Since the early 90s there has been no decline in regular smoking rates among 12-15 year olds in Scotland and a considerable increase in cannabis use among teenagers. This thesis aims to explore the role of cannabis in young people's lives during their early teenage years. By generating contextual data on the social situations within which young people use cannabis and the meanings they attach to this behaviour, this study aims to illuminate how participants' cannabis related beliefs, attitudes and behaviour fit within the broader contexts of their everyday lives. This study also aims to explore the links between young people's cannabis and tobacco use, building in particular on findings from a number of earlier studies. The study used qualitative methods, interviewing 59 young people, aged 13-15, primarily in selfselected friendship pairs within the informal setting of youth clubs. In using this relatively novel approach, the study also has a methodological focus, contributing to debates about researching young people's perspectives. The participants were drawn from different socio-economic backgrounds with a range of patterns of use/non-use of both cannabis and cigarettes. The interviewing and analysis of data were based upon a methodology which assumes that it is possible to learn about young people's social worlds through qualitative interviewing. Through these interviews, `stories' were co-produced and then analysed inductively to generate theory grounded in the data. In order to explore how cannabis fits within young people's lives, the data were analysed using a framework encompassing four main contexts - family, peers, local neighbourhood and aspects of broader culture. Analysis of the interview data revealed that young cannabis users employ a discourse of ambiguity when talking about parents' `knowing' about their cannabis use. For some young people, particularly boys, cannabis appears to play a central role in street based leisure cultures, although this was more apparent in some local areas than in others. Within this context, cannabis was closely linked to aspects of social identity, in particular achieving peer status and recognition. Its use was also associated with demonstrating independence in a context of adult-free space. Placing the study in a broader cultural context, the current debate surrounding cannabis control was also found to be of considerable interest to many young people, cannabis users and non-users alike. For some 'cannabisoriented' participants, their cannabis use also seemed to support and sustain their cigarette smoking behaviour, a finding that has implications for the development of effective smoking cessation programmes. A methodological analysis suggested that using friendship pairs is a promising approach to researching young people's perspectives. This method enables young people to express themselves and demonstrate their knowledge and reasoning in reflective and sophisticated ways, providing occasional glimpses into more private worlds as well as presenting well-rehearsed public accounts, especially about health promotion messages. In particular, interviewing young people in self-selected friendship pairs allows access to interactions between participants, illuminating aspects of their social relationships with one another. This thesis makes both a theoretical and a methodological contribution to our understanding of young people and their lives, particularly in relation to cannabis use, attitudes to cannabis and other health related behaviours. It highlights the significance for health promotion policy and practice of listening to young people's perspectives, in particular, their accounts of how these behaviours fit within the broader contexts of their lives.

Risky lifestyle behaviours have a multiplicative impact on both the length and quality of peoples’ lives. In order to improve health outcomes and reduce social inequalities in these outcomes, behaviour change services are recommended by health care and public health professionals. There is evidence to show that engagement in more than one form of health risk behaviour is common at a population level (for example, many smokers and also engage in potential harmful levels of alcohol intake), yet currently, behaviour change interventions focus on change in a single risk behaviour (e.g. smoking cessation). As partaking in more than one health risk behaviour leads to a multiple, rather than an additive risk for poor health outcomes and in order to maximise the potential of the current infrastructure of behaviour change services, this research programme aimed to examine the feasibility of utilising an existing behaviour change service (smoking cessation) to also deliver an intervention for further behaviour change (alcohol harm reduction). A four step process was undertaken. Following the systematic review reported at the beginning of this thesis, a further series of reviews of the evidence base relating to intervention design and implementation were undertaken in order to inform the design of the research programme. Secondly, following an assessment of existing service processes and staff training needs, two studies were implemented. Study 1 was designed as a quantitative study of behaviour change in clients attending a stop smoking intervention into which a second intervention, to address excessive alcohol consumption was incorporated. For a variety of reasons, this study failed to generate sufficient data for the planned analyses to be conducted. Study 2, a qualitative analysis of stop smoking service practitioners perceptions about the feasibility of delivering this intervention, revealed, notwithstanding the initial training prior to the commencement of Study 1, the practitioners’ normative beliefs about alcohol consumption had affected their willingness to deliver the alcohol-related intervention. To support the incorporation of alcohol-related interventions into existing services more comprehensive training will be required, including the need to challenge the beliefs and values of health professionals.

Since the late 2000s the distribution of what seemed to be unregulated ‘recreational’ drugs by street and online retailers has prompted media hype and public anxiety in Europe and elsewhere. These ‘legal highs’ or ‘new psychoactive substances’ (NPS) were often associated with health risks and antisocial behaviour, and they eventually inspired policy debates along with new scheduling measures. This project explores NPS’ general reception in Romania and their more specific integration into injecting drug users' repertoires, a segment of the local drug market traditionally dominated by heroin. By drawing on mainstream media texts and field data collected around treatment facilities such as a methadone maintenance clinic, it focuses on the troubling moral identities of intravenous substance users and the disciplinary practices of the medico-legal apparatus meant to monitor them. In setting out a moral panic model re-imagined as bouts of collective disgust or social abjection, it seeks to connect lived experiences and moral understandings of emerging drugs with historical layers of prohibition discourses that stratify drug using bodies into abject identities. NPS are thus revealed to shape two types of moral panic as drug abjection in post-communist Romania. The first emerges from media discourse and concerns the clean or valuable youth of the nation, calling for the containment of the new drugs trade to assure the sanitisation and survival of the social body. The second surfaces among injecting drug users, with ‘legalists’ or NPS users being increasingly seen by both drug workers and opiate users as a source of disruption to the regulatory devices and collaborative goals of rehabilitation. This ultimately raises larger questions about the liberal governance of pleasure and consumption in Romania’s transition to market democracy. The fluidity o f ‘NPS’ as a medical and policy object thus seems to indicate the ontological spilling of the rational choice-making self out of the flows of capital, power and historical time

