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Social Science & Medicine 59 (2004) 573583

Social thinking and cultural images: teenagers notions of tobacco use

Marie-Louise Stjernaa,*, Sonja Olin Lauritzena, Per Tillgrenb,c

Department of Education, University of Stockholm, Stockholm S-106 91, Sweden Department of Public Health Science, Division of Social Medicine, Karolinska Institutet, Norrbacka, SE-171 76 Stockholm, Sweden c ( Sweden Department of Caring and Public Health Sciences, Malardalen University, Box 883, 721 23 Vaster as, . .

Abstract The health hazards of tobacco use are well-known, and it is considered particularly important to prevent tobacco use among teenagers. New generations of teenagers still start using tobacco. To develop a more profound understanding of tobacco use among teenagers, the purpose of this study is to explore representations of tobacco use, smoking as well as snufng, at the age when young people often start using tobacco. Focus-group interviews were carried out with 14-15 year olds in two schools in the Stockholm area. The analysis reveals that teenagers are well informed about the healthhazards of tobacco use. At the same time they hold complex and conicting ideas concerning the relationship between tobacco use, risk, the body and human nature. At the most general level of social thinking there is a dynamic relation between the three main representations of tobacco use related to: (1) notions of risk, (2) human nature and; (3) societys efforts to discipline its citizens, which together can be seen as the social representation of tobacco use. These representations of tobacco use are discussed as related to the teenagers identity-work and gender identities. r 2004 Elsevier Ltd. All rights reserved.
Keywords: Teenagers; Tobacco use; Social representations; Gender; Social identity; Focus-groups interviews

Introduction In contemporary society, efforts are made to restrict tobacco use and particularly to prevent tobacco use among teenagers. Despite preventive activities, health education about tobacco at school and the fact that health-hazards related to tobacco use are well-known, new generations of teenagers start using tobacco. In Sweden, as in several West European countries, cigarette smoking is more common among girls (Wold, Aasen, Aaro, & Samdal, 1995; WHO, 2000) while oral snufng1 (smokeless tobacco) is almost exclusively a male habit.
*Corresponding author. Tel.: +46-8-16-31-58; fax: +46-815-83-54. E-mail address: (M.-L. Stjerna). 1 Sweden has one of the highest prevalence of smokeless tobacco use (mainly moist snuff; snus) per capita in the world, whereas the sale of moist snuff is prohibited since 1992 in other countries in the European Union (Bolinder, 1997).

The prevalence of snufng among teenagers has increased since the early 1970s, whereas smoking has decreased slightly during the last decade (Andersson, . Gronberg, & Hibell, 1999). Today, the prevalence of tobacco use is fairly equal in girls and boys: 38 percent of the boys and 36 percent of the girls, aged 1415, used tobacco (smoking and/or snuff) in Sweden in 2000. Among the tobacco users 10 percent of the boys and 15 percent of the girls were daily smokers. 30 percent of the boys and 3 percent of the girls used snuff (CAN, 2001). In this study we address smoking as well as snufng as both forms of tobacco use are addictive, and one can serve as an introduction to the other (Tillgren, Haglund, . 1996).2 A multi-disciplinary Lundberg, & Romelsjo,
2 In pre-adolescence (1112 years) there is an earlier initiation of tobacco use among boys, and a more rapid transition to regular smokers among girls (Galanti et al., 2001). Of particular interest is that experimentation with snufng among boys also marks the transition to cigarette smoking (ibid).

0277-9536/$ - see front matter r 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.socscimed.2003.11.003

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project was carried out in collaboration between the Department of Public Health at the Karolinska Institutet (Stjerna, Marttila, & Tillgren, 2000) and the Department of Education, Stockholm University (Stjerna, 2001). Of particular interest is how tobacco use is described and dealt with in the local socio-cultural context, where cigarettes and snuff are consumer goods loaded with symbolic meanings. The purpose of this paper is to explore teenagers notions of tobacco use, their shared ideas and images, how these notions are reected in their accounts about their own and other peoples tobacco use and also the ways understandings of tobacco use are related to the teenagers development of a gender identity.

moral imperative to strive for health is of particular interest in relation to smoking.

