Health Education Research, Vol. 18, No. 5, 554-567,
October 2003
© 2003 Oxford University Press
Filthy or fashionable? Young people’s perceptions of smoking in the media
School of Population Health, University of Western Australia, Perth, 6009, Australia 1 Present address: Centre for Behavioural Research in Cancer Control, Curtin University, Perth, WA 6102, Australia.
E–mail: N.Watson{at}curtis.edu.au
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Abstract |
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Research has shown that the media over-estimates smoking rates and often associates smoking with favorable attributes or situations. Given that the media plays a large role in influencing youth culture, portrayal of smoking in the media is of concern. In order to explore young people’s perceptions of smoking imagery in the media, 16 focus groups were conducted with 117 school students. Participants were asked to rate smoking images selected from audio-visual and print media, and to discuss their perceptions of these images. The results showed that young people perceived smoking in these media selections to be normal and acceptable. They identified with the stress-relieving and social aspects of smoking, despite being well aware of the harmful health effects. Its acceptability as part of a ‘cool’ image was also noted. Positive images of smoking in the media have the potential to down-play the serious health consequences of smoking by portraying it in a way that young people interpret as a normal part of everyday life. They may also encourage a more neutral or tolerant attitude towards smoking among young people and therefore act to counteract other health promotion efforts to reduce teenage smoking.
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Introduction |
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Findings from a number of recent studies of media content indicate that the incidence of media images of smoking has increased since the early 1990s. These studies have included movies (Hazan et al., 1994
; Stockwell and Glantz, 1997; MacKinnon and Owen, 1999; Roberts et al., 1999; Escamilla et al., 2000), magazines (Gray et al., 1997; Owen, 1997) and TV (Hazan and Glantz, 1995; Sone, 1999). Evidence that the tobacco industry has attempted to influence the Australian media and fashion environments comes from recently revealed tobacco industry documents, in which there is a stated intention to seek influence in the media by establishing close relations with film, fashion and print media executives (Stock, 2000; Sydney Morning Herald, 2000).
Contributing to the prevalence of smoking in the media is the tendency for film producers to rely on cigarettes to convey character information (Hazan et al., 1994; Sydney Morning Herald, 2000). This is often considered by communication professionals as a ‘lazy way’ to communicate depth of character, when the same detail may be portrayed through other means (MacKinnon and Owen, 1999; Sydney Morning Herald, 2000). Tobacco use is most frequently used to reveal character insight or to portray reality, despite the fact that movies portray smoking to be far more prevalent than is the case in reality (Hazan et al., 1994; Hazan and Glantz, 1995; Stockwell and Glantz, 1997; Escamilla et al., 2000).
In addition to over-estimating the use of tobacco, popular media also tend to associate it with more favorable attributes or situations (Cruz and Wallack, 1986; Amos, 1993; Hazan et al., 1994; Hazan and Glantz, 1995; Owen, 1997; Stockwell and Glantz, 1997; MacKinnon and Owen, 1999; Shields et al., 1999). This is of concern given that the media has a powerful role in reflecting and influencing youth culture (Amos, 1993). Young people are more likely to learn and imitate behaviors performed by role models or if they are associated with positive outcomes such as power, sex, romance, social status and success (Breed and De Foe, 1984; McIntosh et al., 1998; Borzekowski et al., 1999; Roberts et al., 1999; Escamilla et al., 2000). In addition, images of smoking in the media portrayed as ‘realistic’ and often incidental increase the likelihood that smoking is normalized and made to appear socially acceptable (Piepe et al., 1986; Hazan et al., 1994; Owen, 1997; MacKinnon and Owen, 1999; Sone, 1999; Escamilla et al., 2000).
Being ‘cool’ is important to teenagers and is integral to the image they present to their peers. The art of being cool involves looking cool without trying to look cool. Teenagers perceive that trying to look cool is definitely uncool (Gray et al., 1996). Thus, the way smoking is represented and who is seen to be smoking has the potential to influence teenage attitudes towards smoking. If teenagers believe that smoking adds to their quest for ‘coolness’, they may be more likely to imitate the smoking behavior of role models.
