The Viewpoints of Urban High School Male Students, Parents and Teachers About Cigarette Smoking by Adolescents: A Social Marketing-Based Qualitative Study, Shiraz, Iran

Background: Smoking is one of the greatest challenges for public health. It is estimated that 7% - 25% of adolescents have experienced smoking in Iran. Objectives: The present study aimed to investigate the viewpoints of high school male students, their parents, and teachers about smoking by adolescents based on four components of the social marketing mix. Methods: A qualitative study with a phenomenological approach was conducted via 12 focus group sessions in Persian language. To this end, 82 participants (30 students, 28 parents, and 24 teachers) were selected based on purposive sampling method in 2015.The data were analyzed through directed content analysis. Results: All the three studied groups viewed “looking older” as the major cause of adolescent smoking, other factors included getting others’ attention, looking smart person, calmness, decreasing pain, and attractive packaging of cigarette. Some differences were observed between the viewpoints of students, parents, and teachers about the complications of cigarette. The students focused on the social consequences of smoking, but the parents and teachers were more worried about its long term physical side effects and addictive properties. Unlike parents, the teachers and students considered imitating from parents and famous people as themainsocio-environmental factor of smoking. All three groups believed that people’s negative social image and negative attention towards smokers should be included in smoking prevention educational programs. However, some differences were reported between their ideas in other educational subjects. Conclusions: Evaluating factors related to tobacco use from three different perspectives can provide a more comprehensive view of these factors and show the reason for the failure of many efforts to prevent student tobacco use and develop a more effective program to promote health.