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Revista Latino-Americana de Enfermagem

On-line version ISSN 1518-8345

Rev. Latino-Am. Enfermagem vol.16 no.spe Ribeirão Preto July/Aug. 2008

http://dx.doi.org/10.1590/S0104-11692008000700022 

ARTIGO DE REVISÃO

 

The search for equality: representations of the smoking act among adolescent women

 

 

J. Adriana Sánchez MartínezI; Cléa Regina de Oliveira RibeiroII

IPsychologist, Professor, Autonomous University of Querétaro, Nursing School, México, e-mail: adrianauaq@yahoo.com.mx
IIPhilosopher, PhD in Public Health, Professor, University of Sao Paulo at Ribeirão Preto, College of Nursing, WHO Collaborating Centre for Nursing Research Development, Brazil, e-mail: clearib@eerp.usp.br

 

 


ABSTRACT

This study aimed to discover the representations of the smoking habit in both non-smoking and smoking female adolescents from a high school in Querétaro, Mexico. It is a qualitative research, carried out with 14 female adolescents in 2005. A semi-structured interview and a socioeconomic survey were used to collect data. Results evidenced adolescents know the biomedical discourse, which proposes that smoking causes serious consequences to health. However, there are other symbolic reasons that influence its use such as the search for equality and image, since they think men find smoking women more attractive and mature. Peer pressure represents an important factor for women to smoke by validating its practice and minimizing its effects to the body.

Descriptors: smoking; women; adolescent


 

 

INTRODUCTION

Several studies have been developed to know about the consumption of tobacco. Most of them focused on the description of the magnitude and on the impact of this practice on population health(1-3).

Some studies show that developing countries still do not present consumption rates as high as in developed countries, where this practice has become an epidemic that entails several diseases and high death rates related to this consumption(2,4). However, since consumption has increased much all over the world, the smokers' behavior is to ignore these effects. In this context, the adolescent population is one of the most affected, because the levels of consumption in this population are getting higher and higher.

The results of the impact of tobacco on health have not been enough to reduce or avoid consumption. Therefore, people continue to consume it, not only due to a lack of information, but also because of a group of meanings and representations the habit of smoking represents to smokers; meanings that change according to the context, period and socio-political and cultural conditions the smoker is inserted in. For the American Indians, the figure of the chamán has, since pre-history, been the main author and the only privileged person to consume high quantities of tobacco, used mainly for religious purposes and healing practices(5). The representations have changed in context over the years, and they guide the actions and attitudes a person will adopt when facing another person, fact or occurrence. That is why in many places there are different representations, changing into plenty of reasons to smoke.

There are many groups that have studied social representations. The French School defines social representation as "a system of values, ideas and practices with two functions: first, to establish rules under which people will be able to guide themselves in their material and social world and take control of it; and second, making communication possible among community members by giving them a code to rule and classify, without ambiguity, the aspects of their world and of their individual and social history"(6).

The representations are regional, not universal, varying from one place to another; they are shared by the community and accepted as truth. Because of this, they guide people's actions in this community. When people are inserted in a society, this society already has a system full of representations which identify and classify actions, objects and people within its structure. So, these representations are obtained by people and constitute the way they see the world; they are like lenses that allow these people to have a view of things in general which for them is the reality.

These representations are kept in categories within people's memories, being part of their mind schemes to express reality. They are factors that produce reality when determining the way people interpret them and how they respond to this reality, being a kind of practical knowledge guiding daily activities.

In a nutshell, social representations are classified as either functional knowledge or practical social theories, which determine a kind of specific knowledge: Common sense knowledge, whose contents reveal the operation of generating functional processes that are socially characterized. In a broader sense, they determine a kind of social thought(7), even though they come together with scientific knowledge; they show the logic and the ideas that make people understand the different actions they perform.

In health care, it is extremely important to perform studies about the representations the agents have of different phenomena, because they experience it daily. The purpose of this study was to detail the representations of female adolescents related to smoking habits - moreover, to verify whether some of these conceptions emphasize the adolescents' consumption and if there are differences among female smokers and non-smokers.

From this perspective, the aim of the research was to get to know how female adolescents' conceive the smoking habit at a Higher Education institution, in order to identify whether these representations emphasize the habit of smoking, and if there are differences in the representations of female smokers and non-smokers.

 

METHODOLOGY

This qualitative study was carried out at a Higher Education institution in the state of Querétaro, México. The participants were fourteen women, either sixteen or seventeen years old, seven of whom were smokers and seven non-smokers. A questionnaire was used to obtain the social-demographic data, and a semi-structured interview(8-10).

Gender was a fundamental element in this study, where only the perspective of women on their conception of smoking was taken into account. The second fundamental element in the informers' selection was whether they were active smokers or not. Thus, this study looked at the differences in representations between adolescents who smoke and who do not. The last element to be considered was class hours. Only students from the morning class group were invited to participate, since this is the time when the highest number of smokers is present.