Tobacco use from a gender perspective The attitude teenagers adopt towards cigarette smoking and snufng can be seen as related to the young persons position in the social order, as a young man or woman approaching adult hood. Our point of departure is thus a gender perspective on teenagers search for an identity. Gender is here primarily understood as what we do in interaction with other people, not what we are (West & Zimmerman, 1991). Doing gender means that differences between men, women, boys and girls are socially constructed and not considered simply natural or biological. Gender is thus to be understood as an ongoing process in womens and mens lives, which children are incorporated into when they learn to observe these differences regarding their own and other peoples behaviour (ibid.). At a cultural level these differences can be described as notions of masculinity and femininity and are reected in ideas of typical male and female characteristics, interest and behaviors. At the same time, the youth of today have possibilities to choose as norms and traditions that put a pressure on former generations may have lost its meaning for generations of today (Holstein-Beck, 1995), even if such choices are circumscribed by ideas of what is considered feminine in local socio-cultural contexts. Jones (1993) argues that young women no longer have to be viewed as socialised into appropriate gender roles, but create their own positions in the social order, and consequently girls can take different positions in different situations. The search for an identity could thus be described as a central project, and young people nd themselves right in the middle of identity-work. As the question of taking up smoking or snufng is most urgent during the teen years, the young persons attitudes towards tobacco use could be seen as a part of his or her identity-work. Earlier work on the meaning of tobacco use from a gender-perspective has addressed the meaning of smoking in motherhood and in the transition towards adultlife. In her study of English womens experience of smoking in the context of motherhood, poverty and low social support, Graham (1987) found that smoking serves a contradictory function in the womens lives. Although undermining their own and their childrens health, smoking helps the women to cope with caring for their families. Cigarette smoking offered them a short break from the routines and strains of family life, cigarettes were often the only consumption women allowed solely to themselves. The meaning of smoking for young women has also been studied in relation to the transition between school and work life. Daykin (1993)

Social representation theory To explore teenagers notions of tobacco use, we take our point of departure in social representations theory, where social representations are dened as a system of thinking that affects our perceptions of and acting in the world (Moscovici, 1988). Within a group of people, social representations contribute to a shared image of reality, at the same time as conicting ideas can exist and be debated at a discursive level (Rose et al., 1995). The focus is on human beings as social and cultural beings, and on the vital function of this system of thinking to both shape and maintain social identity (Jodelet, 1991). Social representations are seen as socio-cultural phenomena which are formed in interaction between people and thus differ from a purely cognitive perspective. The understanding of peoples ideas of tobacco use can be informed by studies of social representations of health and illness. Herzlich (1973) found that when people talked about health and illness, their reections were phrased in terms of the individuals relation to society. Illness is to a great extent understood as caused by the lifestyle of modern society, and the threat to the individuals health emanating from outside. However, the individual can act in order to maintain his or her natural state of health. The relationship between health and illness, and between the individual and society, is thus characterised by conict. In this sense, representations of health and illness relate biology to social life. Today, the concept of health is imbued with far reaching implications, sometimes perceived as synonymous with success and fortune (Herzlich, 1995). To actively strive for health has become an imperative (Lupton, 1995). Also, as Radley and Billig (1996) argue, notions of health and illness are ideological. They are related to wider discourses in society that affect not only the way individuals think, but also how they feel they should think. Denitions of a healthy way of life include judgements and values and is therefore ideological. As smoking is without doubt hazardous to health, the

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found that for young women smoking could offer a symbolic adult status and serve the purpose of balancing their subordinated position both at home and at work, as they struggled for independence. To date, research on tobacco use from young peoples perspective is still limited (Allbutt, Amos, & Cunningham-Burley, 1995), and more knowledge is needed about contexts that promote smoking or non-smoking. Michell and Amos (1997) have demonstrated the importance of the gendered peer-group structure for smoking. Lloyd, Lucas, and Fernbach (1997) and Moffat and Johnson (2001) have explored teenage girls smoking identities and the meaning of nicotine addiction, and Plumridge, Fitzgerald, and Abel (2002) looked at the implication of smoking refusal on personal identity. However, teenagers own notions should be explored to further the understanding of tobacco use in the teens, which also may have implications for health promotion as suggested by Frankowiak (1987).

Table 1 The number of participants in the focus groups Group no. 1 2 3 4 5 6 7 8 9 Total Tobacco habit Tobacco users Tobacco users Tobacco users Tobacco users Non-users Non-users Non-users Non-users Non-users Sex Boys Boys Girls Girls Boys Boys Girls Girls Girls Abbr. T-B T-B T-G T-G N-B N-B N-G N-G N-G Participants 5 3 4 6 6 4 6 5 4 43

Method To capture teenagers notions of tobacco use, a qualitative approach with focus group interviews was used (Krueger, 1994). Lunt and Livingstone (1996) argue that focus-group interviews stimulate everyday communication and thus allow for the analysis of social representations. Furthermore, as Farr points out: Group discussions is a useful way of sampling the stock of arguments available within a particular culture where the researcher is interested in the arguments produced rather than in the individuals producing the arguments (Farr, 1995:6) Focus groups differ from individual interviews in that they capture the social interaction among participants and can provide knowledge about peoples shared understanding of everyday life (Krueger, 1994). Frankland and Bloor (1999) argue that the method is particularly suitable in studies of group norms, especially if participants know each other, which was the case in this study. It is then possible to gain insight into conicting views as well as consensus in the groups regarding a phenomenon. Nine focus groups were carried out with 43 ninthgrade students, 1415-year- old, at two schools in inner Stockholm, in areas with an average socio-economic structure. The rst author (M-L.S.) moderated all nine groups and another member of the research team made close observations of the discussions and interactions in the groups (Stjerna et al., 2000). Girls and boys were interviewed in separate groups, as is recommended in studies of gender issues (Debus, 1990; Krueger, 1994). Tobacco users and non-tobacco users, according to their

