The association of adolescent smoking with stress and coping in Pretoria high schools: a qualitative study

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dc.contributor.author O'Hara, Oscar Reno
dc.date.accessioned 2009-03-23T11:59:42Z
dc.date.available 2009-03-23T11:59:42Z
dc.date.issued 2009-03-23T11:59:42Z
dc.identifier.uri http://hdl.handle.net/10539/6777
dc.description.abstract Adolescent substance use is associated with a number of pressing problems on the public health agenda, including an increased risk of contracting sexually transmitted diseases, teenage pregnancy, violence-related injuries, depression, homicide, sexual assault, and accidental death. Teenage substance use remains high in South Africa, with a prevalence of smoking and alcohol binge-drinking estimated at 18.5% and 23% respectively. A previous quantitative cross-sectional analysis of data from a study cohort from which this study’s sample was drawn, demonstrated an association between adolescents’ sense of coherence (SOC) – a measure of coping ability – and smoking. The current study, using a qualitative approach, thus sought to gain more insight into adolescent substance use, particularly smoking, and to better understand how it may relate to coping. A mixed method sampling strategy was used in selecting 22 research participants between the ages of 16 and 19 in two high schools in Pretoria. They were then interviewed individually by an interviewer blinded to their SOC level and substance use status as documented in the quantitative survey in which this study builds on. The interviews were transcribed in full and a content analysis strategy was used in the analysis of the data. The results obtained were then merged with participants’ substance use status and SOC levels. Of the 22 participants, 6 had strong SOC and had never used substances; 8 had weak SOC and were current substance users. The other 8 also had weak SOC but were not current substance users. Further analysis of the results showed that adolescents’ substance use is associated with stress and coping as they (substance users) reported using substances in attempting to manage stressful life events. Of the 8 current substance users, 7 reported avoidance-oriented (disengagement) coping styles. Five of the 7 reported load imbalance such as academic and social pressures and distress (e.g. schoolwork overload, peer demands, and family problems) as a reason for using substances. The non-substance using adolescents with weak SOC reported strong social support, especially family and peer support in coping with life stressors. Hence, substances were more likely to make up for compromised coping where contextuallevel risk factors (demands/stressors) exceeded coping resources such as social support. Also, of the 8 substance users- in addition to stress related reasons for using substances- 4 reported sensation seeking, whilst 2 reported curiosity/experimentation- which are all non-stress related. Furthermore, although family and peer support were observed to be complementary in most cases, the reliance on peers for support was stronger amongst those whom family support was considered weak, which presented the context for social/peer pressure and vulnerability to substance use. The study findings suggest family support as a moderator of the influence of the adolescents’ inability to cope with stress (or have low SOC) on smoking behaviour. On the other hand, a close relationship was observed between strong SOC and using engagement coping responses and reporting family and school support as sources of support. Notably, all the participants with strong SOC reported that they had never used substances despite being equally affected by life stressors. The implications of the findings are also discussed, especially as related to enhancing SOC. More practically, in addition to providing life skills training to educate adolescents about substance use, school-based programmes could incorporate the notion of stress and coping in helping adolescents to develop desirable and effective coping strategies to deal with social demands as well as adopting advantageous lifestyles to meet their needs for stimulation and adventure (sensation seeking and experimentation). On the whole, the enhancement of social support and adolescents’ connectedness to various social systems may be the key to substance use prevention among South African adolescents. en
dc.language.iso en en
dc.subject adolescent smoking en
dc.subject stress en
dc.subject coping en
dc.subject high schools en
dc.subject Pretoria en
dc.title The association of adolescent smoking with stress and coping in Pretoria high schools: a qualitative study en
dc.type Thesis en


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