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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel

CiteScore 2018: 0.79

SCImago Journal Rank (SJR) 2018: 0.350
Source Normalized Impact per Paper (SNIP) 2018: 0.476

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Volume 30, Issue 1


Adolescents’ knowledge and opinions about smoking: a qualitative study from the Jhaukhel-Duwakot Health Demographic Surveillance Site, Bhaktapur District, Nepal

Lene Povlsen
  • Corresponding author
  • Unit for Health Promotion Research, University of Southern Denmark. Niels Bohrs Vej 9, DK-6700 Esbjerg, Denmark, Phone: +45 2625 2264
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Umesh Raj Aryal
  • Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Sweden
  • Public Health and Environment Research Centre, Katmandu, Nepal
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Max Petzold
  • Centre for Applied Biostatistics, Occupational and Environmental Medicine, University of Gothenburg, Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Alexandra Krettek
  • Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Sweden
  • Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Sweden
  • Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-04-09 | DOI: https://doi.org/10.1515/ijamh-2015-0124



The use of tobacco products among adolescents in Southeast Asia represents a major public health burden. Two out of ten adolescents attending school are tobacco users and several factors influence them to initiate tobacco use. Most studies related to tobacco use are quantitative, whereas qualitative studies exploring adolescents’ smoking behavior and their views, knowledge and experiences are scarce.


To gain a deep understanding of Nepalese adolescents’ knowledge and opinions about smoking and reasons for smoking initiation.


Adolescents from four secondary schools in the Bhaktapur district, Nepal.


Eight focus-group discussions were conducted with 71 adolescents aged 13–16 years and from grades 8–10. Data were analyzed using manifest qualitative content analysis.


The participants knew that smoking represents health risks as well as socio-economic risks, but few described the addictive nature of tobacco and health risks related to passive smoking. Most participants related smoking initiation to the smoking behavior of peers and family members, but easy accessibility to cigarettes, ineffective rules and regulations, and exposure to passive smoking also created environments for smoking. Some expressed confidence to resist peer pressure and refuse to start smoking, but also expressed the need for prevention strategies in schools and for governmental initiatives, such as more strict implementation of tobacco control and regulations to prevent and reduce smoking.


Curbing the tobacco epidemic in Nepal requires healthy public policies and multifaceted interventions to address the knowledge gap on health consequences associated with smoking among adolescents, teachers and parents/adults.

Keywords: adolescents; health behavior; health promotion; Nepal; smoking


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About the article

Lene Povlsen and Umesh Raj Aryal: These authors contributed equally to this work.

Received: 2015-12-12

Accepted: 2016-02-28

Published Online: 2016-04-09

Citation Information: International Journal of Adolescent Medicine and Health, Volume 30, Issue 1, 20150124, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2015-0124.

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