Smoking was one of the dominant lines of discourse across the sample of youth’s narratives of cancer and cancer prevention. Age, gender, smoking status (i.e., smoker or non-smoker), and place of residency did not influence the story line. Youth were considerably more knowledgeable about the association between smoking and cancer and anti-tobacco messages in comparison to any other cancer-related topic. Several youth photographed their own hand-drawn facsimiles or public signage depicting familiar anti-smoking slogans (Figure
Anti-Smoking Sign. Represented youth’s desire that adults should stop smoking.
"When I walk around there’s like no smoking area signs. I think “Oh this is safe,” like it is good to know that there won’t be like smoke around for me to breathe in. [14-year-old male]"
Youth in this study were well informed of how smoking could impact one’s health (e.g., increased the potential for cancer and other chronic illnesses). Of special importance were youth’s perspectives and experiences of parents and other family members smoking around them as represented by the primary theme, It’s not fair, and four subthemes: parenting the parent about the dangers of smoking; the good/bad parent; distancing family relationships; and the prisoner. Each of these themes are further discussed.
It’s not fair
Overall, youth viewed their parents and other family members smoking around children as something unjust. The phrase “It’s not fair” was frequently expressed by youth in this study as illustrated in the following comment,
"Because the kids around parents who smoke have to breathe in, they have to breathe in all of it …and like, if parents want to smoke then they should like go outside becauseit’s not fair to the kids…Probably because they always have to be around it if their mother always smokes every time they’re taking a bath or every time they’re like colouring a picture like every time they do anything, they always have to breathe in the bad- like bad air that’s filled with smoke and stuff like that. Andit’s not fairto them. [12-year-old female]"
Youth could not make sense of why parents would smoke around their children. They also were unsure with how to deal with what they saw was an act of injustice to children. They struggled about how the smoking made them feel, recognizing that their roles as children limited their ability to influence their parents’ behaviour. Their attempts to reconcile their feelings and deal with the unfairness through specific behaviours are further apparent in the following four subthemes.
Parenting the parent about the dangers of smoking
Although youth did share stories of parents talking to them about the importance of not smoking, this was not the major family narrative. Instead of being talked to about smoking, it was more common for youth to share stories of they themselves talking to, educating, and even preaching to their parents about the dangers of smoking. In short, youth took it upon themselves to parent their parents.
"But I’m getting my mom and my step-dad to quit…by talking to them, telling them how it makes all of us kids feel…Yeah, reading like everything the packages say or what the internet says or like what I learn from it and then they’re all just thinking and then they’re saying “well I won’t do that much then. I’ll try to quit.” Now they’re trying to quit but it’s not working for my mom but it is working for my step-dad. [14-year-old female]"
In addition to talking to their parents about how they felt about them smoking, some youth also would take action to reduce their parents’ ability to smoke.
"Like I have just tried, because I just tell my parents straight up to stop and…I always try to, like, hide their stuff on them but it doesn’t work. They get mad. [13-year-old male]"
Talking to their parents about the dangers of smoking arose out of youth’s worries for their parents’ health. The concern that youth had for parents who smoked was in fact one of the reasons youth decided to participate in the study. Youth were looking for answers that could possibly help them to get their parents to stop smoking. Concerns about their parents smoking was also strongly depicted in the photographs. One 13-year-old female took a picture of an ashtray full of cigarettes and said,
"I see them (ashtrays with cigarette butts) all the time. It would be different if it was like you know once in a while kind of thing I probably wouldn’t mind that much, but my parents smoke in the house and in the car and everywhere so it’s kind of I don’t know I wish they would stop
Ashtray. Represented youth’s concern for parents.
Youth who feared that their family members might die, or who had family members who died because of smoking-related illnesses (e.g., lung cancer), especially shared their concerns and would try to make their parents feel guilty.
