Journal of Youth and Adolescence, Vol. 12, No. 4, 1983

Attitudes of Senegalese Schooigoing Adolescents Towards Tobacco Smoking W a l t e r D ' H o n d t I a n d M i c h e l V a n d e w i e l e 2,3

ReceivedNovember30, 1982

Results show that tobacco smoking is a widespread phenomenon among Senegalese adolescents f o r several important reasons: economic (the intensive advertisement campaigns in favor o f tobacco smoking), cultural (the ambivalence o f traditional attitudes o f Western urbanization, and the attractiveness o f the Western way o f life), psychological (the traumas o f modernism on a basically poor developing country). Despite this alarming picture, signs point to an effective preventive strategy aimed mainly at schoolgoing adolescents and based on joint legal, scientific, cultural, and even religious action. INTRODUCTION The damaging effect o f smoking u p o n our health is now established beyond doubt. Several reports and research works provide ample evidence o f this (e.g., World Health Organization, 1979; U.S. Department o f Health, Education and Welfare, 1976). Smoking is directly related to premature mortality; lung cancer; chronic bronchitis, emphysema, and asthma; heart and blood diseases; high blood pressure; mouth, pharynx, and larynx cancer; stomach ulcers; and stillborn babies. The absorption o f

~Professor at the Ecole Normale Sup6rieure, Universit¢~de Dakar. Received a master's degree in psychopedagogy and a postgraduate degree in psychosociology. Major field of research is cross-cultural adolescent psychology. 2Professor at the Ecole Normale Sup~rieure, Universit~ de Dakar. Received a doctor's degree in mathematics and is writing his doctoral dissertation in psychopedagogy. Major field of research is cross-cultural adolescent psychology. 3Correspondence should be sent to M. Vandewiele, Strijdhoflaan 76, 2600 Berchem, Belgium. 333 0047-2891/83/0800-0333503.00/0 © 1983Plenum PublishingCorporation

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nicotine entails psychic and physical dependence and causes a long chain of nervous and psychological disturbances. The advertisement campaigns aimed at developing tobacco smoking in Senegal have been growing stronger and more intensive recently. Three obvious reasons explain this phenomenon. First, FAO figures show that Africa has the lowest mean consumption of tobacco in the world-0.30 kg/person/year versus 2.02 kg/person/year in industrialized countries. The African continent is therefore a huge potential market for the tobacco industries. The second reason is that European regulations against tobacco smoking have been increasingly severe to tobacco firms. Last but not least, the major tabacco firms and the Senegalese legislators seem to be engaged in a race against time. Its latest development is the law voted by the National Assembly at the end of October 1981 and applicable October 1982, which bans all forms of advertisement for smoking and tobacco smoking in certain public places. Le Soleil, the government-funded national daily, finds it hard to choose between two courses: make a maximum profit out of tobacco consumption or take relentless action against it. The "Soleil issue of February 8, 1982 is a perfect illustration of this dilemma: Next to a detailed article entitled "The Tobacco War" appears a prominent advertisement for a well-known tobacco firm. Most of the efforts of the tobacco firms are aimed at the youth, a fragile and easy target, thereby scoring a twofold success: First, the companies address a highly impressionable age group; secondly, they ensure good yields for their investments over a long period-investing in the youth means investing in the future. Advertisement campaigns for tobacco are particularly aggressive and well organized in Senegal. The main objective of cigarette advertising is to create an ideal: Smoking is a sign of manhood, since it attracts smart goldcovered women to the smoker by suggesting his strength and intelligence. Then smoking is a public exhibition of Western ease and wealth, with little or no connection to the genuine African values, in a world where "champagne" and "Rolls Royce" are the only worthy counterparts. Again smoking evokes an idyllic way of life, with plenty of spring, waterfalls, and open space. Finally, smoking means immediate privacy and harmonious intergration within the group. In view of the tremendous impact of smoking both on the Senegalese economy and population, it is essential to assess the vulnerability of schoolgoing adolescents to the temptations of nicotine. Adolescence being the time when life-long habits are being formed, it is self-evident that the analysis of the youth's behavior towards smoking is a prerequisite for any effective action against the scourge. Such is the aim of this study.

