Smoking Motivations across gender: a study among European adolescents

Background In recent years, many school educational programs have been dedicated to smoking prevention. Some of these programs aim to address positive smoking motivations that persist in adolescents’ mind, like smoking helps feeling relaxed or looking cool. Yet, despite widespread reduction in smoking prevalence among adolescents, gender differences in smoking have recently narrowed. This may indicate that girls and boys may have different motives to smoke. Several studies have focused on smoking motivations among adolescents, but they hardly take into account these gender differences. Moreover, they always consider smoking motivations in an individual perspective, while adolescent smoking is known to be a social behavior. In this study, we hypothesize that motives related to smoking differ across genders and smoking status. Methods: In 2016, 12 000 students of 14-16 years participated to a social network analysis survey in 7 different European cities. We classified smoking motives along two axes: (1) negative versus positive motivations; (2) individual versus social motivations. We categorized adolescents according to gender and smoking status. Results All motivations scales differed significantly according to gender. Among the four categories, male smokers scored higher on social positive motivations while girl smokers scored higher on individual positive motivations. Never smoker female had the highest scores for both individual and social negative motivations Conclusions Smoking motivations differs across genders and the social component of boys’ smoking (popularity, having a girlfriend) is important to consider, as well as the individual component of girls’ smoking (relaxation, body image). Main message: Smoking prevention programs could be more efficient if they would adapt to gender differences in smoking motivations. Addressing positive motivations for smoking could be an efficient tool if they focus on boys’ social sphere and girls’ individual patterns