"I always tell them things to make them guilty I’m always like, “Do you want to meet my children, do you want to bring me down the aisle?” It’s working actually. I think my dad said my mom was talking about it so…Ever since my mom started again I really felt it hit me cause, like I want my mom to meet my children and she has to see me get married and have kids and I want my mom to be there. [16-year-old female]"
Youth also provided many stories of their parents’ attempts to quit smoking. Their stories demonstrated how smoking was embedded within their family’s history and identity, as well as how parents’ smoking played a role in their child’s life.
"Well I was really happy when my father quit because he had been smoking since like, I don’t know, before he was even a teenager. He was really young and he said he’d quit sort of when I was born like he’d smoke outside and he’d reduce it, but then when I got old enough he’d continued smoking, and my mom was the same way. She was also a smoker, but she quit like maybe I was five… [15-year-old female]"
"My grandpa passed away a couple of years ago and he died of emphysema and a little bit after he got sick I should say he quit smoking and whenever my aunties and mom smoked, but they don’t anymore, then he would always tell them “Well you should quit because look what’s happening to me.” And that really pushed my mom to quit. [17-year-old female]"
While youth were persistent in trying to convince their parents to stop smoking, most youth felt that their parents would not quit despite their efforts. A sense of helplessness was apparent.
"Well, my parents like they are smoking and if I tell them not to they’re not going to listen because they’re like “We are your parents, you’re not our parents!” [18-year-old male]"
"Like my mom and my dad both smoke and I’d like to tell them to stop and to show them…they don’t really care…I don’t know, like influencing somebody not to smoke is a lot different than I guess them already smoking and quitting. Because like, I mean obviously everything I’ve seen I’m never going to smoke, but I mean it doesn’t really influence my parents. [13-year-old male]"
The good/bad parent
A second sub-theme involved a moral tone in youth’s conversations with respect to how they viewed their parents and other family members who did or did not smoke. On one hand, youth perceived parents who did not smoke as doing the right thing and as part of their parents’ overall plan of keeping themselves and their children healthy.
"Like my parents don’t smoke, they don’t like do drugs or anything like that and they do like everything possible to stay to like be healthy and stuff and to keep me healthy and stuff like that. [12-year-old female]"
In contrast, youth were especially disapproving of parents who did smoke.
"Like if a mother wanted to have a baby so badly in the first place then she should have known that she’s not supposed to drink or she’s not supposed to smoke or she’s not supposed to do any type of drugs or anything…and they don’t know how bad it actually is for the kids who have to breathe it in. [14-year-old female]"
Parents’ second-hand smoking was seen by youth as parents “doing” to their children. “Doing” was viewed in a negative sense where children were put in a dangerous situation in which they had little choice or control as depicted by the following quote and photo.
"I guess for people with families already, like what it’s doing to their family or that second-hand smoking can be almost as bad as actually smoking like what are you doing to the people around you if you’re choosing to smoke.
[17-year-old female] (Figure
Adult smoking beside a young child. Represented parents “doing” to children; children have no choice.
Essentially, youth felt that second-hand smoke was more dangerous than first-hand smoke as one 15-year-old male noted, “This stuff (second-hand smoke) does not get filtered through the back of the butt, it just comes out clear not filtered.”
Youth expressed concern for how second-hand smoking impacted them and their siblings.
"Both my parents smoke so I don’t like it too much because the smell is kind of it bugs me and you know I don’t know because so many people talk about smoking is related to cancer and that kind of thing so I’m kind of scared. I’m scared for myself and for my parents. But I’m more scared for like my brother than I am for me because I can leave more often than my brother’s allowed to… so. Either like my brother developing the habit or something or like him getting cancer because he’s around it too much. [13-year-old female]"
Many youth, whose parents did not smoke currently or had never smoked, were concerned about the effects of second-hand smoke on their friends (whose parents smoked). These youth spoke about their friends’ situations vicariously. Their comments in the interviews arose from their extended empathy towards their peers and their peers’ siblings.