Therefore, any increase in the incidental portrayal of smoking in the media is of concern. Legislation controlling tobacco advertising and sponsorship in several countries has prompted the tobacco industry to explore new ways to promote and reinforce tobacco use among youth (Quit Victoria and Australian Teachers of Media, 1992; Glantz et al., 1996; Chapman, 1997; Stockwell and Glantz, 1997). Understanding the potential effects of incidental smoking images on young people is becoming increasingly important in the fight against tobacco, particularly since teenagers are big users of the media: a recent survey in Western Australia found that 60% of 14–17 year olds reported going to the cinema in the last month and 99% of 10–17 year olds watch TV, with 24% watching for more than 4 h per day. In addition, 65% of 14- to 17-year-old girls and 48% of 14- to 17-year-old boys had read five or more magazines in the previous month (personal communication: AC Nielsen, 2000; Nielsen Media Research, Sydney, Australia).
The following study examined young people’s perceptions of smoking images in TV, movies, newspapers and magazines in Western Australia. In the UK, Gray et al. (Gray et al., 1996) examined young people’s perceptions of smoking images in magazines and reported that the majority of teenagers made either negative or neutral comments regarding the presence of a cigarette. They also reported differences between younger and older teenagers in terms of their reactions to the images and attitudes towards smoking in general. Young people’s perceptions of smoking in films was the focus of a recent New Zealand study that found that teenagers were nonchalant about smoking imagery in films and perceived it as normal (McCool et al., 2000).
This paper presents findings of a study using focus groups to:
(1) Explore the extent to which young people notice smoking in the media when unprompted.
(2) Explore the language used by young people to describe smoking incidents in media photographs, movie and TV scenes.
(3) Test whether this language can be grouped into previously defined concept areas of physical health, mental health, social acceptability and image.
(4) Explore the visual cues in media images that young people use to interpret smoking incidents, with particular reference to the social acceptability of smoking.
(5) Explore young people’s thoughts about and reactions to images of smoking in popular media.
(6) Investigate possible differences according to age, sex and smoking status.
This study differs from other studies in this field in a number of ways. First, we examined young people’s perceptions of smoking images across a wider range of media, encompassing movies, TV, magazines and newspapers. In addition, we explored young people’s thoughts and ideas about smoking specifically in relation to themes identified through early focus group discussions.
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Method |
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Focus groups were chosen as the most appropriate method for the study. The benefits of using focus groups with teenagers and for studies which are exploratory in nature have been well documented (Hastings, 1990
; Murphy et al., 1992; Allbutt et al., 1995; Secker et al., 1995; Gray et al., 1997). This was a two-phase, qualitative project, which comprised six exploratory and developmental focus groups, and 13 structured focus groups.
Sampling procedure
The study involved eight Perth metropolitan high schools, selected to represent a range of socioeconomic backgrounds, and public and private funding. The focus groups were conducted with students in Years 8–11 (aged 13–16 years).
Student samples were selected on the basis of school classes. They were not told in advance that the study was about smoking. On the day of the focus group, the facilitator met with a class pre-arranged by a contact person within the school. The students were told that the study was interested in teenagers’ use of the media, their hobbies, interests and what they like to do with their spare time. Each student was asked to complete a screening questionnaire which included a range of questions relating to their use of the media and their lifestyles, including a question designed to determine smoking status.
Questionnaires were collected by the facilitator, and sorted on the basis of gender and smoking status. Students were then randomly selected within these categories for participation in the focus groups. Smokers were classified by having smoked a cigarette in the last month.
Four groups were conducted at each of four age levels: 13, 14, 15 and 16. All groups were single sex, involved either all smokers or all non-smokers and ranged from four to nine participants. Overall, 117 young people participated in the 19 exploratory and structured focus groups.
Focus group protocol
The focus groups began with the facilitator introducing herself and the general aim of the group discussion. Issues of consent, confidentiality, the right to withdraw from the group and the right not to respond to any question were also covered in accordance with recommended guidelines when conducting focus groups (Hastings, 1990; Grbich, 1999; Seal et al., 2000). Students were told that all points of view were encouraged and that there were no right or wrong answers (Gray et al., 1997).
Exploratory focus groups
The first six groups (including three pilot groups) were informally structured, but did collect individual responses to open-ended and closed questions. The participants were told that the study was seeking their thoughts and reactions to the media in general, to ensure that any comments about smoking were unprompted.
