Review

Those nicotine-age years

SMOKING IN ADOLESCENCE: IMAGES AND IDENTITIES
Barbara Lloyd and Kevin Lucas
Routledge, 1998, £14.99

Smoking will not disappear from the public health agenda in the foreseeable future. The recent finding that women who smoke have a higher risk than men of developing small cell carcinoma of the lung reminds us that we are still learning about smoking and morbidity. Given the recent increases in smoking by US college students and the continuing rise in numbers of teenage girls who smoke in the UK, still more needs to be learnt about why people smoke.

This book is an attempt to unravel the factors that persuade some adolescents to take up smoking. In what the authors claim is a new approach, they address the question by looking at smoking from the adolescent’s own view point rather than imposing a researcher’s interpretation.

The book reports the results of two large, survey-based studies of smoking among adolescents (aged 13 to 17) in Britain. The findings of a number of focus groups are also included. The two studies aimed to explore the importance of social identities in adolescents and through these to understand why so many adolescents smoke.

The chapters examine smoking with respect to families and relationships; parenting, peers and the school culture; mood, stress and pleasure; image; and social identity. An initial chapter sets the scene with an overview of problem behaviour theory and the risks and protective factors related to this.

The authors discuss their results in the light of knowledge gained from the published interventions and conclude with the somewhat disheartening recommendation that there is a need to re-evaluate existing programmes. Given current smoking patterns and the increasing prevalence of smoking in this age group it has to be acknowledged that existing programmes are not working and may not be correctly focused.

But the change suggested—of a spiral curriculum of smoking education changing in parallel with developmental changes in adolescence—is not new. The promotion of self esteem and potential in adolescents and the encouragement of positive relationships between adolescents and adults have been stressed before in relation to smoking and young people.

What is needed, and what the authors conclude, is a concentrated positive approach to the whole area of adolescent behaviour by educationalists, health workers and those adults who have an influence on young people.