own presentation of their tobacco habits, were also placed in different groups to stimulate discussions and avoid a polarization between teenagers with different experiences of tobacco use: Table 1. The non-tobacco users did not smoke or use snuff at all. Tobacco use varied from occasional smoking/ snufng to regular smoking of 1020 cigarettes a day or snufng on a daily basis.3 The discussions4 revolved around the teenagers views on boys and girls tobacco use at home, at school and in their leisure time, and on how tobacco use is represented in the media, with a focus on what they saw as its advantages or disadvantages. All nine groups were tape-recorded and transcribed verbatim. The analysis was conducted in three steps (Stjerna, 2001). First, the teenagers talk about tobacco use was described according to the strategy of analytic induction or deviant case analysis (Frankland & Bloor, 1999). Starting with one interview, eight themes were identied; (1) health and tobacco use, (2) the agelimit of tobacco purchase, (3) school and tobacco use, (4) media and tobacco use, (5) the aesthetics of tobacco use (6) the pointless tobacco use, (7) presentation of self, peers and adults as tobacco-users, (8) presentation of self and peers who do not use tobacco. The description of each theme was then modied, with openness to new themes and sub-categories, in the process of including more material from all groups. The focus was here directed towards conicting views and concordances in the groups. The second step was to identify notions of tobacco use which were shared among the teenagers. At this level, the focus was on the
3 The majority of the 25 non-tobacco-users had tried smoking earlier, 12 boys and one girl had tried snufng. Among the 18 tobacco users more girls than boys use tobacco on a daily basis. 4 A topic guide was used to stimulate to discussions among the focus groups participants and to cover certain topics of interest: tobacco use related to (1) the age-limit of tobacco purchase, (2) school (3) family (4) leisure time (5) advantages and disadvantages of tobacco use (6) media and (7) gender.

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teenagers ways of understanding the world, for example their assumptions about male, female, the body, generation and tobacco use. The nal step was to identify the most general themes constituting the social representation of tobacco use and to develop a deeper understanding of the teenagers cultural repertoire of identities.

related to aesthetic values. Some girls refer to tobacco information they have read in girls magazines:

Like, there are models who appear in magazines and tell you that smoking is bad. That it gives you a bad complexion and then you think y Ill never be Miss Sweden. (Group 3, T-G)

The social representation of tobacco use The analysis revealed that the teenagers shared understandings of tobacco use revolve around notions of risk, human nature and societys efforts to discipline its citizens. At the most general level of social thinking, there is a dynamic interplay between these notions. Tobacco use as risk The teenagers talk about the risk of tobacco use in relation to physical health and addiction to tobacco. Smoking is related to negative social development, such as drug abuse, primarily among non-users, and to images of the problematic smoker. According to the teenagers, smoking will eventually lead to the breakdown of the whole body. Notions of the body as inner and outer, or invisible and visible emerge in the ways the girls and boys talk about the absorption of oxygen and the functioning of lungs when smoking. They describe that the invisible process inside the body, when smoking, will gradually be visible on the outside of the body. This implies a way of thinking of risk as a process, which also is related to a dimension of time. Pictures of the smokers lungs which have been shown in tobacco education sessions at school, are described in terms of how smoking destroys lungs and makes them disgusting. When talking about the outside of the body, a non-smoking girl (group 9) says: Maybe they look good now (others of the same age who smoke), but if you wait, if you, like, look, all our parents who smoke, they dont really have nice teeth. Snufng is not associated with illness and death the same way as smoking, but more with the health and hygiene of the mouth. Among the boys, there is an idea that snufng could have positive effects, such as increasing their sports performance. To this degree snufng is attributed a health value, but if one wants to avoid risk all together one should not use snuff. There seems to be a close relationship between smoking, illness and ugliness. For example, a boy who does not use tobacco (group 6) thinks that it is the cells in the face that will be destroyed by smoking and that a person does not have to become ugly provided he or she abstains from smoking. The bodily processes are also

Some of the aesthetic effects of tobacco use show immediately. Cigarette smoke smells and the snuffer looks ugly as the snuff changes the shape of the lip:

And moist snuff is disgusting when it hangs outside the lip (laugh). Then when it is spit out there is some left between the teeth (laugh). Then it is so damned disgusting when they laugh. (Group 5, N-B)

Furthermore, in the long run the smoker runs the risk of becoming seriously ill as a result of smoking. However, the teenagers stress that it will take a long time before the more serious consequences of smoking occur (if they ever do). This means that ill-health due to tobacco use does not have to be a reality until the distant future. This indicates different notions of risk related to the young and the adult smoker as well as a risk dimension, spanning from almost no harm to serious danger. At one end of this continuum is the teenager who has been using tobacco for a short while, and at the other, the adult who has been a smoker for almost a lifetime. The teenagers seldom question tobacco facts. Such facts are understood as valid on a general level, but the teenagers sometimes wonder if information about smoking is exaggerated:

Except, the information you get, you dont really know if its true. But, it most probably is. I dont know. Most often you think that they only want to scare you and, like, exaggerate about things. Thats what I think they do. (Group 1, T-B)