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METHOD

The research was carried out between 1980 and 1981 with the following sample: 731 subjects aged from 17 to 21 years; 14o70 girls, 86% boys, all schoolgoing and Senegalese; 70% lived in Dakar-Pikine, the remainder were interviewed in Rufisque, Thies, Mbour, Fatick, St. Louis, Ziguinchor, and Kaolack; 30070 belonged to low income nonpeasant families, 18°70 to middle income families, and 607o to high income families; an additional 18 % had peasant fathers, and the rest were undefined. Interviews were conducted in two different ways: 1. A series of 413 interviews (56%) were carried out in 2nde, l~re, and Terminale (last 3 forms in college curriculum) forms in various lyc6es throughout the regions. The questionnaire 4 was administered by two Senegalese collaborators during class hours and was filled out individually and anonymously in order to avoid loss of forms and collective answers. 2. Another series of 318 interviews (44°/0) were administered individually in the various regions of the country. Trained interviewers interviewed schoolgoing volunteers individually and noted the information obtained according to the same prototype used for the collective interviews. The answers to the questionnaire (originally written in French) were tallied independently by two investigators. Interrater agreement was 97% The level of significance for differences between percentages is 0.05, determined using the improved nomograms of Zubin (see Oppenheim, 1966, p. 287; De Landsheere, 1976, pp. 362-364). Results for both forms of interviews showed few significant differences, giving a rather inconsistent set of vague ideas. Several researchers express reservations about the validity of oral interviews to obtain information on tobacco smoking. Wafelbakker (1968) suspects that the young are less honest in their reaction. Van Proosdij et al. (1958) even hold that for vanity's sake, boys would artificially inflate cigarette consumption. Besides, Van Proosdij fears that individual interviews might provoke just the opposite, which explains why he opted for written interviews. Though the same phenomena could be observed here-with the difference that speaking in public in the context of an oral communal civilization often means speaking the t r u t h - w e have not been able to

4The questionnaire (47 questions) will be sent to any interested reader on request.

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confirm such distortions, since results for collective written interviews and individual oral ones showed comparatively little difference.

RESULTS AND DISCUSSION Generalities

Frequency of Tobacco Smoking. Anyone who wants to study and compare tobacco-smoking habits must refer to precise definitions. Wafelbakker (1968) notes that in the literature dealing with the question, there is hardly any uniform criterion to make up a coherent sample. In this stUdy, we describe a smoker as someone smoking at least a cigarette a day throughout our investigation period. In fact our subjects can aptly qualify as "smokers" and "actual smokers," since hardly 1% of them smoked fewer than 9 cigarettes a day. The large majority (81%) smoked 10 to 20 a day. The same observation applies to our "nonsmokers," only 130/0 of whom had smoked once. Consequently, 47.3 % of subjects for our collective anonymous interviews5 are full smokers according to our definition (i.e., almost half of Senegalese schoolgoing adolescents aged 17 to 20 years). The number of smokers in the Dakar adolescent students is the same as that of smokers in the other regions of the country, but the heavy smokers are mostly to be found in Dakar (45 % versus 69%). Modes of Using Tobacco. Baylet et aL (1974a) observe that in Senegal old ways of using tobacco such as chewing it, smoking a pipe, or smoking a cigar are fast disappearing. In some rural areas (e.g., Niakhar) only 15% of the men smoke cigarettes, though the pipe may still remain a favorite with elderly people. The authors conclude that urbanization has caused changes not only in the modes of using tobacco but also in the age of smokers: chewing and pipe tobacco are forsaken in favor of cigarettes, a symbol of both Westernization and youthful modernity. Thus, all the smokers in our sample smoked cigarettes except for 1% smoking the pipe, a choice associated with old age or precocious senility. One can therefore assert that cigarettes represent the major portion of schoolgoing adolescents' consumption of tobacco. 5The percentage for the whole sample rises to 53.5 %. However, this figure must be approached with caution, since individual private interviews mainly addressed people likely to smoke. Among these, nearly 30a/0 smoked 20 cigarettes a day; and half of the nonsmokers declared that they had stopped smoking over a year ago or "long ago."

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A t What Age Do Adolescents Start Smoking? To organize preventive action against smoking, it is important to know the age at which adolescents begin the habit. Two-thirds of our smokers started smoking between 11 and 16 years, but 1407o stated that they had already started between 8 and 10 years of age. The latter data were confirmed by nonsmokers, one-fifth of whom believed their comrades had actually started smoking before the age of 10. This leads us to suggest, together with Bewley et al. (1973, 1974), that any anti-tobacco campaign should aim first and foremost at primary schoolchildren, who are exposed to their first temptations and curiosity about the cigarette fad. This is all the more urgent as Van Proosdij (1960, p. 181) also observes that the young very quickly catch the habit of smoking. The majority (80070) become addicted within two years of their first cigarette. The same author adds that "by smoking earlier and earlier, one becomes a heavy smoker earlier." Moreover, numerous studies have confirmed that adolescents generally have their first experience of tobacco in their childhood. Van Proosdij (1960, p. 183) reported that as early as 1916 in Leiden (a Dutch city) 92070 of boys had already been smoking. In 1957, he examined in another Dutch town (Amsterdam) 2443 pupils aged from 3 to 10 and found that 28% of the boys had smoked once at the age of 9. In the Netherlands, Wafelbakker (1968) observed that a quarter of his respondents (12-to-21year-old boys) had smoked before the age of 10, and Drogendijk (1977) identified 10 years as the age of the first experience. That adolescents start smoking early is confirmed in several other countries: East Germany (Zuber and Zuber, 1973), Ireland (Corridan, 1963), the United States (Veldman and Bown, 1969), and Australia (Leeder and Woolcock, 1973). In a study of seven "primitive" societies (i.e., the Herreros and Boshiman, the Buganda, and other peoples of Melanesia), Damon (1973) observed that half of the respondents forbade their children to smoke, yet children would smoke before the age of 10. In Senegalese urban schoolgoing circles, Baylet et al. (1974b) note that 42070 smoke before 15 years of age and 84% before 20. We must observe here that a precocious habit is acquired on the occasion of circumcision, which generally occurs between the ages of 5 and 11, when young boys have first contacts with tobacco considered as a factor of manhood corresponding to their passage from childhood to puberty. Another practice that encourages the early habit of smoking is the typically Senegalese "after" practice, which means that one cigarette is shared by a band of young boys smoking one after the other in their secret hide away.