 

PROCEDURES

After receiving the institution's authorization, the first group interview was held with twenty female adolescents to invite them to participate in the study. In this meeting, they were told about the main reason of the study, as well as the importance of their participation. Fourteen students who attended the meeting agreed to take part. Next, they received a consent term, to be signed by themselves and their tutors. Then, the dates for the interviews were scheduled according to their availability, and a quiet place inside the educational institute was used for the conversation. The interviews took place from November 23 to December 10, 2005, in the afternoon. They were recorded, transcribed and numbered from 1 to 14 to identify the statements.

Content analysis (11) was applied to the collected information, using systematic and objective procedures for content description to obtain the messages and indicators that implied content categories. The following procedures were used: pre-analysis stage; material investigation; treatment and interpretation of the obtained results; elaboration of the technical report.

The women took part in this study as volunteers, having the confidentiality of their identities assured.

 

RESULTS

Smoking representations

The ways the two groups in the study represent the smoking habit show contrasting opinions. Female smokers believe that smoking is an activity considered "ordinary", reducing its effects when compared to how other habits affect their daily lives. [What do you think about smoking?] In fact, nothing, it is something ordinary, that I do a lot... like drinking water (Interview n.7).

The smoking habit offers them immediate benefits, such as relaxation, but they also consider it as something that is not good, and that it can become difficult to break with a constant smoking habit. Besides, the participants show changes in their representations before and after starting consumption; before starting, they thought that this habit was bad and that it was restricted to certain population groups, including "lazybones" and men; this representation changed when they started to smoke and, as time passes, more people smoke; if there are many smokers, the habit is taken into account by the group, minimizing or eliminating its effects on health.

Long ago, it was strange to see a woman smoking, but not anymore. Previously, I thought that putting a cigarette in one's mouth was seen as bad by others, but not anymore, as if I got used to see it happening, to see just anybody smoking... It is not strange anymore, then you say, if they smoke, why not me? (Interview n.14)

The adolescents are aware that the models of consumption have changed, spreading to other populations. This emphasizes their decision to initiate or maintain the consumption by representing the smoking habit as a daily practice.

On the other hand, girls who do not smoke also seem to be opposed to it. They do not seem to bother when others smoke, claiming that it is not a serious activity. However, they say that people who smoke damage not only their own health, but also that of people around them. I see that as a double-edged sword, isn't it? It affects the consumer as much as the people around... being harmful to health. (Interview n.13)

Even with this ambivalence, non-smoker adolescents are more aware of the damages caused by tobacco and, worried about their health, they avoid starting.

Reasons why a person smokes

The interviewed women indicated influence from friends as the main reason for smoking. Non-smoking adolescents say that people start or keep up the habit in order to belong to a group and to avoid being rejected. After your friends ask you if you want and you say no, they leave you aside. You have to smoke to belong to the group. (Interview n.11)

However, they also consider it as an expression symbolizing the beginning of adolescence and a way to go against society. Female smokers express that the group of friends validate the habit; it is a thing that everybody does, which makes smoking something ordinary, happening daily despite its effects. Because you are surrounded by people like you, and I tell you, they influence you, because my friends smoke, all of them, and at a certain moment you see it as something normal and say: what's wrong with that? (Interview n.1)

Another important difference among smokers and non-smokers was that those who do not smoke present a social discourse, expressing that people who consume drugs (among them tobacco) do it because of family problems, lack of comprehension from their parents or bad communication with them, considering this expression as a false escape from daily problems.

As for the female smokers, this representation changes when they start smoking. They reveal that it is not only because of problems at home that an adolescent smokes but, among other things, because of the psychological benefits they get (relaxation, anxiety reduction, etc.), by habit or taste. Previously, when I didn't smoke, I thought that it happened more often because of problems at home or because people wanted to relax, but after I started smoking I thought, hey, they smoke because they want to. (Interview n.14)

Representation of a female smoker

The women who smoke recognize the social discourse about women who do not see themselves favorably when smoking, and that smoking is a habit "exclusive" of men; they do not agree with this discourse and consider that there is no difference when a woman or a man smokes, because they are equal. In this discourse, there are equal rights between men and women, and smoking is an expression of these rights. Well, this society is already almost completely prejudiced, men are already addicted and women must be careful because they should be well-seen; when a lady smokes she will be seen as a bad person by others. But I don't believe it, well, I don't see any difference. (Interview n.6)

The difference they express in relation to men is that women get pregnant; during pregnancy, they cannot smoke because it is harmful to the baby. So, they have to worry about not falling into this addiction, so that they do not have to try to leave the habit when pregnant. They consider that, when a woman becomes a mother, she is allowed to smoke, but she must hide it from her children. Just like a woman must not do it [smoke], it is better to hide it in case she does (Interview n. 14). Self-image is very important for the non-smoking women; they consider that a woman who smokes is seen as a bad person, and that this habit takes femininity away. The majority agrees with the social discourse that shows that smoking is a men's habit; they have more permission than women. Both groups say that smoking is an expression of equality between men and women. However, those who do not smoke consider that women are risking their health in this search for equality, as well the health of the people around them.

