Littlecott, H. J. et al. (2023) Perceptions of friendship, peers and influence on adolescent smoking according to tobacco control context: a systematic review and meta-ethnography of qualitative research. BMC Public Health, 23, 424. (doi: 10.1186/s12889-022-14727-z) (PMID:36869343) (PMCID:PMC9983235)
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Abstract
Background: A relationship between smoking and interpersonal influences has been well established within the literature. There have been cultural shifts in denormalisation and a reduction in tobacco smoking in many countries. Hence there is a need to understand social influences on adolescents’ smoking across smoking normalisation contexts. Methods: The search was conducted in July 2019 and updated in March 2022 within 11 databases and secondary sources. Search terms included schools, adolescents, smoking, peers, social norms and qualitative research. Screening was conducted by two researchers independently and in duplicate. Study quality was assessed using the eight-item Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-centre) tool for the appraisal of qualitative studies. Results were synthesised using a meta-narrative lens for meta-ethnography and compared across smoking normalisation contexts. Results: Forty one studies were included and five themes were developed, mapping onto the socio ecological model. The social processes by which adolescents take up smoking differed according to a mixture of school type, peer group structure and the smoking culture within the school, as well as the wider cultural context. Data available from smoking denormalised contexts, described changes in social interactions around smoking to cope with its stigmatisation. This was manifested through i) direct peer influence, whereby subtle techniques were employed, ii) group belonging whereby smoking was less likely to be seen as a key determinant of group membership and smoking was less commonly reported to be used as a social tool, and iii) popularity and identity construction, whereby smoking was perceived more negatively in a denormalised context, compared with a normalised context. Conclusions: This meta-ethnography is the first study to demonstrate, drawing on international data, that peer processes in adolescent smoking may undergo changes as smoking norms within society change. Future research should focus on understanding differences across socioeconomic contexts, to inform the adaptation of interventions.
| Item Type: | Articles |
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| Additional Information: | Dr. Hannah Littlecott, the principal researcher, is supported by a Cancer Research UK Population Research Postdoctoral Fellowship (C64562/A26532). The work was undertaken with the support of The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UKCRC Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. It was also supported by its successor, The Centre for Development, Evaluation, Complexity and Implementation in for Public Health Improvement (DECIPHer), funded by Welsh Government via Health and Care Research Wales. Mark McCann was supported by Medical Research Council partnership grant MC_PC_13027 and by the MRC and Scotland’s Chief Scientist Office through the SPHSU Complexity (MC_UU_12017/14 / SPHSU14 / MC_UU_00022/1) and relationships (MC_UU_12017/11 / SPHSU11 / MC_UU_00022/3) programmes. |
| Keywords: | Smoking, tobacco control, adolescents, schools, friendship, peer influence, systematic review, meta-ethnography. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | McCann, Dr Mark |
| Authors: | Littlecott, H. J., Moore, G. F., Evans, R. E., Melendez-Torres, G. J., McCann, M., Reed, H., Mann, M., Dobbie, F., Jennings, S., Donaldson, C., and Hawkins, J. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | BMC Public Health |
| Publisher: | BioMed Central |
| ISSN: | 1471-2458 |
| ISSN (Online): | 1471-2458 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in BMC Public Health 23: 424 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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