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Expenses Occasioned by the Use o f Tobacco. Regarding the expenses of smoking (cigarettes are often sold one by one), only one-third of smokers estimated them at less than 1000 FCFA (= $2.50) per month. Some 10% even situated them between 5000 and 10,000FCFA a month. Half the nonsmokers who have had previous experience estimated their expenses at less than 1000 FCFA a month. In view of the low standard of living in Senegal, the high cost of living in towns, and the scarcity of schoolgoing adolescents' financial resources, these figures are considerably expensive and show that high cost is not an absolute deterrent. However, Wafelbakker (1968) observed that among his subjects, boys with less pocket money smoked less than the rest. Tobacco Smoking According to Sex. In almost all the studies conducted throughout the world, the sameobservation recurs: Boys smoke more than girls (e.g., Bewley et aL, 1973; Gadourek, 1965-1966; Horn et aL, 1959; Van Proosdij et al., 1958). However Gadourek (1965-1966) observes that the more educated and urbanized women are, the more they smoke, since the use of tobacco is a sign of women's emancipation and independence. It is also true, as Baylet et al. (1974c) pofnt out, that "the Senegalese society does not always tolerate tobacco-smoking by young girls." However intellectuals have already begun to contest what they consider as a restriction upon women's freedom: "Senegalese women," they hold, "have the same rights as men, they should be allowed to smoke without incurring any remonstrance for it." Drogendijk (1977, pp. 22-23) and several other researchers have also observed the considerable increase in the number of female smokers, compared to the past. Our own sample showed twice as many boys who smoked as girls. Statistically significant differences (p < 0.05) in the interviews also occurred: 1. Female smokers, compared to male smokers, smokedat a later age, smoked more in private and less in public. Females smoked to show maturity and autonomy to their male counterparts or boyfriends, or to get rid or boredom, nervousness, or sentimental blues. However, females would discontinue the use of tobacco with age, growing responsibility and desire for respectability, and on realizing that smoking is waste of money and a threat to one's health. 2. Female nonsmokers, compared to male nonsmokers, smoked more on the occasion of festivities upon their friends' enticements despite their awareness of the harmful effects of smoking. Another important factor invoked by both female smokers and nonsmokers was the growing indifference of parents in keeping with the so-much-decried permissiveness

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of modernizing societies. Finally, female nonsmokers found it easier to stop smoking for either social and moral reasons or budgetary ones. Tobacco Smoking in Dakar and in the Hinterland. We compared the reactions of the highly urbanized Dakar adolescents to those of the hinterland adolescents, who are more often than not in a rural environment. Statistically (p < 0.05) meaningful differences were as follows: 1. Dakar smokers, compared to non-Dakar smokers, smoked at an earlier age under all circumstances, but did not believe as firmly that smoking has no advantage. They smoked more out of personal curiosity (temptations in large towns are greater and more frequent). Because of their greater awareness of the harmful effects of smoking due to better information in the urban areas, because they also suspect urban anonymity to foster all such modern vices, their parents more often advised them to refrain from smoking, while fewer of their friends blamed them. Finally "mere pleasure" was less quoted as a reason for smoking than "loneliness" or "fatigue," the latter two conditions being more frequent in the stressgenerating urban environment. 2. More nonsmokers in Dakar, compared to non-Dakar nonsmokers, considered smoking as a bad habit caught through imitation, bad company, and vice. They also smoked more to relieve headaches. 3. Dakar ex-smokers, compared to non-Dakar ex-smokers, confirmed that they had smoked mostly out of curiosity and did not think smoking was altogether "a bad thing." Drogendijk (1977, p. 101) did not find any difference between urban and rural areas, probably because of the nature of his sample. Indeed, one can wonder whether in the Netherlands there still exists a real rural area and rural mentality, while in Senegal the countryside has often been left unpolluted by the social and psychological diseases of modern urbanizing centers. Motivations

Any study of motivations regarding tobacco smoking should give careful consideration to Dunn's preliminary remark (1973): "Most of the existing studies have been made post-factum, which precludes the researcher's involvement in the very process of the smoker's motivations." Dunn (1973) also notes "a general consensus on the incipient and terminal

