Smoking Initiation and Continuation A Qualitative Study among Bruneian Male Adolescents

Background: Cigarette smoking is one of the leading global causes of premature and preventable death. In Brunei Darussalam, smokingrelated diseases have been a primary cause of mortality for the past three decades. Despite the increasing efforts that have been made in recent years to reduce the consumption of tobacco products in Brunei, the prevalence of adolescent smoking cigarette, however has risen alarmingly, from 8.9% in 2013 to 11.4% in 2014, with a higher prevalence found in males (17.8%) than in females (4.8%). In response to the need for more effective smoking prevention programmes in Brunei, this study sought to explore factors that influence Bruneian male adolescents to start and continue smoking. Materials and Methods: A qualitative study using focus group discussions (FGDs) as the data collection method was conducted from October to November 2015. A total of 43 studentss, comprising 31 smokers and 12 nonsmokers, aged 1317 years, from two government secondary schools in Bandar Seri Begawan, participated in six FGDs. Discussions were recorded and translated. Transcripts were entered into NVivo10, before thematic analysis was conducted. Results: We identified three themes under the core construct of factors influencing smoking initiation (family as teachers, overt pressure from peers and perceived smoking has many advantages) and three themes under the core construct of factors influencing smoking continuation (craving and addiction, smoking as a social activity and easy accessibility of cigarettes). Conclusions: Based on the findings, it is recommended that future prevention activities should be embedded in a comprehensive approach, involving all stakeholders within a community, and should be focused towards bringing a change in smoking and parenting behavior of parents, social norms within the culture towards all population levels, and at strengthening the existing nonsmoking policies in schools and other public places where young people congregate.