The initial discussion explored teenagers’ interests, hobbies, Internet use, and favorite movies and TV shows. The teenagers were then introduced to an activity involving top-of-mind associations (Kerlinger, 1986). Next, media examples were presented, including movie and TV clips, magazine and newspaper articles, and popular advertising logos. Only some of the media examples showed smoking and the extent to which young people commented on smoking in these examples was noted.
At this stage, young people were encouraged to discuss their thoughts on each of the media items shown. The facilitator did not specifically prompt any issues about smoking unless the participants themselves raised them.
The second part of the focus group asked the students to describe, by writing three to five single words, how smoking and smokers appeared in a range of presented print, TV and film media. The language used by the teenagers to describe images of smoking was then used to develop semantic scales that were subsequently used in the remaining 13 focus groups. A similar protocol was successfully used in a study by Amos et al. (Amos et al., 1998), where young people were asked to write five words to describe images in magazines.
The semantic scales were grouped into the four main categories reflecting different characteristics of smoking. These categories were: social acceptability, physical health attributes, mood attributes and appearance or image attributes. For example, ‘social acceptability’ included descriptives such as cool/uncool, sociable/unsociable and successful/unsuccessful; physical health included fit/unfit and healthy/unhealthy; mood attributes included stressful/relaxing, happy/unhappy and confident/insecure; and appearance/image included attributes such as attractive/unattractive, glamorous/daggy and casual/try-hard. The complete list of the attributes which make up each of these categories can be seen in Table I.
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Structured group interviews
Thirteen structured focus groups were conducted in seven schools. Students were asked to individually rate, on a self-completion questionnaire, a series of film and TV clips and print media images using the semantic scales developed from the earlier groups, according to how they thought the image or scene made smoking or the smoker look (see Table I). Each media item had between two and six scales which were specific to that item. Descriptives were chosen based on their relevance to the scene or image. Any response was considered to be positive if it related to attributes which were supportive of smoking or reflected on smoking in a favorable way. Similarly, negative responses were unsupportive of smoking or reflected on smoking in an unfavorable way.
A final question was included, which asked the students to indicate whether, overall, they thought the media clip represented smoking as a good thing to do or a bad thing to do. There was no option to answer ‘neither’ to this question.
After individually completing the scales for each media item, students were asked to discuss their answers with the facilitator and the rest of the group, and to describe the reasons behind their answers. These discussions were tape recorded and transcribed. The responses to both the semantic scales and the verbatim comments were analyzed in terms of whether they related to a positive or negative aspect of smoking.
Media items
Using information supplied by a media placement company, the media items used in the focus groups were selected mainly from media vehicles popular with 13–16 year olds. They comprised a combination of movie and TV segments, magazine photos, newspaper articles, and cartoons. Movie clips were drawn from Titanic, My Best Friend’s Wedding, Independence Day and Beautician and the Beast. TV clips were drawn from Ally McBeal and The Simpsons. Magazine photos of celebrities (such as Elle McPherson, Kate Moss, Richard Ashcroft) and non-celebrities were drawn from a variety of Australian and international magazines. One newspaper article from The West Australian newspaper was included, as was one cartoon of ‘The Phantom’.
All media items featured smoking. Items were selected to show a range of smoking situations and to include people with a range of physical characteristics, such as age, sex, appearance and clothing.
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Results |
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This paper will primarily present the results from the 13 structured focus groups.
When young people in the six exploratory focus groups were asked for their thoughts and reactions to images of smoking, they gave a diversity of responses. Nevertheless, their comments and opinions about these images were consistent with the four a priori thematic classifications of smoking developed by the research team, i.e. physical health, mood effects, social acceptability and appearance/body image effects. The results from these focus groups also showed that 78% of the teenagers aged 13–16 noticed and commented on smoking images presented in the media, when unprompted by the facilitator.
The results of the ratings of the media clips from the structured focus groups are summarized in Table II. The proportions of positive, negative and neither ratings are presented separately for each of the media clips and for each of the thematic categories. Overall, young people were able to make statements about how the scenes made smoking look in most media scenes. When rating the physical health attributes of smoking, Movie Scene 2 was the only instance where more than 50% of the young people felt they could not make a statement about whether the scene made smoking look positive or negative in terms of physical health. Across all scenes, the mean proportion of ‘neither’ responses on the physical health theme was 21%.
