The social context of smoking among African-American and white adolescents in Baltimore City

Objective. To describe and understand variations in social influences on smoking behavior among African-American and white male and female adolescents in Baltimore City, USA. Design. A qualitative study where adolescents, both smokers and non-smokers, were interviewed individually (n = 21) and participated in focus groups (n = 18 focus groups, 3-10 participants per group). Results. Social contexts emerged as most relevant and salient themes related to smoking behavior. White females perceived the most permissive parental messages around smoking, while males, especially African-American males, reported receiving the strictest parental sanctions. Females' need to fit in with peers contrasted with males' being coerced to smoke. Possible reasons for African-Americans' non-use of cigarettes include a desire not to disrespect parents and being turned off by parental addiction to nicotine. All adolescents cited the school's lax anti-smoking policy as a reason teens smoke at school. Conclusion. Interventions targeted at schools and families offer promise for reducing adolescent cigarette use.