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stages of transition and of continuity," a situation that sharply contrasts with the physiological research on the subject, in which several experiments have been conclusive. Therefore, our own research here cannot pretend to be an exception to Dunn's criticism. Smoking is caused by a set of complex motivations. Respondents were prompted to freely express themselves by such questions as "Why do you smoke?", "What led you to smoke?", "Who drove you to smoke?" The three most frequent reasons put forward by our subjects were "I like it" (18070), "out of habit" (18o7o), and "to dispel boredom and unpleasant thoughts" (14°70). Other reactions quoted were under 10070 of the total answers. The very same reasons were also quoted by nonsmokers, though in different proportions (respectively, 20%, 5%, and 9%). Nonsmokers further commented that others also smoked "out of vice" (16%) or "to pass for adults" (12°70). They quoted motivations hushed up by smokers such as "they're trying to be cute" or "they want to feel like warriors" (tough guys) and "Publicity drives them to smoke." In these specific cases the perception of causes varies according to the status of respondents (i.e. whether they are smokers or noti. A wide range of other reasons scoring between I°70 and 10% was quoted by smokers and nonsmokers alike. People smoked because "it is fashionable," "it gives confidence," "to control one's nerves," and "to remedy loneliness." Smoking also provided "relaxation and pep," "kept one busy," "annihilated fatigue," "gave lucidity," "made one happy," or was simply "enjoyable." Comparatively few Senegalese quoted "curiosity" as a main motive for tobacco smoking, in sharp contrast to other research in which this item was quoted in the first place (see Bothwell, 1959; Corridan, 1963; Drogendijk, 1977; Forrest, 1966; Van Proosdij, 1960, p. 182). On the other hand, non-smokers mentioned curiosity as an incentive for smoking. Some of our respondents held that smoking brought them relief in sickness, cured nausea, and made drinking alcohol enjoyable. In this regard, Gadourek (1965-1966) underlines that smoking and drinking alcohol are often considered as typical adult attitudes to which the youth aspire. Both represent for the young a way of asserting their autonomy, their own maturity and virility. Curiously enough, contrary to what happens in several other researches (see Bewley et al., 1973, 1974; Bothwell 1959; Forrest, 1966; Gadourek, 1965-1966), our respondents rarely insisted upon the socializing role of tobacco smoking as a factor of group cohesion, Contrary to their Western counterparts, African adolescents are used to a highly communal life that seldom resorts to such artificial social props. Though smoking helps the African child better integrate with his own age group, it later

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hinders his integration with the society at large, as it encroaches upon the code of respect and politeness in the adult society. Bewley et aL (1973, 1974) further comment that smoking is an answer to the social pressure exerted by the group or peers. Most young children, they continue, smoke at first without any pleasure or satisfaction, and have an attitude toward tobacco smoking that is rather negative. Van Proosdij (1960) speaks of the magic effects of tobacco and its social function of helping overcome shame and uneasiness and of increasing self-confidence. However, he also observes that cigarette smoking may be an unintentional obstacle between smokers and their environment. Smokers may hide behind a cloud of smoke or feel ill at ease when others mind their smoking. Among all the research on the social role of tobacco smoking, Damon's (1973) is a special case. Studying seven "primitive" societies, Damon concluded that the major incentives for cigarette smoking are not social factors, but are related to the mere satisfaction of personal physiological needs. However, he acknowledged that such conclusions are strongly at variance with the social role of tobacco smoking in North and South America (e.g., the importance of the peace-pipe ritual among Native American Indians.) Finally, Leeder and Woolcock (1973) have shown in their studies of various groups of immigrants in Australia that smoking habits are closely determined by culture. To the question "What circumstances led you to smoke?" or "Who enticed you to smoke?", almost 40% of our smokers replied "influence of friends whom I had imitated." Answers to the question "Who enticed you to smoke?" further confirmed this, with the interesting characteristic that adolescents were very rarely influenced by their fathers, contrary to the findings of other studies. Fathers scored 1.5% and brothers 3.5%. The obvious reason is that Senegal is a predominantly Moslem country, so that more than three-quarters of the smokers' and nonsmokers' fathers do not smoke; and the majority of mothers do not smoke either. A little over one-third of smokers and nonsmokers had at least a brother who smoked. All in all the family environment far less induces to cigarette smoking than peers. In an inquiry on tobacco smoking in Dakar, Baylet et ai. (1974b) note that family inducement is modest while the role of comrades is self-evident. Urged by the desire to do as their comrades, these adolescents start the habit, then become addicted in the long run. That the family does not induce to cigarette smoking was evidenced by some adolescents confessing that they "hid in order to smoke," that it was "impolite to smoke at home in the presence of other members of the family."

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Wafelbakker (1968) has already observed that male adolescent smoking was determined by whether the fathers smoked or not. Van Proosdij (1960) believed that smoking mothers presented greater risks for youngsters. On the other hand, Gadourek (1965-1966) denied any link between adolescent smoking attitudes and parents' bahavior (also confirmed by Drogendijk, 1977, p. 77). Gadourek even found that adolescents with permissive parents smoked less than those with repressive parents. Smokers and nonsmokers have the same ideas about the persons and circumstances that influenced their smoking, with a slight difference: Twice as often as smokers, nonsmokers said that people "smoked because they had problems"; and four times more often than smokers, nonsmokers said that people smoked to show off (out of snobbishness). These two reasons require from smokers a high degree of self-criticism, which explains why such attitudes were less frequent among them. Forrest (1966) observes that most people who have never smoked think that smokers start smoking because they suddenly are brought under tension, and they go on smoking to maintain their emotional balance, thus becoming cigarette addicts. His study finds that the never-once smoker's opinion coincides with that of the "heavy smoker" (smoking to ease tension), and the opinion of those who have smoked in remote times coincides with that of occasional smokers (smoking to feel at ease in society).