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Similarly, only in relation to Magazine Photograph 3 did one-half of the young people report that they could not make a statement about how the photo made smoking look in terms of mood. The mean proportion of ‘neither’ responses for the mood theme was 15.5%.
In relation to the scenes making smoking look socially acceptable, the overall mean proportion of ‘neither’ ratings was 10.4%. This suggests that in the majority of cases, young people could rate with confidence whether the scene made smoking look socially acceptable or socially unacceptable. The mean proportion of ‘neither’ responses across all media scenes on the appearance/body image theme was 16.5%; therefore, most young people made judgments on how the scene portrayed smoking in relation to appearance or image effects.
Overall, there were no significant differences in the rating of media scenes between smokers and non-smokers or between males and females. Given the qualitative emphasis of this research and the small subsample sizes, significant differences were not expected. A few cases where apparent differences emerged between younger and older teenagers will be discussed later.
For the purposes of this paper, each thematic area will be discussed separately, using extracts of focus group transcripts to highlight particular issues.
Social acceptability
In this study, if smoking in the media clip was perceived by young people as appearing normal, it was coded as positive for social acceptability. Table II shows that, in general, the social acceptability of smoking was rated quite positively across the majority of media clips. The mean proportion of overall positive responses was 64%. Those images of smoking which rated particularly positive for social acceptability were depicting smoking in association with success, sociability, coolness, popularity and reward.
One of the concepts that many young people seemed to particularly identify with was the sociability of smoking. They were likely to score smoking more positively on this theme if a scene was shared by two or more smokers or if a smoker appeared to be popular and friendly:
He’s popular because he’s with his friends... he looks like the leader sort of thing. [Female, 13 years]
It looks sociable. She’s in a bar with other people having a drink and a smoke, looks like the usual thing to do. [Male 16 years]
An everyday thing. She is just so casual and it’s [the cigarette] just there and seems so natural. [Female, 16 years]
Comments in the general discussion, from both smokers and non-smokers, suggest that many of the young people saw smoking as socially acceptable anyway. It appears that many young people either did not notice or did not pay undue attention to smoking images in these media items, as they saw them as a reflection of a ‘real’ social environment:
It’s an everyday thing. Smoking is just like chewing chewing gum. [Male, 15 years]
Movie Scene 2 was rated very negatively in relation to the social acceptability of smoking. This movie scene portrayed the actress as condescending and snobbish, leading teenagers to think the character was ‘stuck-up’ rather than friendly.
Cool
There was some variation in each young person’s idea of what is ‘cool’. Generally, however, attractive and fashionable people and exciting movie scenes were rated as ‘cool’ by most participants:
His appearance makes him look uncool. [Female, 15 years]
They were cool because they were wearing suits and successful. [Male, 16 years]
According to the literature, being cool is associated with image, and young people admire people who appear popular and to be good fun. Given this, many young people looked favorably upon images of this kind, despite the fact that all of these ‘cool’ characters were smoking. In some instances, they thought smoking even added to the overall ‘cool’ image:
He’s cool because he’s like walking casually and everything. He’s surrounded by friends and he’s got like the latest style hair and stuff. [Male, 13 years]
He’s cool because he’s the hero and he just pulls out the cigar and starts smoking it. [Female, 14 years]
The most common reasons for young people rating the image as making smoking look uncool were knowledge of the negative physical health effects, an undesirable appearance or image, or if the character was trying to look cool:
Uncool because it’s a very stupid show in my opinion and smoking is a pretty stupid thing to do because it’s disgusting and you choke to death. [Male, 16 years]
She’s uncool because she’s trying hard to look cool, but it’s just not working. [Female, 16 years]
Thus, young people perceived that smoking may be associated with cool people but wasn’t sufficient in itself to make the person smoking look cool.
Physical health
Physical health attributes in general were rated quite negatively, although overall the mean proportion of negative responses was less than 50%. This is in part because 21% of all responses indicated that the images portrayed smoking as neither positive or negative on physical health characteristics. The overall mean proportion of responses that were negative towards the physical health attributes of smoking was 46%, while 33% of responses were positive.
