Adolescents’ interpretations of smoking imagery in film: implications for future smoking

Abstract

Smoking uptake during adolescence continues to present a perplexing public health issue in New Zealand. The plethora of adolescent smoking research is testament to the immense academic effort devoted to developing an understanding of what factors motivate smoking initiation. It is evident that the causal pathway to smoking is both complex and multifaceted and therefore precludes a simple etiological explanation. Favourable portrayals of smoking in popular film have been investigated as a potential motivator to smoking uptake among adolescents. However, few studies have been conducted which explore adolescents’ perceptions of smoking imagery in film or assess how these beliefs and common understandings are moderated by various social demographic and cultural contextual factors. Two principal theoretical approaches, social representation theory and a cultural studies perspective, guided the interpretive analyses of the studies. Three studies were conducted to investigate the role of tobacco imagery in film in the development of an adolescent's self-concept and smoking-related beliefs. The first two studies employed a qualitative research methodology to develop rich, descriptive accounts of young and older adolescents' understandings of tobacco imagery in film. A series of focus group interviews were conducted with Year 8 students (12-13 years) and subsequently with Year 12 students (16-17 years). Groups of 6 - 8 students were randomly selected from a range of Auckland schools. The studies aimed to explore how young people made sense of smoking imagery that are presented in recently viewed films. The two studies (year 8 and Year 12) were conducted independently. During the interviews, participants discussed their recollections of, and responses to, images of tobacco use in recently viewed films. Findings from the studies suggest that younger and older adolescents perceive smoking imagery to be highly pervasive in popular film. In addition, adolescents in the studies were predominantly nonchalant about smoking portrayals in film. However, various factors influenced the extent to which a smoking image was perceived as salient and credible. Images that resonated with expectations and experiences of tobacco use were therefore considered an accurate representation of reality and were more likely to be considered authentic and credible. Within the older adolescent study, findings suggested that images that depicted the lived experience of being a smoker (addiction, cravings, and smoking as stress relief) were especially salient. Alternatively, younger adolescents were more likely to draw upon a scripted knowledge of tobacco use, or familial experiences of being a smoker, to register film representations of smoking as authentic. Evidence of a patently ‘fake’ smoking performance detracted from the salience of an image. Overall, few participants expressed negative responses to the inclusion of smoking imagery in film. A questionnaire was subsequently designed based upon the theoretical constructs extrapolated from the two qualitative studies. A randomised, stratified sampling strategy was used to obtain two representative samples of Auckland Year 8 and Year 12 students (N = 3042). The sample was stratified according to school decile rank, gender and ethnicity. The total sample constituted 48% (n = 1464) Year 8 students and 51.8% (n = 1576) year 12 students. The median age of Year 8 students was 12 years, within the Year 12 group; the median age was 16 years. The questionnaire was designed to assess different perceptions of smoking in film and smoking in real life as a function of age level, gender, smoking status, and ethnicity, on young people's perceptions of smoking imagery in film. The second aim was to assess the extent to which smoking imagery is perceived to be an influential factor in the transition to smoking. The third aim of the study was to develop and test a model that would assess the relationship between the theoretical constructs that emerged from the qualitative studies, and smoking expectations. Findings revealed that age level, gender, smoking status, and ethnicity were associated with perceptions of smoking imagery in film and the normalcy and acceptability of smoking in real life. Specifically, smokers were more likely to perceive that smoking imagery is common in film. A significant difference was also detected between the age levels and smoking status across smoker stereotypes. Age level, smoking status and ethnic group affiliation were associated with perceptions of smoking prevalence among friends and adults. Path analyses were also conducted to test the relationships between the constructs in the theoretical model. Results indicate that perceptions of smoking prevalence, a non-judgmental attitude towards smoking in real life and positive associations with tobacco use in film are associated with smoking in the future. Findings from the studies provide evidence that young people are attentive to smoking imagery in film and these images have differential meanings according to a range of contextual and cultural factors. Smoking imagery in film may play an important supporting role in the construction and maintenance of ambivalent smoking beliefs. Socio-demographic variables, in particular age level and smoking status, are associated with adolescents’ perceptions of smoking imagery in film. Perceptions of smoking in film are also associated with contextual factors such as beliefs about the normalcy and acceptability of smoking in reality. The findings therefore emphasise the relevance of exploring viewers' perceptions of smoking imagery and their lay beliefs about tobacco use when assessing the impact of smoking imagery on smoking outcomes.