The meaning of these facts is sometimes renegotiated at the level of the individual, making smoking or snufng seem appropriate for some individuals. The teenagers stress that people differ in bodily constitution as well as values. Some people may never experience illness due to smoking. A boy who smokes puts it this way:

I dont feel the need to quit smoking. I dont know why. I havent noticed that Im less t, than I need to be, because I dont feel less t. I still ride my skateboard and, like, play oor ball and stuff like that. I can still do it just as well. (Group 2, T-B)

The teenagers assume that people evaluate what is important to them. It is not possible to smoke if you want to be a successful sportsman or woman, but if you

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are just an ordinary jogger, the issue of smoking is not as important. Also there is the idea that some people are attracted to danger, and see a value in risk-taking, which is one reason for them to choose to smoke. The teenagers are thus informed about the risks of tobacco use. However, an underlying dimension in their reasoning is the assumption that it is possible to be healthy and smoke. At the same time a constant danger, a health hazard, is lurking in the background. Lupton (1995) refers to the function of cigarettes as an expression of beauty, pleasure and death: Cigarettes are negative pleasure; they risk death even as they full desire (Lupton, 1995:153). The smokers caring for ones own health has been described as subordinated to other concerns (Graham, 1987; Lupton, 1995). What is indicated in this study is that tobacco use and health are not always seen as contradictory at the level of the individual, and smoking during teen years is not necessarily thought of as turning away from health. Tobacco use and human nature The teenagers express the idea that human nature makes people susceptible to tobacco use. This idea is related to the view of the teens and is closely associated to teenagers identity work. Smoking is sometimes described as part of teenage lifestyle; such as being together with friends, going out and enjoying oneself. The girls who smoke talk about growing older when they will quit smoking:

* *

When youre like 30 years old, you dont go out with your friends in the same way. Maybe, you just sit at home and watch TV with your husband and kids (laugh). God, that sounds boring. Yeah, I know but then you dont really have the need to smoke. (Group 4, T-G)

Family life is thought to put adults under the obligation not to smoke. Parents should not smoke in front of their children or allow them to smoke:

considered more responsible than teenagers. Some boys who use tobacco (group 1) say it is okay if their parents smoke, but only if they try to stop. Less common are explicitly expressed worries about a smoking parent He smokes lots and lots, an awful lot. And that is, like, and I become sad, because you know that, what the risks are, that he can get cancer and all that stuff. (Group 8, N-G). The overwhelming reason why adults smoke, according to teenagers, is because they are addicted to tobacco. The idea is that parents and grandparents started to smoke at a time when they didnt know much about the health-hazards. This is seen as a legitimate reason for adult smoking but less legitimate for teenagers, who smoke just in order to be cool: Its idiotic to start smoking now, but it wasnt back then. No one knew that you could get cancer then and the thing with nicotine, you just cant quit later on. (Group 6, N-B). Smoking is thus seen as a symbol of adult life, but thought of as loosing its attractiveness after the age of 18, when one is ofcially grown-up. When it comes to their own tobacco use, the teenagers describe the meaning of peer-pressure differently according to their experiences of tobacco. The non-users argue that smoking gives young people access to social life, and peer pressure is about belonging to a certain group: This thing with smoking. Its just a status thing with wanting to belong to a group and stuff like that, I think. You want to be cool (Group 6, N-B). The peerpressure is then seen as the smokers desire to attain a certain image. Everybody has a dream of being popular and some people do anything to achieve this. Susceptibility towards smoking could in this sense be understood as a deeply human need to belong to others. As rational beings, smokers act in order to full their needs, for instance to achieve high status or belong to a social group. Among boys who smoke, the credo is that it is wrong to expose others to pressure to smoke, but everybody has the right to make ones own choice:
* * *

One person in our class is allowed to smoke at home. Her dad lets her. But I think it isy Thats no good. I dont think that is taking their responsibility as parents if they let their kids smoke a home. (Group 9, N-G)

I think every one should do as they wish. Yeah, I do too. I guess thats how it is with everything. Only if it doesnt directly affect others. You get so much information. You know that its dangerous. It you want to smoke, you can do it anyway. (Group 1, T-B)

Also, it looks bad if mothers smoke: she sat with her little baby over her shoulder. The baby was like, two weeks. She sat and smoked over her kid (Group 4, TG). At the same time, there is an opinion that adults have limited possibilities of controlling teenagers. For example, a boy (group 2) says that his mum doesnt approve of him smoking, but there isnt much she can do about it. There is some acceptance of adult smoking, as adults are supposed to do what they want and are

All but one of the smoking girls emphasise it was their own choice to smoke. When they started, smoking was a fun thing to do. These girls focus on the pleasure, the new and the excitement of smoking, but stress they dont smoke in order to be cool: if I dont smoke or drink then Im still cool, Im still noticed, no but heard, noticed, everything, just the same in school (Group 3, T-G). From this point of view smoking is seen as an offer, possible to realise through friends who smoke.

