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‘The missing picture’: tobacco use through the eyes of smokers
  1. Rebecca J Haines1,
  2. John L Oliffe1,
  3. Joan L Bottorff2,
  4. Blake D Poland3
  1. 1School of Nursing, University of British Columbia, Canada
  2. 2Faculty of Health and Social Development, University of British Columbia, Okanagan, Canada
  3. 3Department of Public Health Sciences, University of Toronto, Canada
  1. Correspondence to Rebecca J Haines, NAHBR, School of Nursing, 302-6190 Agronomy Road, University of British Columbia, Vancouver BC V6T 1Z3, Canada; rebecca.haines{at}


Background The use of visual methodologies has gained increased prominence among health researchers working with socially marginalised populations, including those studying tobacco and other types of substance use.

Objectives This article draws from two separate studies combining qualitative and photographic methods to illustrate the unique insights that visual research with smokers can generate for tobacco control.

Methods A purposeful selection of photographs and captions produced by research participants in a study with (1) 20 new fathers that smoke and, (2) a study with 21 adolescent girls that smoke are analysed and discussed in detail.

Results Images produced by smokers illustrate the roles of gender and social context in shaping smoking status, as well as the private struggles with tobacco use experienced by smokers in their day-to-day lives and relationships.

Conclusions Photographic methods have the potential to generate information that may assist in developing tobacco control messaging and programming that speaks to smokers' perceptions of their tobacco use.

  • Tobacco control research & practice
  • visual methodologies
  • advocacy
  • gender
  • social context
  • tobacco control imagery
  • visual methods

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  • Funding The projects discussed in this paper were funded by a student research grant from the Canadian Tobacco Control Research Initiative (CTCRI) (RJH, no. 015521) and grant funding from the Canadian Institutes of Health Research (CIHR, Institute of Gender, Sex and Health) (JLB and JLO, no. B05–0296). RJH is supported as a trainee in the Integrated Mentor Program in Addictions Research Training (IMPART) and Psychosocial Oncology Research Training (PORT) program. JLO is supported by investigator awards from the CIHR and the Michael Smith Foundation for Health research.

  • Competing interests None.

  • Ethics approval Ethical approval for this research was obtained from the University of British Columbia (study A) and the University of Toronto and the Hospital for Sick Children (study B). All of the images we discuss in this paper are shared with the express consent of our research participants who signed consent and photograph release forms agreeing that their photographs could be used in academic publications. Please note that in order to comply with BMJ Group patient consent policies we could not include images in this manuscript that identify people.

  • Provenance and peer review Not commissioned; externally peer reviewed.