Circumstances Leading To Tobacco Smoking

We have already examined a few circumstances that lead adolescents to tobacco smoking. To analyze this problem in depth, adolescents were asked if there were any specific circumstances in which they smoke more or less than usual, and whether they smoked in the presence of certain persons. Smoking was heavier when smokers were nervous (18%) (under the assumption that it cured nervousness),e The same proportion of nonsmokers confirmed this observation, but also found twice more than smokers that festivals and parties offered better opportunities for smoking. Nonsmokers put forward two arguments that escaped smokers: "Smokers smoke when they have headaches" (15%) and "when they find themselves in the presence of the opposite sex" (9%), which was confirmed by as many girls as boys. As has been mentioned, boys also learned to smoke at

*Drogendijk(1977, p. 79) was alarmedat findingthat a fifth of his sampleof regularsmokers smokedto controltheir nerves,whichprovedthat schoolgoingadolescentshad a great dealof tensionto absorb.

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circumcision time, 7 by "picking up cigarette butts," and "in the cold periods of the year." On the other hand, several circumstances were mentioned by smokers, but not by nonsmokers, such as "I usually smoke more when I am lonely and sad" (8°70) of "when I am in an unfamiliar environment." All smokers and nonsmokers agreed that smokers smoked more when they were surrounded with friends (10OTo), because smoking helps create an atmosphere especially when "sitting up socializing with friends" (all-night tea parties are very frequent among Senegalese adolescents, the tea ritual being an almost national habit). Several other circumstances were mentioned. Subjects smoked while drinking tea or wine. Though the combination of smoking and alcohol is some times regarded as a European custom to be rejected by the youth (according to Fougeyrollas, 1967, p. 106), there is a positive correlation between smoking and alcohol, and also between smoking and coffee or tea, as has been confirmed by several other researchers (Forrest, 1966; Lilienfeld, 1959). Subjects also smoked after meals, in the evenings, and at night (mostly females when in company according to Forrest, 1966), during the long holidays, to "try being cute," to raise their spirits, and to overcome fear. "In what circumstances do subjects smoke less than usual? Subjects smoked less when it was hot (16o70), when they were tired (9070) or sick (9o70), and when they were moneyless (8070). Whether work stimulated the desire to smoke could not be ascertained among our subjects. However, twice as many smokers as nonsmokers declared they smoked less while working, contrary to American smokers (Veldman and Bown, 1969), who were markedly less motivated to work than nonsmokers. The same ambiguity prevails regarding whether smoking increases or decreases with smokers' problems, both in smokers' and nonsmokers' opinions. On the other hand, when smokers were happy, they indifferently smoked more or less. Subjects smoked less in the mornings and at school, when they became aware of the noxious effects of tobacco smoking, and when they practiced sports. Wafelbakker (1968) observed that members of a sports club smoked less than nonmembers. However, other researchers (such as Horn et al., 1959) did not find any relation between smoking and the practice of a sport, especially a collective sport. Nearly three-fourths of smokers stated they refrained from smoking in the presence of certain categories of persons. These persons are aged people and smokers' own parents, in whose eyes such behavior means impoliteness 7Baylet et aL (1974b) found that in certain parts of Senegal, smoking was recommended during initiation ceremonies and ritual funerary vigils.

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and disrespect. Subjects also refrained from smoking in the presence of religious leaders. For some time now, the Mourides, one of the largest sects in Senegal, have banned smoking in their religious capital city, Touba. Another religious sect on the outskirts of Dakar, the Lay~nes, also ban smoking at Camb6r~ne as well as playing music. In other regions of Senegal (e.g., Medina Gounasse, Thi6naba), religious leaders strongly advise against tobacco smoking. Despite this general tendency among Senegalese Islamic brotherhoods, Baylett et al. (1974a) are right to say that "certain Muslim sects do not formally ban tobacco-smoking though they advise against it." Islam does not recognize any merits of tobacco. Since most parents are perceived by the young as being very pious (Vandewiele et al., 1980), it is out of the question for youth to smoke in parents' presence in the name of respect, politeness, and religion. Cattell and Krug (1967) also found a negative correlation between smoking and the practice of a religion, while McArthur et al. (1958) confirm that nonsmokers and their parents are often very pious. A few smokers further specified that they refrained from smoking in the presence of foreigners, women, and sick people. Regarding the favorite places for smoking, many smokers had none. Others were content to smoke in their own rooms, far from their parents' inquisitive eyes.