Physical health attributes appeared to be a difficult theme for young people to rate, due to the fact that there was rarely sufficient relevant information in the media event. This was particularly the case for magazine photographs, compared with movies. Other physical attributes were often used to make inferences about physical health, with attractive physical characteristics being equated with being healthy and unattractiveness being equated with being unhealthy:
She was really pretty, so I thought healthy because she’s pretty. [Female, 13 years]
She looks healthy. Because she’s not wrinkly or anything. [Male, 13 years]
She looks unhealthy. The way she is standing, she’s all skinny. [Male, 13 years]
Look at the cheekbones on her... She looks like a piece of chalk actually... And her teeth are a bit discolored. [Males, 16 years]
It’s both. He’s unhealthy because he’s smoking, but he’s walking so he must be fit which would class him as a healthy person. [Female, 16 years]
In terms of physical fitness, the young people seemed to recognize the contradiction between what they saw in the images of smoking and what they knew about the health effects of tobacco use:
Oh yeah, she definitely looks fit. Yeah, even though she smokes she’s got a really good body. [Male, 16 years]
In rating the movie scenes, young people not only relied on physical attributes, but also looked for any of the negative side effects usually associated with smoking. It was often apparent that there was a lack of any visible detrimental effects of smoking, health-related or otherwise.
Yeah, they were healthy. I didn’t see any bad coughing, they weren’t having a hard time. They were just smoking and relaxed. [Male, 16 years]
I put healthy because it didn’t look like it was doing them any damage. [Male, 16 years]
Some young people also used mood or mental health aspects to infer the status of physical health:
It’s unhealthy because she is totally stressed. [Female, 13 years]
As presented in Table II, young people rated physical health positively in Magazine Photographs 1, 4, 6 and 7. The outstanding feature of each of these photographs was that they all featured attractive and slim models (two male and two female photographs). This reinforces the finding that some young people relied on aspects of physical attractiveness when rating the scene with respect to physical health.
Physical health was rated very negatively in Movie Scenes 1 and 4 and Magazine Photographs 3, 5, 8 and 9. In these instances, the images involved unflattering depictions or the actors/models portrayed other attributes that the young people interpreted as unhealthy (i.e. appeared stressed, sad or disheveled).
There were no consistent differences in the scoring of physical health based on smoking status, age or gender. However, 13 year olds were slightly more inclined to rate physical health attributes positively than either 14 or 15 years olds (44 versus 13 and 6%, respectively).
Mood
Results for the mood attributes of smoking were reasonably consistent across the 11 media examples. The concepts of stress relief and emotional control seemed to be the issues most readily identified by young people when coding the association between smoking and mood:
They were in a stressful situation and it relaxed them. [Female, 16 years]
He’s in control. He looked relaxed. Nothing was bothering him. He’s got everything organized. [Female, 13 years]
Overall, the mood attributes of smoking were rated positively across 10 out of the 11 relevant media clips. The mean proportion of positive responses across all scenes was 65%. Magazine Photograph 3 received a more negative mood effects rating. Discussion revealed that half of the young people thought this model looked ‘rough’ or ‘angry’ and therefore rated mood attributes negatively.
Images that were rated very positively for mood (i.e. Movie Scenes 2–5 and Magazine Photographs 1, 4, 6 and 9) were associated with smoking being perceived as a form of stress relief. Images which were perceived as portraying control or confidence were rated as a positive association between mood and smoking.
Appearance/image
Compared with physical health and mood attributes, there was more variation in the rating of associations between smoking and appearance or image for each individual media item. In general, responses were evenly divided, with 39% of responses across all scenes being positive and 44% being negative.