"Um, I’m pet sitting for a friend while she’s in Florida and her parents are usually always smoking or getting ready to light another cigarette and so I went there it just smells so bad in their house and I feel sorry for her cause she’s got a sister in kindergarten and it’s her in grade nine and her parents are smoking and their dogs in there and cat and it just sticks to the furniture and it just smells smoke. [14-year-old female]"
Youth felt that parents who smoked were poor role models and that their behaviour could influence their child’s desire to smoke.
"Cause when children see, children do, right? Yeah, so lots of kids when your parents smoke when you’re like in grade two or something and kids get the idea that it’s cool or like whatever and then they want to be like their parents cause they think their parents are awesome. So then they start doing everything their parents do and then they start smoking… [14-year-old female]"
"Or sometimes you can get addicted to smoking if both your parents smoke a lot and then like my cousin who smokes uses that excuse cause I’m like”Why do you smoke, that’s disgusting!” And he says “Well both my parents smoke so I started.” I don’t think his parents are a very good influence since they both smoke. And I’m not sure if they ever told him not to smoke, but maybe they just accepted his smoking not saying it is bad or anything. Like if my kid started smoking I would get mad. [13-year-old male]"
Parents who smoked were also considered by youth to be less reliable and credible when talking to their children about the dangers of smoking.
"When my parents found out I tried it (smoking) once, they knew that they couldn’t do anything cause since they were smoking too! [13-year-old female]"
In general, parents and other adult family members who smoked were viewed by youth to be weak in character.
"So like one year he (family relative) came out from Ontario with his wife and my grandma and it was pouring rain and he decided to go outside for a smoke, so he really ran across our yard and hid in the shed and smoked. I’m like, it’s pathetic. [14-year-old female]"
It was evident from the youth’s narratives that parents’ smoking behaviours were unacceptable and should never be tolerated.
"And I mean people really need to kind of jump on it and say don’t do this around your kids because it will affect them. Don’t do this around any young child because young children are really open to being affected by something like that and so I think definitely being careful about where you’re smoking or something like that is definitely a really big factor. [16-year-old female]"
Distancing family relationships
A third sub-theme that emerged was one where youth were separating themselves, both physically and emotionally, from their family members. In addition, youth associated smoking with causing emotional stress or strain on the family.
"Youth:And they always get problems because of it so I kind of don’t want to have to deal with all those problems. And all that stress and everything so I’m just going to like leave it alone.Interviewer:Okay. So like what problems?Youth:Like family issues.Interviewer:So like you said that they have family issues and stuff, why is it important to you not to have that in your life like those things?P:Cause I already have enough family problems. I guess I don’t want anymore. [14-year-old female]"
The discussion with youth revealed that smoking had, in varying degrees, disrupted family relationships. Just the presence of family members smoking around them resulted in youth altering their behaviour and wanting to physically distance themselves from smoker family members.
"I live with my grandparents. They make me supper and then I have to usually eat in my room because they smoke, and I don’t like the smell of smoke when I’m eating. I hate the smell and it’s just I grew up my whole life with it and I just think I just see my grandma a lot of my family members have like my great-grandma had passed away with lung cancer and stuff. I just think it’s bad. [17-year-old female]"
At times, being around parents who smoked resulted in feelings of worry and frustration for youth.
"Well my step-dad smokes and he’s always saying, “No, it won’t happen to me, it won’t happen to me!” And he actually has a really high chance of catching it cause he started smoking when he was really young and he continued smoking and, uh, he still thinks it won’t happen and doesn’t believe any of the commercials or the ads on that stuff. He just keeps going so… [17-year-old male]"
"I was riding with my dad and he was smoking. I was like, “Do you have to do that when we’re in the car?” Like I get so bugged by it when people do it. It’s like. “Look at the cigarette box!” I get so mad. I was like…like when we were getting out of the car and I said, “Oh can you just not do that?” I walked ahead of him and he said, “I’m sorry.” It’s like, “Okay!” [15-year-old female]"
Youth were also sensitive how their negative reactions and behaviours towards family members who smoked could result in hurt feelings.