Reactions of Smokers' Environment

How do smokers perceive the reactions of their immediate environment to them? The study of this question was limited in our research to social groups that most influence schoolgoing adolescent behavior, namely, parents, teachers, and friends. The most frequent reaction from parents was to blame smokers (36°7o). They either disapproved of smoking or even more strongly forbade it (10%). Parents reprimanded smoking children, sermonized on its prohibition by Islam, and sometimes threatened "not to cure them anymore." Parents insisted upon the noxious effects of tobacco smoking on their children's health. However, some youngsters pointed out that their parents had resigned themselves to abstaining from forbidding them to smoke, even though over one-fifth of smokers explained their parents' silence by the latter's ignorance of their smoking. 8

aComparatively, only 9.40/0 of Dutch smokers aged 10 to 18 years interviewed by Drogendijk (1977, p. 92) smoked incognito.

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We can therefore state that a great many adolescents dissimulate their smoking behavior for fear of family sanctions. If we add that a large portion of our respondents, though verging on adulthood (the mean age is 19. l years), feel uneasy about smoking in the presence of their parents, we can take as certain the existence of a guilt complex on which preventive action could build to curb cigarette consumption among adolescents. Nonsmokers' keen sensitiveness to parents' scorn, and indignation at smoking in presence of parents or older people, already indicate the preventive efficacy of such psychological and cultural action. Even though great consideration was given to teachers' reactions, the percentage of those who advised against smoking hardly rose to 48%. Respondents observed that many teachers abstained from any criticism to avoid interfering with the problem ("they said that we were free to smoke or not to") or simply because teachers smoked themselves. Should a campaign against cigarette smoking be launched among schoolgoing adolescents, all teachers would obviously have to be involved and commit themselves not to set bad examples anymore, especially as it is a well-known fact that adolescents generally (ake example from their teachers. At present, only 5% of smokers reported that their teachers forbade smoking, while a few teachers had students believe that smoking lowered intelligence and the quality of school results or still caused delinquency. Finally, 5°70 of nonsmokers denounced the shocking inconsistency of some teachers who preached against smoking while smoking themselves. Friend's reactions were far more favorable than parents' and teachers' for two reasons: Either friends were indifferent to subjects' smoking (28070), or friends were smokers too (22070). In some cases, friends even encouraged smok~g, which nonsmokers strongly resented, as 21% declared that their comrades induced them at times to smoke in their turn. On the Other hand, other subjects reported that their friends advised them against cigarette smoking (I 8 %) or, at all events, advised them to cut it down (I 2 %). Several researches have confirmed the dominant role of smokers' peers. Wafelbakker (1968), for example, noted that 48% of smokers versus 3% of nonsmokers in his sample had nearly all friends who smoked. On the other hand, only 5 % of smokers versus 63 % of nonsmokers declared that most of their friends did not smoke. Very few parents, teachers, and friends used the expense of cigarette smoking as an argument against it, no doubt because adolescents are not wage earners. That parents, friends, and teachers argued that "smoking was bad" was quoted by nonsmokers three times more often than by smokers. This finding is a clear sign that smokers' social spheres are growing more tolerant of or, at any rate, less sensitized to the noxiousness of tobacco smoking.

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The influence of smokers' environment is also apparent in the socioeconomic circumstances that surround them. Even though our study did not provide precise information on this subject, we may infer some considerations from the relevant literature. Drogendijk (1977, p. 100) discovered no significant correlation between the number of smokers and the father's profession, while Wafelbakker (1968) held that there were more smoking fathers in the high income groups than in the poorer ones. Salber and MacMahon (196) confirmed these findings that smoking was heavier among low or middle income groups. McArthur et al. (1958) made the same observation for an American sample, and he also found that smokers often belonged to social professions and the business world.

Perception of the Consequences of Tobacco Smoking Subjects were asked to specify the consequences of tobacco smoking in two opposite ways: the beneficial effects and the noxious ones. Less than one-quarter of total smokers and over one-third of nonsmokers held that smoking was altogether unprofitable. However, over 10°70 of smokers believed that smoking helped them overcome their trouble, kept them busy, put them in good spirits, relieved and relaxed them. Such a feeling of relaxation and well-being was also evidenced by Swedish subjects in a study by Myrsten and Andersson (1978). These subjects contended that smoking enabled them to concentrate better. Yet, according to the authors, the growing selectiveness of subjects' attention made them feel more sensitive to the essential aspects of their tasks rather than to the secondary ones. Our subjects contended that tobacco smoking relieved loneliness and brightened their ideas. Thanks to smoking, they felt more self-confident, more balanced and courageous. It dispelled sleepiness, made food more pleasant, and gave them a glib tongue. A few male smokers,also expected smoking to help them make a good impression on girls, while some female smokers hoped to lose weight by smoking. Some nonsmokers mentioned, above all, the pleasure and enjoyment as well as the success that cigarette smoking was supposed to provide. Such perceptions of the beneficial effects of tobacco smoking are undoubtedly the result of the intensive advertisement campaigns carried out unceasingly by the tobacco industry. Some of the subjects' comments merely reproduced the slogans used by radio, TV, or press announcements to praise such and such a brand of cigarettes. Regarding the noxious effects of tobacco smoking, over a third of smokers and nonsmokers believed that tobacco smoking ruined their