The most outstanding feature in the rating of this theme was that smoking tended to be rated more positively if the person featured in the scene was physically attractive or if they appeared to take care in their appearance (i.e. hair, clothes, etc.):
She looks attractive because of what she’s wearing, how she’s sitting, just the look on her face and stuff like that. [Female, 15 years]
I put attractive. A lot of people want to make it rich in the business scene and they would seem to think that he would be a role model. [Male, 13 years]
However, some teenagers automatically interpreted the images as making smoking look unattractive simply due to the fact that the person in the photograph or movie scene was smoking:
Good body, quite pretty. Looks good. But she’s smoking, that’s the one bad thing. If she didn’t smoke, she’d be lovely. [Males, 16 years]
Yeah well, she’d probably look fine without it, but because she’s got it she just doesn’t look good. [Female, 14 years]
There was reasonable consensus among and between groups on physical attractiveness concepts. However, males were often reluctant to rate a male character as attractive and instead rated the image as neutral. In addition, females were sometimes very critical of other women in magazine photographs:
I think she’s unattractive. She’s trying to be attractive. I bet you the guys would say she’s attractive. We’re just jealous, that’s why we’re saying all mean stuff about her. [Female, 14 years]
When judging style, young people appear to place particular emphasis on the clothes a person wears:
The clothes make him look stylish, like he’s going out somewhere. They look really decent and the cigar doesn’t change its effect. [Female, 14 years]
Another aspect of this theme was a scale relating to class. Responses varied depending on the characteristics of each scene. Many young people seemed to look for environmental cues and cosmetic appearance when rating whether an image made smoking look classy or tacky:
It (smoking) looked classy, just the way she did it, like with the cigarette holder it just made it look classy. [Female, 15 years]
She looks scraggy because her hair’s all messy and her face is really tired looking. [Female 13 years]
She looks tacky. Just sitting against the wall. She doesn’t care, she’s depressed and everything. [Male, 15 years]
When assessing ‘casual’ or ‘try hard’, young people tended to consider someone’s probable or perceived personality. They tended to rate the image of smoking more negatively if they thought someone was trying too hard to be popular:
They were ‘try hards’ because they looked like they were trying to impress someone just by smoking [Male, 16 years]
Alternatively, if the young people thought the characters had achieved an attractive or casual image without actually trying, they were more likely to rate it positively:
They were just casual. They just looked like they were relaxed and having a good time after work. [Male, 16 years]
Magazine Photographs 3 and 5, which were rated most negatively for appearance or image attributes, featured less flattering images of people that teenagers saw as unattractive or ‘try-hards’. Those images that resulted in smoking being rated most positively (Movie Scene 5, Magazine Photographs 1 and 4) featured stylish scenes with attractive people wearing fashionable or smart clothes.
Overall, 13 year olds rated cosmetic/body image effects more positively than other age groups in eight out of 12 media examples.
Overall rating of smoking as a good thing to do or a bad thing to do
Young people were slightly more likely to rate the 16 different media items examined in the study as representing smoking as a good thing to do rather than a bad thing to do (52 and 48%, respectively). In general, the rating given to the overall tone of each media clip depended on the main themes of the scene and the issues that young people identified with in each case. Magazine photographs typically have one or two main themes, while movie and TV scenes provide opportunity for a wider range of information to be conveyed to the audience. However, in both cases, it appeared that one or two issues were prominent, had particular impact on young people’s perceptions of the scene and therefore influenced not only the rating of individual scales, but also the overall tone.