"Whenever they smoke around me I just like take a shirt or something and just like cover my mouth and nose and my brothers and sisters are doing that too. Yeah, so just to try and keep it away. My parents don’t mind, but I’m pretty sure it hurts their feelings or something. [13-year-old female]"
Many youth described family tension and conflict because a family member was smoking.
"It can really bring your family down, if smoking hurts someone in your family. Um, it could really cause a lot of tension there… [16-year-old male]"
"And like my cousin, her parents smoke. They quit. She helped them quit but then they started again and then she started crying and crying and crying and crying, and then she’s scared that her parents are going to die from lung disease or a lung cancer and she always cries when they do that and then one time they said “It’s our choice if we do this. It’s not your fault if we die or not and they said that they only smoke once a day, not too much.” Now she’s still gets mad but she doesn’t have temper tantrums anymore. [12-year-old female]"
Feelings of anger were also associated with family members who smoked. One youth who had an extended family member who died from lung cancer was upset with a son-in-law who continued to smoke in spite of his father-in-law’s death.
"I saw him smoking and I was like “Why? Like you saw what your father-in-law went through. Why are you still doing that?!” And it, it really angers me. Like I don’t know, just even talking about it gets me so mad like you’re seeing all these things like you know it happens. Why are you going to ruin that? [15-year-old female]"
Notably, of all the feelings expressed by youth in the study, it was a deep sense of sadness that was most apparent in their narratives with respect to families who had a history of smoking. The sadness was in relation to a past or future loss of family members. For some youth, the sadness was physically evident through youth crying and holding back tears while being interviewed. Some held the view that smoking was the defining feature of their families that ultimately would lead to its destruction (Figure
Funeral Sign. Represented smoking as a sign of cancer and death.
"Lots of my family smokes and I’m worried about them getting cancer and then not surviving it. [16-year-old female]"
"Okay, I took two pictures of smokes cause the first reinforces that smoking could lead to lung cancer. And the second is cause it relates to me and my life because my mom smokes. My grandpa smokes, my grandma smokes, my aunty smokes because a lot of people smoke in my family. Well I feel sad that she probably could die soon like she maybe diagnosed with cancer like any time because she smokes a lot. [13-year-old male]"
The final sub-theme that emerged in the study was a sense of resigned acceptance, powerlessness, and being held as a prisoner. Ultimately, the unjust nature of parents smoking in the family home was truly felt by those youth who described having little choice but to feel trapped inside the smoke.
"Um, yeah. Well I had to stop volleyball and taekwondo for a little while because my knees were really bad and I have been experiencing like a hard time breathing. But I think that’s particularly because after my dad died my mom let these people move in and the guy smoked a lot and I wasn’t used to that amount of smoke in my personal area. Like downstairs was all mine before, but then I was close to my bedroom and his smoke would come in my room. So I was I was stuck with that all the time. [16-year-old female]"
"Whenever he smokes I’m like in a car with him or in the house with him. He’s always supposed to go outside of the house to smoke, but when I’m in the car with him I roll down the windows so I don’t have to breath in the smoke and I just go on with him and like, “Okay, you can do whatever you want, then I’m just going to do what I want to do.” [17-year-old male]"
Within their home (and while travelling in vehicles with their parents), youth had few ways of escaping the second-hand smoke and little, if any, influence over their parents’ smoking behaviours and rights to live in a pollution-free environment. Some even described how they had to cover their nose and mouth when walking through their house. These youth were like prisoners within their homes. They experienced their own, and witnessed their siblings’ exposure to second-hand smoke, but felt they were unable to help and protect themselves, let alone their siblings. Youth expressed feeling caught in an unpleasant situation which was difficult to escape. They perceived it as unfair and just had to put up with it.