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This is in line with other studies suggesting that girls who smoke are more socially skilled, self condent and rebellious than their non-smoking peers (Clayton 1991; Michell & Amos, 1997). The point is that girls who smoke are not unable to refuse cigarettes, but actively choose to smoke. Both boys and girls who smoke stress that one reason they smoke is because it is a social thing to do. When smoking, they spend time together with friends during breaks in school or after school hours and at parties, which means that smoking functions both as an activity and a way to make friends:
* *

dont have to be like others. You dont have to, like, follow theirsy (Group no 9, N-G). To conclude, it is not human nature, the susceptibility to tobacco use, that varies, but the individuals ability to handle the consequences. Furthermore, the human ability to deal with tobacco use is seen as related to the phases of the life-cycle. Teenagers differ from adults in terms of maturity, which determines their different abilities and obligations to take responsibility for their own and others behaviour. Tobacco use and societys efforts to discipline its citizens The third theme in the representation of tobacco use is the role of society. The teenagers opinions about the role society ought to take, actively or passively, is related to their view on tobacco use and human nature, in particular the ways tobacco use is perceived as normal or not normal. The teenagers who use tobacco argue that frequent smoking among adults makes it normal. They (smokers) are a part of society. They are everywhere so, like, I mean its not really anything you think about, much. Oh no, that person is smoking, who cares (Group 2, T-B). The idea that tobacco use is an articial need, which makes it not normal, is most strongly articulated among the non-users. However, the scientic evidence of the health hazards is used as a strong argument why society should act among both users and non-users. This evidence is often presented as a moral imperative to abstain from tobacco, and in the focus group discussions it is apparent that the responsibility for ones own health and the responsibility towards others is closely associated to guilt; tobacco use is perceived as non-hygienic and causing illness. Snufng, however, is more at ones own risk and is mostly related to aesthetic values: But I think its better, because the ones who use snuff just affect themselves. Its nothing that affects anyone else. But if someone is standing smoking and blows smoke in your face, then you also breath it in and that affects you. (Group no 8, N-G). In this study, the teenagers present themselves as the informed generation, who are well aware of the health hazards of smoking. There is a strong consensus among boys and girls that there is no new information about smoking. However, the case of snufng is less clear. The teenagers stress that they do not know as much about snufng compared to smoking, but snufng is viewed as less hazardous to health than smoking:

* *

But you smoke because its sociable. Yeah, you make new friends, can stop a goodlooking guy in town and ask for light (laugh) Yeah, exactly, its terric. So I mean, when I came to this class, then it was, I got to know her just because we went out and smoke at recess, like. Like, what would we otherwise have done? (Group 3, T-G)

According to the teenagers, there is a difference between smoking as a social act and being addicted to tobacco. The smoking girls are not sure they want to give up smoking. When they have tried to quit they get irritated and in a bad mood and some describe physical cravings for smoking, such as cramps in the stomach. The boys who use tobacco say they are able to stop whenever they want to, thus locating themselves in a phase of invincibility, which can be seen as a paradoxical standpoint I smoke, but I am not a smoker (Moffat & Johnsons, 2001, p. 673). At the same time it is perceived as risky to continue smoking: But what I think is that I know that I can quit right now, but then maybe you keep on thinking that youve only just begun, so maybe some months pass by without thinking about it, then maybe suddenly, you cant quit (Group 1, T-B). Compared to the boys, the girls present a smoking identity which recognises their addiction to tobacco, which similar to Moffat and Johnsons (2001) study of American girls. Smoking gives you pleasure (you dont really want to quit) and at the same time it is out of control (it is difcult to quit). From this point of view, addiction to tobacco is seen as the inevitable result of continuous use. Among non-users, the disposition to develop an addiction is also understood as a human weakness. At the same time there is an understanding that individuals are different. For example, non-users, like themselves, have the mental strength to resist the pressure to smoke. The boys who do not smoke (group 6) suggest that to refuse smoking at their age proves a certain maturity, strength of character or self-condence. The nonsmoking girls argue that it feels good not to do as everyone else: I think is an advantage in being able to say that you dont smoke. Youre not like others. You

They should remove the sign (health information on snuff package), because it isnt known whether its as harmful in that way (the boy is referring to the cancer risk). The only thing is that, like, its eats away your lip, the underside of the lip. You get cancer, you can get cancer.

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But its not like, its, you cant die from using snuff. Or anyway, they havent found that yet. (Group 5, N-B)

