Why do young adult smokers continue to smoke despite the health risks? A focus group study

The focus of this article is on constructions of health and illness in relation to smoking. Specifically, we were interested in how culturally embedded health promotion messages were discussed and understood by our young smokers - and how continued smoking was rationalised in the context of a thoroughgoing anti-smoking climate. To investigate accounts of smoking maintenance, we conducted focus group discussions (N = 22 groups) with young adults from both high school and university settings. Techniques from discourse analysis were used to identify significant patterns of talk around health and smoking, and three main repertoires were elicited. First, the health risks of smoking were downplayed in several ways (e. g. by citing other risky activities). Second, the putative health benefits of smoking were emphasised (e. g. stress relief). Third, smoking was construed as a temporary, youthful phenomenon, which would cease upon entering responsible adulthood. The implications of these three interlocking repertoires are discussed in relation to smoking maintenance, and suggestions for targeted health promotion are made.