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health, and more than 10070 considered it a waste of money. Hardly 2070 of smokers were categorical in their judgment and found no disadvantage to smoking. Many subjects were also quite aware that tobacco smoking could cause serious intoxication and various diseases: It was said to cause cancer, tuberculosis, irregular breathing. It also provoked headaches, nervousness, fatigue, nausea, and even nervous breakdowns. Subjects were persuaded that smoking blackened the teeth, reduced eyesight and appetite, caused loss of weight, and even gnawed at intelligence and induced abortion. It was feared that tobacco smoking drove one into laziness and delinquency, caused bad odors that upset nonsmokers. The latter, more than smokers, denounced the risks of fires. One subject summed up the noxious effects of cigarette smoking in this striking simile: "Smoking is another form of enslavement." Therefore, regarding the noxious effects of tobacco smoking, a good many prejudices prevail which are still based on incomplete or even erroneous information. However, even when the quality of information is handled with great care, it does not necessarily guarantee a successful prophylaxis and prevention. Two examples can further illustrate our point. In a study by Forrest (1966), one-quarter of subjects denied any correlation between smoking and cancer (i.e., percentage four times higher than that of nonsmokers). Smokers considered that the results arrived at by scientific researchers could not apply to them individually. Secondly, Bewley et al. (1974) observed that in England children were aware, at a very early age, that smoking can cause cancer, even though some of them did not consider smoking dangerous to their health. This would suggest that the "message of cancer" is often misunderstood and ill prepared. Objective information should be integrated with a global anti-smoking strategy if any significant progress is to be made. Adolescent subjects had greater awareness of the noxious effects of tobacco smoking than of the beneficial ones. Disadvantages were on a physical hygiene and health level, advantages on a psychic level. Despite such awareness of the damaging effects of smoking on one's health, there was no firm and consistent condemnation of smoking. To the question "What do you think of the habit of smoking?", 43070 of smokers and half of the nonsmokers replied a categorical "it is bad," but opinion was divided sharply for the rest of the sample: 96070 of nonsmokers condemned smoking versus 73070 of smokers; when requested to judge other smokers, 39°70 of smokers had no opinion. More than 10070 of smokers found smoking was good because it relieved them, "was not a serious matter indeed," or because "I smoke very little" or "I can easily do without it." There were relatively few self-critical

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comments: Subjects granted that they were dissatisfied with themselves, unfair to others, that they smoked too much and had to stop. However, 6% confessed openly that they just could not do without tobacco smoking. To the question "Do you contemplate to stop smoking?", over 12°/0 of smokers replied negatively because "it was a habit," they "did not even give it a thought," it did not ruin their health, or because it relieved them and even stopping smoking would cause headaches. However, the large majority of smokers had good intentions, since they wanted to improve their health conditions, avoid diseases, and spend less money. Others stopped smoking to please their parents, "to avoid polluting their environment," or "to set an example for the family." Some wanted to stop "to remain athletic" or because "their friends had stopped and they did not want to be enslaved to cigarette smoking." When smokers were asked "whether it would be easy for you to stop smoking," only 35%o believed so (versus 69%o of nonsmokers who once smoked in the past). A third of these ex-smokers had stopped smoking because it ruined their health, and another third described their former habit as "bad and unpleasant." Only 13% of those ex-smokers had stopped for lack of money, and a mere 10% at their parents' injunction. Some declared they could not get used to the taste of tobacco, that it made them feel tired very soon and took away their appetite. For the sake of comparison, half the subjects in Gadourek's research (1965-1966) contemplated stopping smoking, but one-quarter of t h e m - t h o u g h aware of the noxious effects of tobacco smoking--owned that they were incapable of doing so. Another large group declared they would not probably stop because youngsters were attracted by the risks involved in the habit (Dorn and Thompson, 1974). The Royal College of Physicians in London (Drogendijk, 1977, p. 10) found that one out of five smokers stopped, but only momentarily, especially the young. This report sums up the main reasons why smokers stopped smoking: First, they did not want to take any more risks with their health (cold, heavy breathing, cancer, etc.), then because smoking was too expensive, and last because they wanted to show their self-control. The bad taste of tobacco was seldom considered as a deterrent against smoking.

Structure of Personality Though the study of personality structure is not part and parcel of our investigation, we are forced to consider the fact that subjects regularly refer to traits pertaining to character when requested to comment on the habit of smoking, such as "it makes one lazy" or "it makes one nervous."