Also, there is an understanding that society has possibilities and obligations in the restriction of teenage use of tobacco. However, the teenagers nature makes it difcult, as teenagers are thought of as living here and now and also stretching rules. The teenagers attitudes towards societys right to intervene are related to the question of whom the measures are directed to. Children are considered incapable if taking responsibility for their actions and should therefore be protected from tobacco use. In addition, tobacco use is viewed as inconsistent with the idea of childhood. The age-limit of tobacco purchase (18 years) is worthwhile because it could prevent young children from smoking:

of tobacco use. Part of identity-work consists of . s, 1995), we examine developing a gender identity (Forna the meaning of collective identities that are used by the teenagers to develop an understanding of social life. Such cultural images, in turn, say something about values and ideals in our culture. The identity of the young smoker, snuffer and non-user One characteristic of teenage culture which emerges in this study, is that smokers are largely portrayed in a positive manner. It is the cool ones with high status in the teenagers hierarchy who smoke. The popular ones go to parties, drink alcohol and smoke. The idea of peer-pressure is intertwined with this positive image of those smoking. Also, according to the teenagers, those who begin smoking widen their circle of friends: But if you start smoking, then you start drinking, then you get to know everyone, the ones who are so-called popular and cool. (Group 9, N-G). This is in line with other studies of the structure of young peoples social networks. Urberg, Degirmencioglu, and Pilgrim (1997) showed that when young people tried smoking or drinking alcohol, they often started to socialise with peers who smoked or drank alcohol. A limited use of tobacco or alcohol could lead to positive changes in the relationship to peers, as found in a study of German teenagers (Maggs & Hurrleman, 1998): for example, more occasions when peers spent time with each other and increased experiences of having a central role in the circle of friends. In a Scottish focus-group study, teenagers described their relations as formed within a hierarchic structure (Michell & Amos, 1997). Girls at the top, who were cool and good-looking, were the ones smoking. These girls can be more vulnerable to smoking as they could use cigarettes to form a certain image of themselves. For boys with high social status, smoking did not seem to have the same social signicance. Participation in sports activities and other interests, such as computers and music, seemed to protect them from smoking, as in this study. However, a substantial proportion of the young Scottish female smokers also had sophisticated social skills, which makes the image of their smoking behaviour more complex. In our study, we have seen that both girls and boys who use tobacco stress that it is a personal choice to start smoking. Although smoking has a gender loading towards the feminine, it is also perceived as gender neutral:

* *

But then these little kids who see the cool people standing back here smoking (at school). Then they think that it is okay, because there isnt any age limit or anything. Then no one talks about it. Then, maybe, like, hash begins to be like this, likey Smoking. Yeah, right and then it just gets worse and worse. I dont think that you can, you cant just cant just go ahead and allow it. (Group 6, N-B)

The majority of teenagers who use tobacco argue that at 1516, the teenager has attained the awareness to handle tobacco use. The non-users present a rival idea; smoking during the teens could be described as youthful foolishness, even though the psychologically mature teenager is able to decide about his or her own life. The teenagers think that most adults want to quit smoking, but are unable to, and smoking in middle age is thus described as a cul-de-sac: Then I think (the girl is referring to adults who smoke) poor, poor person, like, that is stuck and has smoked their whole life, type of thing. (Group 3, T-G). To summarise, teenage smoking and adult smoking are viewed as separate phenomena. Risk, the possibilities of society to intervene and to a certain degree the human nature is thought of as varying in relation to different phases of the life span. The teenagers also stress the differences between smoking and snufng. The risks of using tobacco are thus seen as varying. The teenagers representations of tobacco use can thus be seen as characterised by a dynamic relationship between, on the one hand, notions of the susceptibility of human beings towards the risky smoking and on the other hand, the opportunities and obligations of society to intervene in this course of events.

A cultural repertoire of identities To understand the gender aspects of tobacco use, we looked more closely into the different cultural images

I dont think it matters if they are girls or boys. Its just the ones who, like, want to meet others instead of sit at home and study. I think that its probably those ones that start smoking. (Group1, T-B)

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According to Michell and Amos (1997) smoking does not seem to be an issue for girls positioned in the middle of the teenagers hierarchy. Those girls who were doing well at school and had positive aspirations for the future did not feel a pressure to smoke and were safe from smoking. Plumridge et al. (2002), on the other hand, argue that smoking as well as smoking refusal are important identity statements, which means that nonsmoking teenagers are always faced with the problem of accrediting themselves against superior smokers cool group (2002 p. 167). In our study, the non-users present positive images of non-smokers and negative of their smoking peers, which could be described as rivals to the positive image of the smoking teenager. This implies that smoking could always be understood as a topic of interest in the teenagers culture. Although images of smoking and non-smoking youths seem to circulate in teenager culture, this does not necessarily mean that the non-smoking individual always will nd him or herself having to struggle against their inferior status compared to peers who smoke. Rather, these images could be understood as a repertoire of different values and ideals among teenagers, with implications for smoking uptake or refusal. This reasoning gets some support in a British focus group study of girls construction of non-smoking and smoking identities which demonstrated that girls not only have different tobacco habits, but also different ideals (Lloyd et al., 1997). The non-smokers identity was rated more sensible than the smokers, by nonsmoker as well as smokers, whereas the smokers identity was rated more fun-loving. On the other hand, being mature was desirable to smoking as well as non-smoking girls, but may be constructed differently as both groups claim to be mature. If we assume that different groups of teenagers accept different ideals, this can be problematic for the non-smokers as well as the smokers. Individuals are not free to fashion their identity as they choose, but have to do so under conditions of others readings of their competence. Each has to make a claim to some identity, but lacks the power to ensure the claim (Plumridge et al., 2002, p. 169). However, smoking alone is no guarantee for being accepted as cool, the right clothes and being seen with the right people was just as important (ibid). The conclusion is that there seem to be continuos ongoing negotiations concerning identity claims in the social space of teenagers. In our study, the teenagers speak about non-smokers as associated with psychological strength and willpower to make ones own choices. The boys who represents themselves as athletes (group 6) say it is a natural thing not to smoke, but snufng is possible for a hockey or football guy. Also, their smoking peers can claim that those who do not smoke are smart or are impressed by their non-smoking status. This is in line

