title: A qualitative analysis of Māori and Pacific smokers' views on informed choice and smoking.
abstract: Tobacco companies frame smoking as an informed choice, a strategy that holds individuals responsible for harms they incur. Few studies have tested this argument, and even fewer have examined how informed indigenous smokers or those from minority ethnicities are when they start smoking. We explored how young adult Māori and Pacific smokers interpreted 'informed choice' in relation to smoking.
  
  
  
  Using recruitment via advertising, existing networks and word of mouth, we recruited and undertook qualitative in-depth interviews with 20 Māori and Pacific young adults aged 18-26 years who smoked.
  
  
  
  Data were analysed using an informed-choice framework developed by Chapman and Liberman. We used a thematic analysis approach to identify themes that extended this framework.
  
  
  
  Few participants considered themselves well informed and none met more than the framework's initial two criteria. Most reflected on their unthinking uptake and subsequent addiction, and identified environmental factors that had facilitated uptake. Nonetheless, despite this context, most agreed that they had made an informed choice to smoke.
  
  
  
  The discrepancy between participants' reported knowledge and understanding of smoking's risks, and their assessment of smoking as an informed choice, reflects their view of smoking as a symbol of adulthood. Policies that make tobacco more difficult to use in social settings could help change social norms around smoking and the ease with which initiation and addiction currently occur.
authors.affiliation: Whakauae Research Services, Director's Office, Whanganui, New Zealand.
authors.forename: Heather
authors.initials: H
authors.lastname: Gifford
authors.affiliation: Department of Public Health and Psychosocial Studies, AUT University, Auckland, New Zealand.
authors.forename: El-Shadan
authors.initials: el-S
authors.lastname: Tautolo
authors.affiliation: ASH New Zealand, Director's Office, Auckland, New Zealand.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Erick
authors.affiliation: Department of Marketing, University of Otago, Dunedin, New Zealand.
authors.forename: Janet
authors.initials: J
authors.lastname: Hoek
authors.affiliation: Department of Public Health, University of Otago Wellington, Wellington, New Zealand.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Gray
authors.affiliation: Department of Public Health, University of Otago Wellington, Wellington, New Zealand.
authors.forename: Richard
authors.initials: R
authors.lastname: Edwards
mesh_terms: D002755:Choice Behavior; D003657:Decision Making; D005260:Female; D006266:Health Education / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009520:New Zealand; D036301:Qualitative Research; D000074285:Smokers / Q000523:psychology* / Q000706:statistics & numerical data; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D055815:Young Adult
keywords: PUBLIC HEALTH; QUALITATIVE RESEARCH; SOCIAL MEDICINE