Smoking to stay thin or giving up to save face? Young men and women talk about appearance concerns and smoking.

OBJECTIVE This study was designed to investigate how young men and women smokers and non-smokers talk about the impact of smoking on appearance, with the aim of using these accounts to inform anti-smoking campaigns targeted at young people. DESIGN Volunteer smokers and non-smokers took part in 24 focus groups. METHOD Eighty-seven men and women aged 17-24 were asked to talk about impacts of smoking on appearance. RESULTS A thematic analysis of transcripts suggested that weight gain after quitting was only a significant concern for the younger (17-year-old) women. Non-smokers of both genders expressed concern about yellowing of skin and teeth if they started smoking, and women non-smokers were concerned about skin ageing. Smokers believed that smoking made them look 'cool', mature, and sophisticated and would quit only if skin ageing and other negative effects on appearance became visible. CONCLUSIONS Appearance concerns are relevant to the decision whether to start and quit smoking, and are linked to gender and age. Results are discussed in relation to implications for the development of age- and gender-relevant anti-smoking interventions.

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