The media clips that were consistently rated negatively across all of the thematic categories were generally rated negatively overall and vice versa. A minority of clips had mixed positive and negative ratings, e.g. Movie Scene 4 was rated negatively for physical health and appearance/image, and positively for mood and social acceptability. In these latter clips, a prominent theme or issue tended to sway young people’s opinions about the overall tone, as indicated by the following quotes:
It made it look like a bad thing because it made her look on edge... She didn’t look very happy... The whole way through she wasn’t happy and she was in a rush... [Males, 13 years]
I put bad because they were stressed. [Male, 13 years]
I reckon it was a good thing because it made them relax and they could socialize. [Male, 13 years]
In addition to prominent themes, the absence of negative health effects were also noticed by some young people. This was often interpreted as the media portraying smoking as a good thing to do:
It looks like a good thing because it didn’t show the side effects of smoking. Like she was beautiful and she didn’t have anything like, wrong. [Male, 13 years]
It was a good thing to do because everything about it was rewarding. And exciting. And adventurous... Yeah because they didn’t show any negative consequences of smoking... [Females, 16 years]
In deciding whether a media scene represented smoking as a good or a bad thing to do, some young people attempted to reconcile what they had been taught about smoking with what they perceived in the media images. This presented difficulties in some cases:
Bad thing to do. Because we know it’s bad and it leans me towards thinking that it was bad but it could look good if you didn’t know that. [Male, 16 years]
Overall attitude to smoking images in the media
Older teenagers were more cynical and generally displayed an awareness or suspicion of the intent behind the incidental portrayal of smoking in the media:
Nothing that is displayed on TV is going to make it [smoking] look unhealthy, unless it’s an anti-smoking campaign. [Male, 16 years]
All pictures of smoking show that smoking is good. They try to make it look good. [Female, 16 years]
Some older teenagers were also more likely to be accepting of smoking images in the media, seeing it as a reflection of everyday life:
They don’t notice that it’s a negative thing or that it’s even there... It’s practically in every movie now... It’s just become so much of an everyday thing... [Females, 16 years]
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Discussion |
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There were a number of limitations to this study. It was suspected that there were inaccuracies in self-reported smoking status of participants. This may have been due to the school-based setting of the focus groups. Students may have felt apprehensive about revealing their smoking status out of concern that school personnel may view the results. Other studies have reported similar problems with ‘perceived’ confidentiality in school-based settings (Balch, 1998
; McCormick et al., 1999). This factor may reduce any differences in results reported in smoking and non-smoking focus groups. The other limitation of this study is the small number of scenes viewed by group participants. The number of scenes shown to each group was limited by the time allocated to the focus groups. This was dependent on the length of the class timetable and meant that most groups ran for 45–60 min. Other scenes may have revealed extra themes or different cues that influence the rating of smoking in the media.
Despite these limitations, this study has yielded some important results regarding young people’s awareness of and reactions to smoking images in the media. The aim of this focus group research was to determine whether young people pay attention to smoking in the media when unprompted and how such media images are interpreted by teenagers. The pilot focus groups and open-ended discussions indicated that young people notice smoking in the media, and that the presence of smoking adds considerable visual information about the characters. In the structured groups, young people were able to rate smoking images in relation to social acceptability, physical health, mood and image concepts.
Young people appeared to rely on elements of attractiveness, style, environment and perceived personality to guide their rating of smoking and smokers in media scenes. The tendency for young people to seek clues, such as clothing and background, when forming perceptions of images in the media has been reported previously (Amos et al., 1998) and fits with the theory of the ‘halo’ effect (Rossiter and Percy, 1987; Cialdini, 1988). This theory suggests that one positive characteristic can dominate the way a person is viewed by others (Cialdini, 1988; Myers et al., 1999). Research on the ‘halo’ effect shows that attractive people are often perceived as having characteristics they may not possess, such as intelligence, popularity and success. This is often described in terms of likeability and similarity. That is, if a young person sees someone as likeable (e.g. attractive and popular) and similar to themselves, i.e. someone they relate or aspire to, then they are more likely to look upon that person favorably, across a whole range of measures (Rossiter and Percy, 1987; Cialdini, 1988). In this way, smoking can also appear to be a desirable activity, even though young people are clearly well aware of the harmful health effects.
The tendency to seek information other than that relevant to the specific scales used was particularly true in the case of the physical health dimensions where, in the absence of the portrayal of any explicit negative health effects, young people relied on derived information to rate the scene. For example, an attractive character was more favorably rated on physical health attributes than someone who was unattractive. However, for some young people, the presence of a cigarette in a scene or photo was enough to prompt them to rate physical health negatively, regardless of other physical or environmental attributes.
This halo effect was also observed in young people’s ratings of the image of smoking. In general, image or appearance attributes were rated more positively if the person featured in the media scene was physically attractive and/or fashionable.
The young people in these groups felt that most images portrayed smoking positively in terms of mood attributes. One of the key findings of the study was that young people perceived smoking to be a way of relieving a stressful situation.
Similarly, most scenes were rated positively in terms of the social acceptability of smoking. Young people clearly identified with the sociability of smoking and saw it as a normal part of their social environment, despite being aware of the negative health consequences.
These results are consistent with findings by Allbutt et al. (Allbutt et al., 1995). This study found that young people associated smoking positively with social activities and relaxation. Similarly, other studies have identified that smoking was commonly used to control emotions and that women in particular tended to smoke in times of stress or in an attempt to regain control (Donovan and Leivers, 1988; Escamilla et al., 2000).
