Explore Perceptions of Smoking Initiation Among Highly Susceptible Precontemplators in Urban Low Income Communities

Tuesday, July 12, 2011: 9:10 AM

Huey-Shys Chen, PhD, RN, CHES
Melanie Percy, PhD, RN, FAAN
School of Nursing, University of Medicine and Dentistry of New Jersey, Newark, NJ

Learning Objective 1: The audience will be able to describe the perceptions related to smoking initiation for highly susceptible precontemplators in urban low income communities.

Learning Objective 2: The audience will be able to determine the factors that help highly susceptible precontemplators remain smoke free.


  To describe highly susceptible African American children's perceptions and attitudes towards beginning smoking at the precontemplation stage; to determine effective strategies to keep highly susceptible precontemplators smoke free.


  African-American children, (ages 9-11 years) from an urban, low-income, after-school program were recruited for this study. A screening tool was used to identify children who had never smoked, but had at least one risk factor for smoking initiation. A convenience sample of 70 children were invited to join the study. Focus groups were used to understand the meaning of smoking, and how those meanings influence smoking behaviors. Interviews were audiotaped and transcribed. A content analysis was conducted to identify and organize the themes.


Three themes were identified: 1) reasons for smoking; 2) why it's hard not to smoke, and 3) ways to avoid smoking.. Children from the study identified reasons that that high-risk precontemplators to begin smoking; such as having smokers in the family, peer pressure, “fitting in”, needing an increase in energy ,being “stressed out” , “being cool, like an adult”. Participants also identified important reasons not to smoke, these included smoking can cause: death, health problems, addiction, negative effects on others, and bad impressions about people who smoke. Some of the most useful interventions to prevent children from smoking were regular exercise, stress reduction, and smoking prevention interventions.


These findings suggest that the contents of smoking prevention programs with highly susceptible African American school aged children should focus on: 1) increasing the children's self-efficacy and ability to resist social influences that encourage smoking ; 2) enhancing decision making ability; 3)emphasizing the health consequences of smoking and the benefits of resisting smoking; , and 4) teaching effective stress management skills.