A longitudinal study of Liverpool schoolchildren's experiences of smoking aged 9-11
Smoking is the greatest avoidable cause of premature death in Britain today, particularly
among the poorest people in society. Most smokers take up the habit during childhood,
and the age at which children begin to smoke is falling over time. Although patterns of
regular smoking are often established during the teenage years, rates of experimentation
with cigarettes peak during preadolescence. Despite this, in the UK there has been little
longitudinal research into the process of smoking uptake during preadolescence, and this
research fills that significant gap.
The Liverpool Longitudinal Study of Smoking (LLSS) is a unique longitudinal study that
has tracked a cohort of approximately 250 children during their early years at primary
school. This thesis continues and develops the LLSS by exploring the cohort's
experiences of smoking during preadolescence in order to understand how children's
early smoking careers develop between the ages of 9 and 11. Baseline quantitative and
qualitative data collected at age 9 (in 1999) were compared with data collected at age 10
(in 2000) and at age 11 (in 2001) in order to identify key elements of change. These data
were analysed longitudinally using a multiple case study approach that identified the
individual trajectories of five children during preadolescence. A cross-case comparative
method was then used to identify and explain the relationship between views, intentions
and behaviour, and how these were shaped by the social context in which the children
lived. The themes that emerged from the case studies were then explored and developed
in the context of data generated by the whole cohort.
Statistical analysis revealed that smoking by best friends, fathers and brothers, together
with knowing someone with a smoking-related disease, at age 9 predicted smoking by
age 11. The discourses that the children used to talk about smoking uptake emphasised
the role of parents at age 9, but by age 11 the cohort suggested that friends were the key
influence on smoking onset. Each year, anxiety about being bullied into smoking by
older children also emerged as a key concern for this age group. In addition, the analysis
revealed that preadolescents appropriate adult discourses around the use of smoking as a coping strategy. The use of these discourses was patterned by socioeconomic status.
Children who lived in deprived areas suggested that both adults and children might
smoke to counter stress and to relieve boredom. However, some of the girls living in
relatively affluent areas perceived that adults smoke to control their weight. The study
also considered the implications of these discourses for differential rates of smoking
uptake at primary school.
A key finding of this phase of the LLSS is that preadolescents construct smoking as an
adult behaviour, and therefore some children smoke in order to negotiate status in
anticipation of the transition to adolescence and as a strategy of resistance to the exercise
of adult power. The reduction of rates of smoking among children and young people is
central to the government's tobacco control strategy, and this research has significant
implications for the development of both interventions and policy.