, one of the teenagers said that “… I watched the episodes of a movie, which the movie actor constantly smoked, and when I saw this actor’s smoking, I wanted to smoke immediately, and I saw these scenes affect my smoking”.