For non-smokers, care with their self-image and health are the two most important reasons for not smoking. I criticize women who smoke, and I say "yes, she is seen in a bad light"... I feel as if a woman has lost a lot. As if their ambition to be equal to men has denigrated part of them, which in the end does not only affect them, but also, if they want to procreate, and the people around them, and everything else (Interview n.11).

Reasons why a woman smokes

The female smokers reveal (among other reason) that they smoke because of the benefits this habit offers them at a psychological level, such as lowering anger and tension.

Another important reason is self-image, since they consider that a female smoker is more attractive to men and that she is seen as more interesting. Hence, smoking is a strategy to draw men's attention. On the other hand, they consider smoking as an expression of equality because, when they smoke, they are shown as having the same rights, an important reason that is emphasized even by men: Sometimes I think that women want to be like men, and men say why not?, we also smoke, ok, and we do foolish things too (Interview n.5)

The non-smokers also reveal this representation of considering that women smoke because of equal rights, although they consider self-image as the most important reason. They reveal that a female smoker is seen in a bad way, but mention that men think they are attractive and mature, and that this is why women smoke: to attract their attention. There is also the need to belong to a group, so that they are not rejected by their friends who smoke, and so that they can join the social circle.

Place

The place of consumption is a category that was elaborated only based on the discourse of the female smokers, and it expresses the context of where they indulge in the habit. The women smoke at school or on the streets. They do not smoke at home, because, among other reasons, their parents do not know that they smoke, because nobody at home smokes, because nobody is allowed to smoke at home and because home is a place of "respect". At home, no, I do not smoke, no, I don't know if they allow it, because at home nobody smokes, it is more here at school... at school or on the street. (Interview n. 1)

Every day, they smoke their first cigarette at two o'clock in the afternoon, which is when they start school. This situation may imply that smoking is not an individual activity, but performed in the group they belong to, and where the habit is taken into account.

Effects

The female smokers mention cancer and pulmonary emphysema as the main consequences of tobacco consumption and, among them, symptoms like breathing difficulties, chest pain and extreme relaxation.

The female non-smokers presented a series of consequences, mentioning cancer and pulmonary emphysema, along with asthma, respiratory diseases, bronchial and teeth damage and the possibility of death by asphyxia. Moreover, there is a series of related symptoms, such as coughs, hoarseness, headaches and bad breath. They consider that smoking causes various psychological symptoms, such as anxiety, anger, negative thoughts and hysteria.

 

DISCUSSION

The adolescents are aware of the medical discourse, which shows that smoking causes serious consequences to health. However, the representations that appear at a symbolic level are more important than health itself.

Like in other studies (12), it was found that, for the population studied, smoking represents a list of factors, such as autonomy, adult age, the need for acceptance and group belonging, typical of adolescents. Therefore, there are some exclusive representations of women present in Mexico, which are due to gender conditions.

Like in other studies (13), women reveal that there is a double moral at the social level, which considers smoking as a man's habit and that women are seen in a bad way. For the women in this research, the smoking habit appears as a manifestation of what they consider equal rights, and smoking allows them to show their value. Besides, there is the representation in which female smokers see themselves as more attractive and mature and say that these qualities attract men. They manifest that smoking is a strategy to seduce and draw men's attention.

In both representations there is the condition of values. On the one hand, smoking is an expression of equality between men's and women's rights; on the other hand, smoking is expressed as a value attached to looking more attractive to men.

 

FINAL CONSIDERATIONS

It is important to emphasize that most prevention and reduction campaigns of tobacco consumption, which appear in mass media, claim that family problems are the main cause of consumption. Like in other research(14), this study demonstrates that this phenomenon is not just casual and does not manifest itself in one single way, but that it depends on the values, the way and the representation in the context. In this research, female non-smokers agree with the social discourse that considers family problems as the main cause, whereas female smokers used to agree with it until they started consuming. Once they started, they revealed many other causes, reasons and symbolizations they could be aware of or not.

The programs executed to help people stop smoking should consider these implications, since replacing tobacco with nicotine substitutes is not enough; tobacco is only a symptom, and action is needed to achieve the intended result.

 

ACKNOWLEDGEMENTS

Acknowledgements to the Inter-American Drug Abuse Control Commission/CICAD of the Sub-Secretary of Multidimensional Security at the Organization of American States/OAS, the Brazilian Anti-Drugs Secretary/SENAD, faculty members at the University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Brazil, to the population who participated in the studies and to the representatives from eight Latin-American countries who participated in the I and II On-Line Specialization Program for Research Capacity-Building on the Drugs Phenomenon-PREINVEST, offered in 2005/2006 by the University of São Paulo at Ribeirão Preto College of Nursing, as a distance education course.

 

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Recebido em: 28.3.2007
Aprovado em: 10.1.2008

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