Chinese male adolescents resisting cigarettes from peers: qualitative research on tactics, perceptions and contextual characteristics

Abstract

Aims: Cigarette passing and sharing contribute to early smoking onset among Chinese male youth. Refusal efficacy, considered pivotal in smoking prevention, has not been addressed in published research regarding specific refusal tactics and resistant communication behaviors. This focus group study aimed to uncover cigarette resistance responses, cigarette-offering agents' reactions to refusal, social barriers, and contextual characteristics among targeted Chinese male adolescents. Methods: Twenty focus groups with 7-10 male smoking and nonsmoking students per group from vocational and junior colleges (N = 165) were interviewed in two cities in China. The data were coded and analyzed. Findings: Nonconfrontational refusal tactics were frequently used. Of the nine identified cigarette refusal categories, consistent and firm declarations of the nonsmoking status were considered most effective. Upon rejection, a majority of people offering cigarettes made no further attempts. Most participants expressed neutral attitudes toward cigarette refusals, in contrast with the assumption in the literature that teenagers pervasively dislike such refusals. Conclusions: Health educators likely can use the finding of peer agents' general neutral (rather than negative) attitudes toward cigarette refusal to relieve teenagers' apprehension about rejecting cigarettes and thereby help build their refusal confidence. The reported effective strategies should be further tested prior to implementation for training teenagers.

Are E-Cigarette and Tea Cigarette Gifting Behaviors Associated with Tobacco Use and Failed Quit Attempts in China?

“…Gifting cigarettes was defined as giving and receiving at least one unopened pack of 11 cigarettes [24,31]. It was measured by asking if the participants agreed with the following statements: "in the past year, have you given someone/received at least an e-cigarette or one unopened pack of tea cigarettes as a gift?"…”

“…A key risk factor for tobacco use in China is the social norm of gifting cigarettes [23]. Cigarette gifting means offering and accepting single cigarettes for immediate consumption in a wide variety of social settings [24]. It is one of the main causes of smoking [25] and contributes to the failure of cessation [26].…”

The State of Norm-Based Antismoking Research: Conceptual Frameworks, Research Designs, and Implications for Interventions

“…Further, researchers examined smoking norms by focusing on the act of smoking without adequate attention to other acts that directly or immediately lead to smoking. For example, in one study that examined offering cigarettes as a normative social smoking behavior, passing cigarettes to others was generally met with little resistance, particularly during smoking experimentation among teenagers (Sheer et al, 2018). Interventions targeting the reduction of cigarette passing can reduce social cigarette sharing.…”