Understanding smoking behavior among young adults in rural Gujarat: determinants and preventive strategies

Youth is a critical developmental stage marked by curiosity, risk-taking, and strong peer and social influences. Tobacco initiation often occurs during this period, making young adults a key target for prevention. Despite national and state-level tobacco control efforts, smoking remains prevalent among rural youth in India. In Gujarat, easy availability of tobacco products, social acceptance, and limited awareness further reinforce smoking behavior. Understanding context-specific determinants is essential for effective prevention strategies. A descriptive type of qualitative study was conducted in Changa village, Gujarat. Six young adult smokers (aged 19-24 years) and seven parent key informants were selected using snowball and consecutive sampling, respectively. Data were collected through in-depth interviews and a focus group discussion, audio-recorded, transcribed verbatim, and analyzed manually using thematic analysis. Ethical approval was obtained, and informed consent was taken from all participants. Three major themes emerged: health concerns, influencing factors, and governmental norms. Participants were aware of smoking-related health risks; however, peer influence, emotional distress, curiosity, and parental modeling contributed to continued use. Early signs of dependence, normalization of smoking, and desensitization to health warnings were evident. Structural factors, including easy access to cigarettes, weak enforcement of regulations, and low awareness of cessation policies, further sustained smoking practices. Parents emphasized the role of school-based sensitization and community awareness initiatives. Smoking among young adults in rural Gujarat is influenced by individual, social, and systemic factors. Comprehensive, multi-level interventions focusing on education, parental engagement, regulatory enforcement, and accessible cessation support are crucial to reduce smoking initiation and promote cessation.