with Michell and Amos (1997) ndings that an interest in sports or computers can protect from a meaningless life, which could be the breeding ground for smoking. The dreary character of the swot also changes when the school is presented as an interest which prevents you from smoking, as found in a British study where the non-smoker was portrayed as interested in school life. Girls who adopted this identity were likely to refer to girls who smoke as stupid (Lloyd et al., 1997). At times, the non-users talk about tobacco use as problematic behaviour. For example, the smokers hang around, consume alcohol and are potential troublemakers. By the use of tobacco they take risks which could lead to drug abuse:

If I think back to when I was in elementary school, its like, when you look at the photos: everyone was so little, no one is going to smoke. Then, there they stand with a cigarette in their hand or lying somewhere in a ditch drunk. Its like, its almost sad to think about. Such little children: you sit and you look at the pictures. In that picture they didnt know that they would begin smoking and drinking. (Group 9, N-G)

Images of female and male tobacco use The teenagers assume that girls and boys are brought up to a female and male identity, respectively. According to this view, upbringing in the family and the commercial market are important socialising agents. The reason why girls and boys, act differently in some respects, is associated with different ideals and the different expectations they are confronted with: I think that girls are more into their appearance and stuff like that. Because they are more used to that role, they put on makeup and stuff like that. And its like, smoking is a little more like, the appearance like, how you look(Group 6, N-B). One idea, put forward by the non-smoking girls (group 9), is that girls smoke in order to avoid eating candy and putting on weight, based on the assumption that girls learn to pay great attention to their appearance. Smoking is also understood as an attribute that girls can use in order to create a special image of themselves. The entertainment business is given a prominent role in this process, as a creator of images. Boys are also presented as anxious about their appearance, but boys and girls are thought of as having different ways of expressing themselves. Boys and girls deal with smoking in different ways, even if there are exceptions:

Girls are more discreet about smoking. When they come into the classroom they breath more through their nose. They try to avoid their ngers, and they ask: Like, do I smell of smoke? When boys come into

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the classroom they couldnt care less if they smell of smoke. Right (laugh)? Thats exactly right. Most of themy Well, take Maria, for instance. This is how she is (the boys inhales and exhales) then she enters like this. But, like, she doesnt give a damn about anything. (Group 2, T-B)

The teenagers argue that girls shouldnt snuff. Snufng is considered un-feminine and thus a typical male thing; If girls smoke, if boys smoke, no there is no difference. They can smoke as much as they want to, as we want to. But no snufng. (Group 1, T-B). They stress that it is not common for girls to snuff, but if they do, they snuff in a more tasteful and discrete manner than boys. It is more acceptable for a man to snuff. The girls who use tobacco (group 3) say that although snufng is disgusting, boys who snuff can be friendly and very sweet. But in any case boys shouldnt snuff for aesthetic reasons: I dont think that boys should use snuff either, because its so unattractive. I mean, God, just putting it in like that, no you cant do that, like making your face uglier. (Group 3, T-G). Furthermore, for the teenagers the meanings of ! s are associated with certain elds, contexts and cliche female or male signicance. Different types of tobaccos have male or female connotations, which in turn are associated with different contexts. Pipes and cigars are male. Cigarettes are both male and female with domination towards the female. Snufng is considered male. Further, snufng is associated to male elds such as hockey, football, hunting and construction work:
* * *

Snuff, yeah, its likey Yeah, its manly or men in their 30s. Like, construction workers. Yeah, like with checkered shirts. Who hunt. (Group 9, N-G)

When associated to glamour, smoking is consistent with a feminine style: Yeah, but like, they (the boys is referring to girls his age), they want to look so bloody good and go around with their cigarette trying to look glamorous. (Group 2, T-B). The teenagers also reect on smoking heroes (men) in action movies:

