Stories of nicotine dependence told by teenage girls : a narrative inquiry

The prevalence of smoking cigarettes has increased among teenage girls over the last decade. Smoking onset typically begins during adolescence and is associated with subsequent nicotine dependence. Much of the research on tobacco use neglects the perspective of teenage girls. While nicotine dependence is well documented among this population, little is known about the meaning that teenage girls ascribe to nicotine dependence. In this qualitative study, narrative inquiry was used to explore the meaning of nicotine dependence among teenage girls within the context of their lives and patterns of smoking. Twelve teenage girls, aged 14 to 17, participated in this investigation and all had recent experience with smoking. Data analysis of in-depth interviews focused on structure, content and interpersonal factors as well as the language used in stories about nicotine dependence. The study findings point to the importance of semantics and identity issues as teenage girls tell stories about nicotine dependence. In addition, this investigation provides important insights into how teenage girls portray themselves and others with regards to nicotine dependence. Three narratives emerged in this inquiry that include Invincibility, Giving In and Unanticipated Addiction. In the first narrative, those who felt invincible described how they were in control of their smoking and not addicted to cigarettes. In the second narrative, participants who were giving in told stories about yielding to external forces and smoking. In the third narrative about unanticipated addiction, storytellers described their surprise upon realizing that they were addicted to cigarettes. In addition, two subnarratives entitled Needing to Quit and Repeating History are presented. In the first sub narrative, Needing to Quit, participants described how they knew that they needed to quit smoking and how they would quit later. In the second sub-narrative about repeating history, participants contrasted their mothers' nicotine dependence with their own smoking. The findings in this study have vital implications for health-care professionals who work with teenage girls who smoke and provide direction for ongoing smokingcessation interventions for both social smokers and regular smokers. Including "the voices" of teenage girls is paramount in our continued efforts at tobacco reduction within this population.Applied Science, Faculty ofNursing, School ofGraduat