How influences on teenage smoking reflect gender and society in Mali, West Africa.
OBJECTIVE
To provide further understanding and discussion on the influences on smoking in young people in Mali.


METHODS
A generic qualitative methodological approach was used following Caelli's generic principles. Six focus group discussions were conducted with a total of 31 participants followed by two semi-structured interviews. A reflexive account was kept to record development in the researcher's theoretical position


METHODS
The setting was recreational areas of Bamako, capital city of Mali, West Africa.


METHODS
Participants aged 13-15 years were recruited opportunistically in a recreational area of Bamako.  MAINOUTCOME MEASURES: To develop further understanding of the influences of teenage smoking in Mali, West Africa.


RESULTS
FIVE MAIN CATEGORIES THAT EXPLAINED INFLUENCES ON YOUTH SMOKING EMERGED: knowledge and awareness of smoking; associations with smoking; influential people; key messages in Malian society; and access to tobacco. The results showed that influences were complex and interwoven, notable gender differences were revealed, and the role of elder members of the community proved decisive in participants' smoking experiences. Participants described vague knowledge of the impact on health of smoking and reported trying smoking from an early age. Often contact with smoking was through elders and being sent to buy and sometimes light cigarettes for them. Associations with smoking were influenced by gender with smoking more desirable for boys than girls.


CONCLUSIONS
Any approach to preventing smoking initiation in young people requires an understanding of the social influences and pressures on young people. A tobacco control strategy is required to look at all areas of influence on smoking behaviours. Different needs should also account for the differing characteristics and perceptions of specific population groups.
NHS Sussex ,  Public Health ,  Chichester, West Sussex ,  UK.
Anna
A
Kirk