Changing perceptions that influence tobacco smoking in central Sri Lanka: Preliminary findings from a qualitative investigation

We present the initial findings of an ongoing ethnographic study of tobacco smoking among urban youth in central Sri Lanka. We have explored an apparent disparity in smoking rates among males in high- and low-income communities, focusing on research conducted thus far in the low-income area. Multiple ethnographic interviews and systematic collection of qualitative data were used to investigate the influences on smoking among youth in this poor urban community. The preliminary findings suggest that the combined effect of the health transition and the country’s stagnant economy is influencing smoking by the young in this community in a paradoxical manner. On the one hand, the informants seemed to be well aware of the negative health effects of smoking; in addition, smoking is not tolerated by families, neighbours, community members or prospective spouses. On the other hand, smoking is encouraged by peers, reinforced by difficult work situations and promoted at community events. In the current economic and social climate, these young males appear to be more strongly influenced by pro-smoking social influences.