woman, a seductive and slightly dangerous femme fatale. These images could be related to smoking women earlier in the 1900s, who were not considered respectable (Waldron, 1991). Also, the feminine and masculine can be reected in the way one smokes and holds the cigarette. The girls who smoke (group 4) think it is charming and smart if boys smoke in a certain manner, which is relaxed and cool. The teenagers reasoning reect roles and identities divided by gender. At the same time it is possible to break gender norms and expand conventional gender roles. As Jones (1993) argues, there are several positions for a female subject. In the group of boys who use tobacco (group 2) suggest that it is alright if tough birds use moist snuff compared to mini catch which is seen as a more feminine snuff. However, to break norms can be risky. A boy who smokes in a feminine manner runs the risk of being seen as sissy. A girl who snuffs could be viewed as mannish. The teenagers usually do not explain gender differences in terms of biology, but snufng is a less clear case since it is considered to be a male practice given by nature; men have for a long time practised the habit. Consequently, the ways snufng is reserved for men is not viewed as discrimination of women. However, girls can break into this male eld if they do it in a way that is consistent with what is accepted as feminine in the culture. To sum up, the repertoire of possible identities to some extent reects the cultural images that teenagers face and have to deal with as part of their identity-work. The analysis shows that the teenagers cultural images of female, male and youth identities and behaviour are fairly stereotyped. However, the tension between different types of images, such as the cool or the problematic smoker, as well as the possibilities of crossing gender barriers and expanding traditional gender identities, indicates that what should be considered feminine, masculine and the identity of the young smoker is continuously negotiated in different social situations. At the level of the individual the teenager can draw on these cultural images in different ways in different social contexts. The cultural images could thus be seen as offers and allow for different ways of expressing gender identities.

* *

when we saw a movie at the cinema. It starred Bruce Willis and what the hell he is calledy Die hard? No, but never mind about that. In it he smoked so damned much and he was really mean, really shooting down every last person and stuff like that. (Group no 6, N-B)

Conclusion What conclusions can be drawn from the analysis of the teenagers social representation of tobacco use? The fact that the notion of the cool smoker emerges in this study, limited to urban Sweden, as it does in other European studies (Michell & Amos, 1997; Plumridge et al., 2002) indicates a more general notion of the tobacco user in Western teenage culture. However, the analysis reveals a more complex pattern. First, the

If it is a tough cowboy who smokes, the genderloading is male, the strong man. This male stereo! ; the glamour type could be compared to a female cliche

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tradition of snufng adds another dimension to tobacco use in Sweden, which is presented as less harmful than smoking and goes well with a traditional male identity. Secondly, the teenagers are informed about tobacco facts and do not question the health hazards at a general level, even if the correctness of these facts are discussed. At the same time, the risk of tobacco use is reinterpreted at the individual level. The individual has a responsibility for her own and others health, but this is open to be negotiated within the local socio-cultural contexts of teenage life. Most importantly, smoking during teenage years and adult life are viewed as separate phenomena. The teens are viewed as a phase in life characterised by certain conditions, and tobacco use in this phase is not necessarily thought of as turning away from health. In these ways, the teenagers challenge a more fundamental imperative of health (Lupton, 1995) and cultural understandings of health as a symbol of happiness (Herzlich, 1995) in contemporary Western societies. The conclusion is that, although well informed about the health-hazards, the teenagers notions of tobacco use forms a paradox; although considered risky, smoking is thought of as possible during the teenage years, since the most alarming dangers are attributed to the adult smoker. This pattern, in turn, seems to be intertwined with certain youth and gender identities. The teenagers see the individual as shaping her own destiny, as an individual acting within a social context. This takes place in a rapid stream of different inuences, such as upbringing in the family, teenage culture, market forces and societys efforts to discipline its citizens. Part of this inuence is the possibility of tobacco use. When confronted with the offer of tobacco use, loaded with symbolic meaning, teenagers are thought to differ in psychical strength and capacity to handle this offer in the context of identity-work. Here, the notion of human nature is important, and the nding that teenagers separate the childs nature from the teenagers, but not male from female. However, even if the teenagers nature creates a common platform for identity-work, to be a boy or a girl, weak or strong is seen as making a difference. We would argue that teenagers notions of tobacco use should be understood within this context of identity-work, reecting the fundamental condition of modern man to be obliged to form an identity (Giddens, 1991; Smart, 1999). This study has shown that the teenagers hold complex and conicting ideas concerning the relationship between tobacco-use, risk, the body and human nature. These results may have implications for preventing tobacco use among teenagers. Of particular importance are the ways images of tobacco use are intertwined with ideas of different identities that the teenager could strive for or try to avoid. We have seen that boys and girls tobacco use are described as related to different values

and gender loadings. Also, some teenagers, mostly girls, articulated an identity as smokers whereas others were more likely to view themselves as social smokers. Other researchers (Michell & Amos, 1997, Plumridge et al., 2002:169) have stressed that girls seem to be more vulnerable to smoking uptake due to different peer pressure and have more limited possibilities of forming alternative identities to the cool smoker, whereas boys seem to be more protected as they can establish themselves as physical beings. In other words, there are gendered solutions to the problem of being a nonsmoker. We agree with Wearing, Wearing, and Kelly (1994) argument, that to prevent smoking in girls, there is a need to provide enriching experiences in the leisure eld, which can extend the repertoire of female identities beyond the traditional. To do this, we think it is important to take teenagers social representation of tobacco use as a point of departure.

Acknowledgements We would like to thank the teenage girls and boys who participated in the focus groups discussions and Dulcinia Da Costa for her translations from Swedish of the teenagers vividly described views on smoking and snufng. We would also like to thank the anonymous referees for constructive comments on an earlier version on this paper, as well as the Swedish Cancer Society for funding the initial phase of this study.

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