The issue of tobacco smoking is increasingly becoming an essential element to discussions about community and individual health. As smoking and all of its side effects and co-morbidities are the most preventable behaviors and diseases in the world (Bricker, Rajan, Andersen, & Peterson, 2005). The diseases and/or conditions directly associated with smoking are the most deadly group of diseases there are and yet young people continue to begin smoking at alarming rates (Munafo, & Black, 2007). This work will specifically look at the identifiable social/cultural and personal reasons why people and specifically young women ages 18-30 in the U.S. begin smoking in the first place.
The work proposed will be a mixed methods research methodology that utilizes both qualitative and quantitative data. In general, most of the research related to cigarettes that has been done is quantitative in nature, relying on statistical analysis. While quantitative research is important to find out smoking prevalence, smoking patterns, and smoking-related illness, it cannot alone capture the complex social, cultural, political, and economic aspects of cigarette use. Qualitative research has thus emerged as the way to improve the understanding of some of the more elusive aspects, such as why women start and continue to smoke. Qualitative research is also the way to explain some of the findings from quantitative research or to provide data that can inform research questions in quantitative research.
This work will take the form of a metaanalysis associated with smoking behaviors among women ages 18 to 20. The metaanalysis will look at both qualitative and quantitative research on the subject and include only those works which include all three factors, smoking behavior, female subjects and the age group of 18-20. The research itself has been reported as lacking in information associated with gender differences in motivation for starting and stopping smoking and therefore a metaanalysis would constitute a legitimate manner in which to explore this hypothesis, regarding the literature. Additionally this research will glean from the available literature information from the various study participants and would attempt to develop an argument for causal factors of smoking behaviors among women, who have been repeatedly reported as having differing motivational as well as physical reasons for exhibiting risk taking behaviors than men in this same age group (Berlin, Gasior, & Moolchan, 2007) (Baker, Maes, Larsson, Lichtenstein, & Kendler, 2011) (Kawai, Kang, & Metherate, 2011). The work will not compare men to women but will look specifically at women participants and pull from that the potential evidence to support a more accurate ideation of smoking as a risk taking behavior among women.
Review of Literature
It has been theorized that the fact that females tend to mature earlier physically and mentally that boys they are less likely than boys to begin smoking, during adolescence. Additionally, some detail the association between increased parental supervision among girls as another factor that contributes to less smoking and other risk taking behaviors among girls and young adult women, during an adolescent risk period. The literature does not however support either of these assumptions as many studies have indicated that there is only a minimal difference between percentages of boys and girls regarding smoking behaviors beginning about age 13 but that the pattern of starting actually rose sharply with girls and more gradually with boys to the age of 18 (Bernaards, Kemper, Twisk, van Mechelen, & Snel, 2001, pp. 640-641).
One study found that a gender difference that can be established is that women over time, and through development are far more likely than men to quit smoking (Munafo, & Black, 2007. P. 397) Additionally, with regard to gender it was found to be more likely for men to be heavy smokers than women, even if they did continue to smoke into adulthood (p. 400). This same study also found a strong link between two personality traits, extroversion and neuroticism, which seem to transverse gender and create a higher likelihood of beginning initiating smoking and continuing to smoke into adulthood. Gender did not alter this trend but the authors made a strong link between these personality traits and heritability, meaning these two traits are commonly passed from one generation to the next and presuppose a higher propensity for becoming a lifelong smoker (pp. 397-398).
Bell and Lee (2006) found that life transitions tend to affect smoking and other health related behaviors for women, where stress was an indicator for smoking behaviors and stress was triggered by life stage transitions being interrupted, such as going from independence back to the parental home. Additionally the work found that becoming mothers also had an effect on smoking behaviors, in a longitudinal study of women in Australia; "…young women's smoking patterns are significantly associated with the transitions of emerging adulthood. Specifically, both marriage and pregnancy were associated with smoking cessation, whereas young motherhood was associated with resuming smoking after cessation, (p. 266) Overall the work indicated that if things were going along as is socially accepted that the young woman was less likely to continue to smoke if she had begun in adolescence to do so, but that if she somehow got off the "normal" path that the stress associated with this was a contributing factor to continued or recurrence of smoking behaviors.
Peer and parental influence was discusses and researched by Brook, Pahl, & Ning, (2006) who chose to look at minority girls and women (African-American and Latino) in an attempt to discover the influence of environmental smoking on these women. The literature review in the work pointed out some seminal findings of other researchers who contended that research indicated that peer group smoking was a large factor of smoking risk behavior among girls, and not among boys (p. 261). Additionally the work found that parental and peer smoking in both genders determined a greater likelihood of early initiation as well as persistence of smoking into adulthood (p. 261). This finding is interesting for this research as it implies that smoking cessation teaching for girls should include attempts to remove girls and young adult women from the peer influence of smoking in much the same way that alcoholics are informed that they need to break their patterns of drinking by making a break with the people they tend to drink with.
Along the same lines of thought Bricker, Rajan, Andersen, & Peterson (2005) demonstrated that children who had adult parents who smoked were far more likely to quit smoking as young adults if their parent(s) quit when children were young. Conversely they also found that those whose parents quit later in their lives did not have a higher chance of quitting themselves as young adults. Again this finding stresses the need to alter peer and/or parent behavior or exposures at integral times in the early live of people. Lastly, socioeconomic status (SES) seems to be another smoking start and continuation factor, as both boys and girls in families of what the researchers termed the manual labor class. This finding indicated that even adult children's own SES improvement did not mitigate the lasting effects of smoking as a continuing behavior (Huurre, Aro, & Rahkonen, 2003).
Statement of Purpose
To explore the unique and common motivations for smoking behaviors among women ages 18-30, in both starting and persistence of smoking through a literary metaanalysis.
Hypothesis: Female young adults will have characteristically and environmentally unique motivations for both beginning to smoke and continuing to smoke into adulthood.
This research proposal will use several academic research databases to collect a large subset of scholarly literature on the subject of smoking, smoking cessation, gender or sex differences, or exclusively female study participants utilizing either a longitudinal method that includes the age groups 18-30 or exclusive age group research, and studies of qualitative, quantitative and mixed methods designs. The work will include the use of Ebsco databases; Academic Search Complete, HealthSource Consumer Edition, HealthSource Nursing/Academic Edition, PsycArticles, PsycInfo as well as Biological Abstracts, CINAHL and the Cochran Library Databases. After a complete term search for all the categorical terms included above the researcher will review each article for topic inclusion as well as academic merit and statistical accuracy. Once, what is assumed to be a large number of articles is limited to those that are of specific interest for this work, likely a result of about 100, the researcher will then do a term and data search among all these works to determine the nature of trends, comparing data where possible and qualitative transcription as much as possible. The work will then be broken down to two subsections one for qualitative data and one for quantitative data interpretations. Finally the work will then be organized by data set specific information and a lengthy discussion of the findings will be compiled. Lastly, recommendations for future research as well as any cessation/treatment trends that become apparent as effective in specifically supporting women to quit smoking…