Smoking prevention: towards a process approach.

Current studies of smoking prevention treat the adolescent as a target of influence, they emphasize the acquisition of skills for resisting peer pressure and give too little attention to motivation for resistance. Studies consistent with this social learning framework show moderate reductions in the incidence of smoking for the short term; recent, long-term follow-ups show no reduction in experimental over control conditions. We propose a re-examination of the influence framework and suggest that adolescents use smoking and dress, to project an image of self that will increase the likelihood of success in the formation of relationships in which participants share feelings and attitudes toward each other and the adult world. We also suggest that adults focus upon external, perceptible, and remote threats, e.g. smoking is seen as evil, a response to peer pressure, and a long term threat to health, and ignore discourse about proximal, subjective feelings respecting the changing sexual urges and feelings of social anxiety that accompany adolescence. The socialization of these affects is left to the peer group. It is suggested that future programs intensify their focus on motivation for resisting smoking based upon a revised view of the adolescents objectives in self definition, and combine this with the best of the current skills approaches.