Consistent with research elsewhere (Allbutt et al. 1995), young people identified a link between smoking, style and image, and displayed some variation in their opinions about style and image. This is most likely due to the subjective nature of what constitutes style, class and attractiveness. In addition, the impact of the image on the viewer varies according to their own self-image and the characteristics of the image in the photo or scene (Amos et al., 1998). Thus, the image of a smoker may be rated positively or negatively depending on whether the observer identifies with or aspires to the particular images being portrayed (Gray et al., 1996).
Differences in young people’s definitions of ‘coolness’ were also apparent in this study, as in previous studies (Gray et al., 1996). Young people clearly distinguished between ‘looking cool’ and ‘trying’ to look cool. In general, people were rated as cool if it was perceived that they were not actually ‘trying’ to be cool (Gray et al., 1996). Characters which fell into the latter category were generally viewed negatively and often referred to as ‘try-hards’. Young people in this study perceived that smoking was associated with cool people, but was not sufficient in itself to make the person smoking look cool. However, smoking could enhance the coolness of an already cool person.
The teenagers in this study appeared to understand the negative health effects of smoking, but some still tended to rate social and mood attributes, and in some cases image attributes, quite positively. Other studies have reported the tendency for young people to hold both positive and negative views about smoking at the same time (Allbutt et al., 1995; Gray et al., 1996). Allbutt et al. (Allbutt et al., 1995) reported that young people had a good knowledge of the negative health effects of smoking, although the perceived benefits were also well known and often experienced. This would account for the occasions when an individual incident is rated positively on some concepts and negatively on others. Also, variations in ratings between each individual would be based on their knowledge, experiences and social environment.
Older teens’ comments indicated they were accepting of smoking images in the media, but many were cynical of its presence. The results indicate that at least some older teens are able to ‘see through’ the imagery and not be persuaded by the messages being presented. However, the fact that these young people were accepting of smoking in the media suggests that they saw it as normal or ‘no big deal’ and were therefore more likely to consider it as socially acceptable.
There did not appear to be any consistent differences in ratings based on age, gender and smoking status. Other studies have reported a largely negative attitude towards smoking among younger teenagers, with a tendency for them to hold more ambivalent views towards smoking as they get older (Allbutt et al., 1995; Gray et al., 1996). This finding was not replicated in this study, although the number of participants was small.
This study has focused on young people’s perceptions of media images of smoking and not on demonstrating how these images impact on their smoking behavior. Causal implications need to be assessed in other ways. Nevertheless, this study suggests that images of smoking in the media have the potential to down-play the serious health consequences of smoking by portraying smoking in a way that young people interpret as a normal part of everyday life. Similarly, these media images have the potential to desensitize young people to the negative health effects of smoking and to encourage a more neutral or tolerant attitude towards smoking. Moreover, they may counteract other health promotion efforts to reduce teenage smoking. Perhaps the finding of most concern in this study was that in many cases, young people seemed to view smoking as an everyday, normal and socially acceptable activity. Other studies have found similar results in focus group studies exploring young people’s perceptions of smoking in the media (Gray et al., 1996; McCool, 2000).
These findings have a number of possible implications:
(1) By normalizing smoking, incidental smoking images in the media could reinforce the behavior of current smokers, especially when they are faced with criticism from other sources, such as school and health campaigns.
(2) These positive images may create tentative positive attitudes towards smoking among experimenters or those who have never smoked, which may lead to acceptance of smoking. It is possible that these latter young people may then be more likely to succumb to cigarette smoking at a later time.
(3) Non-smokers could become more accepting of ‘smokers rights’ and less likely to express negative comments about smoking to their peers.
(4) Tobacco control campaigns that focus only on health effects could be less effective than campaigns that additionally attempt to counter the association made in the media between smoking and attractive, glamorous images.
Perhaps one way to counter these positive images of smoking is to increase efforts to place anti-smoking messages in movies, TV programs, novels and music, the strategy known as ‘edutainment’ (Egger et al., 1993) or ‘enter-education’ (Singhal and Rogers, 1999).
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Received on June 22, 2001; accepted on July 23, 2002
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