Student and staff beliefs about smoking in further education settings: qualitative findings from a process evaluation

Abstract Background Preventing young people from taking up smoking is crucial to maintain and accelerate recent declines in smoking rates. Most prevention efforts have focused on schools, with almost no research conducted in further education settings, despite 44% of regular smokers indicating that they started smoking between the ages of 16 and 19 years. Using data collected during the process evaluation of a smoking prevention feasibility trial in further education settings, we aimed to explore young people's beliefs and behaviour regarding smoking and smoking prevention in these contexts. Methods 11 focus groups of students (n=69) and six of staff (19) were conducted in three further education institutions (two colleges, one school sixth form) in Wales between May 1 and Sept 30, 2015. Focus groups included between two and 13 participants selected by convenience sampling. The groups covered views on student smoking behaviour, perceptions of the intervention, and perceived impact on student and staff smoking behaviours. Discussions were recorded, transcribed verbatim, and analysed in NVivo (version 10). All transcripts were coded line by line using a framework derived a priori from research questions and emergent indicative codes. Findings Students and staff expressed liberal, non-interventionist views about smoking. Though recognised as harmful, smoking was seen as a personal choice that should not be infringed, and students felt jaded by anti-smoking messages. Students used smoking behaviours to signify successful transition to adulthood—not by appearing grown-up, but by demonstrating their understanding of appropriate, responsible smoking behaviour (eg, protecting minors from second-hand smoke, being considerate to non-smokers). Staff commitment to fostering student autonomy conflicted with their perceived duty of care and institutional rules. For example, one institution banned smoking, causing tension between students and staff, who tried to respect student autonomy while enforcing the rules. Interpretation Our findings highlight students' liminal identities and tensions that can manifest as further education staff and institutions attempt to safely accommodate and nurture young people's transition to adulthood. Smoking is denormalised among this population and students can be desensitised to smoking prevention messages in this setting. Interventions in further education must be sensitive to the transitions young people experience. Funding The National Institute for Health Research (NIHR) Public Health Research Programme funded the feasibility trial (13/42/02). The work was undertaken with the support of The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UKCRC Public Health Research Centre of Excellence.