Adolescents' beliefs, attitudes and social norms with regard to smoking and sports: A qualitative study

Objectives The aim of this study is to explore the beliefs, attitudes and social norms of Dutch adolescents with regard to smoking and sports. In addition, we examine whether there are differences between adolescents at sports clubs with versus without an outdoor smoke-free policy (SFP). Design Qualitative design in the form of focus group interviews. Setting Focus group interviews (n=27) were conducted at 16 sports clubs in the Netherlands. Soccer, tennis, field hockey and korfball clubs were included. Focus group discussions were transcribed verbatim and analysed thematically using MAXQDA. Participants 180 adolescents aged 13-18 years old were included in the study. All participants signed an informed consent form. For participants younger than 16 years, parental consent was required. Results With respect to smoking in relation to sports, participants had mostly negative beliefs (ie, smoking has a negative effect on health and sports performance), attitudes (ie, sports and smoking are activities that do not fit together; at sports clubs smoking is not appropriate), and social norms (ie, it is not normal to smoke at sports clubs). The same beliefs, attitudes and social norms were expressed by participants at both sports clubs with and without an outdoor SFP. However, argumentation against smoking was more detailed and more consistent among participants at sports clubs with an outdoor SFP. Conclusion Adolescents have negative beliefs, attitudes and social norms with regard to smoking in relationship to sports. Outdoor SFP at sports clubs might reinforce these negative associations. These findings point to the potential importance of sports in the prevention of adolescent smoking.