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We have limited ourselves to analysis of a few findings taken from an abundant literature on the subject and partly synthesized in Smith's works (1970). This author has analyzed consistent empirical data on the relationship between tobacco and personality and his results confirm our findings-the tendency of smokers to grow lazy or nervous as a result of tobacco smoking. Smith's (1970) main points follow. 1. Smokers more than nonsmokers are extroverts (Cattell and Krug, 1967; Eysenck et al., 1960; Eysenck, 1963, Schubert, 1965) and have more asocial tendencies (also see Evans et al., 1967), i.e., are "rebellious, misbehaving, arrogant, and unpleasant." 2. Smokers are also more "externally controlled," from James et al.'s (1975) concept of "internal-external control," which Smith defines as smokers' tendency to think that events are caused by chance or by other people's manipulation, rather than by their own striving and abilities. 3. Smokers appear more impulsive (also see Schubert, 1965) and have greater oral need (see Jacobs et al., 1966; Veldman and Bown, 1969). In a psychoanalytical perspective, Fenichel (in Van Proosdij, 1960) even speaks of the satisfaction of oral eroticism provided by cigarette smoking, but this theory of fixation is contradicted by Gadourek (1965-1966). 4. Smokers are in a poorer health condition than nonsmokers, though results are sometimes contradictory. It is certain that "no research has yet demonstrated that smokers have a better psychic health than non-smokers" (Smith, 1970, p. 59), which led Gadourek to deny any positive correlation between smoking and the symptoms of neurotic behavior. Salber and Rochman (1964) observed that female smokers had greater self-confidence than female nonsmokers, that heavy smokers had more unsatisfactory relations with parents and authorities than nonsmokers. For these authors, such resistance to adult authority drives these subjects to seek refuge and security by smoking with their peers, an action that therefore symbolizes their defiance at the adult world. Veldman and Bown (1969) found that smokers had a poor opinion of themselves and poorer cognitive abilities than nonsmokers. Smokers had a higher degree of anxiety (Srole, 1968), but seemed more self-dependent (Pflaum, 1965). Regarding the link between tobacco smoking and intelligence, we have only referred to comments of our subjects which are pertinent to the subject and can shed light on personality structure as it may be influenced by smoking. Opinion was divided among our subjects whether smoking made one more or less intelligent. Several researchers also reflect this ambivalence. We can assume that subjects who believe that smoking made them more intelligent do so because it actually enabled them

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to overcome certain inhibitions and feel more at ease and more performant. However, a great number of investigations (Pumroy, 1967; Veldman and Bown, 1969) have confirmed that tobacco smoking often entailed poor school results. To this explanation by Wafelbakker (1968). 1. Poor school results are the consequence of tobacco smoking (as tobacco smoking entails bad health and poor concentration). 2. Smoking is the consequence of poor school results. 3. Smoking and poor school results are linked to a third factor: the social class of smokers, and the structure of personality (and even the biological factor). We opt for the third hypothesis, together with Drogendijk (1977), for smoking is a very complex activity in which sociocultural background plays an important part and in which the relationship with personality cannot be reduced to a mere cause-effect type. Before concluding, a general observation should be recalled here: The majority of research on the question has been made on Anglo-Saxon populations. It would be hazardous to extrapolate such findings to African populations. A great deal of research must still be made prior to any conclusive statements.

CONCLUSION AND SUMMARY One obvious conclusion of this study is the close relationship in Senegal, as in most developing countries, of tobacco smoking and the growing adoption of Western values and ways of life concomitant with industrialization and urbanization. Over the past few years tobacco smoking has been on the increase largely because of the persistent advertisement campaigns launched by the tobacco firms in all the media. Simultaneously, the fast pace of industrialization and urbanization has created new needs and further maladjustments for which tobacco smoking has appeared to be a miraculous panacea. Most Senegalese adolescents seem to have focused on cigarette smoking as a palliative for the stress and insecurity-mostly psychological-that they feel in their society. It also helps them go through the hesitations and frustrations typical of their immaturity; it is also a "rite of passage" for their initiation into their age group and into self-confidence. The latter psychological interpretation may be an extension and transposition of one value of smoking in the traditional society, which associates smoking with old age as procuring powers of concentration, inspiration, and knowledge.

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However, several factors, more psychological and cultural then economic, militate strongly against tobacco smoking. The first factor is health. Though a great many adolescents are aware that cigarette smoking is generally hazardous to their health, they can hardly visualize the real effects it has on them, since precise information on the subject is often lacking. Secondly, as students grow into adulthood and greater self-confidence, as they become more responsive to the often d e b a t e d - in classrooms, on the radio and T V - notions of national identity and cultural authenticity, they tend to outgrow the smoking mania. Finally, in compliance with the avowed preference of most religious leaders for nonsmoking, a large number of adolescents are willing to quit smoking. All these reasons indicate that for such a young developing nation as Senegal, where the youth is still open to the virtues of scientific discoveries and to the genuine values of the cultural past, where religious authority and the power of government are still very considerable, a well-conceived and carefully implemented anti-smoking strategy should yield particularly fruitful results. At a time when the World Health Organization (1979) is raising world consciousness of the manifold dangers of tobacco smoking, certain Third World countries, particularly African developing countries such as Senegal, seem to be experiencing ever-increasing pressure from the magnates of the tobacco industry. Tobacco smoking is all the more serious in Senegal, where it is a cultural, psychological, and economic problem. This article has analyzed the attitudes of schoolgoing adolescents towards tobacco smoking from these points of view.

ACKNOWLEDGMENTS The authors are profoundly grateful to the Belgian Cooperation Service for the material assistance they kindly provided us. The authors wish to thank Mr. A. Ndiaye for his collaboration.

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