Developing and Testing Interpersonal Strategies for Resisting Smoking Initiation among Male Youth in Mainland China: A Formative Research Project

Holding the top place in its total tobacco consumption, China faces a serious public health challenge in tobacco-caused deaths (Gu, Kelly, Wu , et al., 2009). Smoking is forecasted to claim a third of all current young Chinese men's lives within 30 years (The Epoch Times, 2004). The youngest smokers surveyed recently were 14 years old, 5 years younger than the youngest group surveyed in 1997; the percentage of young smokers has increased since 1997 (WHO, 2002). Thus, China needs to focus its anti-smoking efforts on young people, particularly among male youth. The 1996 National Prevalence Survey in China showed that approximately only one out of every six smokers has actually tried to quit, and merely a small percentage of them have quit smoking successfully. The majority (83%) of current smokers do not indicate an interest in quitting (Chinese Academy of Preventive Medicine, 1997). The figures and evidence point to the fact that once men begin smoking, they are not likely to quit; which necessitates efforts in preventing smoking onset.

The typical age for starting smoking among Chinese men falls in the range between 16 and 20 years old (Wang, Borland, & Whelan, 2005), when male teenagers begin experimenting with tobacco use and smoking socially and regularly (Kang, 1992). Most Chinese youth begin smoking upon initiation from teenage peers, colleagues, and friends (Committee on Youth Smoking Prevention, 2010). Thus, effective smoking prevention can begin by enhancing male teenagers’ efficacy in resisting interpersonal smoking initiation, which requires the identification of barriers and dilemmas associated with smoking rejection and situation-appropriate communication strategies.

In the current project, we propose to conduct focus-group discussions (Study 1) to discover typical situations in which smoking initiation occurs, find out about Chinese male youth’s cultural, social, interpersonal, and psychological barriers for rejecting cigarette initiation, and discover effective and appropriate smoking resisting strategies. On the basis of focus-group findings, we create an inventory of cigarette-resisting strategies for various situations. Then we will conduct a survey (Study 2) to test the degree to which these strategies are effective and appropriate to given situations. Findings from this project can build a foundation for interpersonal interventions to reduce smoking onset among Chinese male teenagers.

A research-based health intervention process typically consists of four stages: formative research > intervention program production > implementation > summative research. Our formative research project is illustrated within the dotted lines.