MDMA is a popular psychoactive drug that is highly associated with raves and clubbing culture. Consumers experience feelings of euphoria, joy, and confidence. Despite the considerable research on MDMA, non-problematic aspects of use remain under researched. The aim of this study was to understand MDMA use and pathways into and out of consumption. More specifically, the research examines the experience of ex-heavy MDMA users through their MDMA journeys. This qualitative study employed an online questionnaire inspired by the Life Story Approach. Participants were recruited using ethnographic research methods and through related online forums. The inclusion criterion was individuals who self-identified as ex-heavy MDMA users, who have now cut down or completely stopped MDMA use. 104 former heavy MDMA users were surveyed. Data was analysed thematically from which six main categories were identified: Journey; Polydrug use; Role of drugs during consumption; Changes in drug use pattern; Changes in life; and Advice. A common positive tone runs through all the themes, and most reported negativity is due to drug use as a whole. Data analysis highlighted Harm reduction and Function and pleasure enhancement as important overarching themes for participants. MDMA was generally used in specific settings to enhance an event or experience, such as music related events. But MDMA also enhanced intimacy, social bonding, meditation, and was used by some as a cognitive enhancer and therapeutic aid helping to think and feel differently. Many described positive psychological and social effects of use that remained after MDMA use, and often lasted permanently. Although a stop or a cut-down in MDMA use is often a natural process, it could still be cut-down or stopped actively by making lifestyle changes such as distancing oneself from the associated scenes and people. The results of this study bring a foundation of understanding MDMA use and pathways into and out of frequent use, which could particularly be useful in designing appropriate harm reduction programs and inform policy making. Likewise, present findings could help to address further aspects of MDMA use and non-problematic drug use in general.

Negative perceptions of anti-social behaviour have been shown by previous research to have harmful repercussions to both an individual‘s mental and physical health as well as the neighbourhood‘s long term prospects. To track such perceptions the Labour administration of 1997 to 2010 developed quantitative measures at both the national level (using the Crime Survey for England and Wales until recently known as the British Crime Survey) and at the Local Authority level via Place Surveys – a postal survey of residents in all Local Authorities. This thesis argues that the Place Surveys were methodologically flawed. Multilevel small area synthetic estimation can provide an alternative to such localised surveys by using statistical models that predict the probability of a target variable using national data, but adjusting that prediction to take account of local characteristics of both the place itself as well as the people living there. The overarching aim of this thesis is therefore to provide, for the first time, a truly localised picture of perceptions of alcohol and drug-related anti-social behaviour across all English neighbourhoods. The validation tests on the synthetic estimates calculated for this thesis demonstrate a high degree of concordance with the vastly more expensive Place Surveys thus showing that synthetic estimation of crime and criminal justice issues based on the Crime Survey can add value for money to existing datasets, as opposed to spending substantial sums of money on poorly answered local surveys.

Young people are considered to be a key market for the tobacco industry and are therefore vital targets for public health intervention. Current estimates in the UK suggest that more than 200,000 young people under the age of 16 try tobacco smoking each year. As tobacco and cannabis use share the common method of consumption through burning and inhaling smoke, the link between these two substance has drawn a growing focus from researchers. However little is known about the interplay of these two behaviours with specific gaps centring on the risk factors of co-consumption and an awareness of how young people’s own beliefs about cannabis and tobacco co-use drives these interconnected behaviours. There is also a particular absence of literature on place-based practices (e.g. contexts and locations of use) of cannabis and tobacco and how one substance may be used as a result of nuanced aspects of the other. Responding to these gaps, this thesis examines the complexity and inter-connected practices of tobacco and cannabis use among young people in two empirical studies. First, the prevalence of co-consumption is investigated via an online questionnaire with 4,499 11-16 year olds in 12 secondary schools. Second, in a complimentary study, in-depth interviews conducted with 51 adolescents aged 12-19 in two youth club settings explore narratives of use. Results illustrate that co-consumers may not report using tobacco in surveys unless they use tobacco specifically for cigarettes and that young people may rationalise cannabis use due to a lack of evidence indicating that cannabis is unsafe. Results also suggest that cannabis users may deliberately smoke tobacco cigarettes in order to conceal their cannabis use in public settings and this demonstrates the need for a focus on place-based practices alongside individual reasoning for co-use. The thesis extends a small body of research outside of the UK indicating that despite negative attitudes towards tobacco and an avoidance of acknowledging their own involvement with tobacco, young cannabis users may continue to use tobacco because it plays an important role in facilitating cannabis use.

Following the implementation of the smokefree law in 2006, which formed part of the Smoking, Health and Social Care (Scotland) Act 2005, smoking in enclosed public spaces has been prohibited in Scotland. The law has led to a number of improvements in public health but does not cover homes and cars where children are primarily exposed. Secondhand smoke (SHS) exposure is associated with particularly significant risks to child health, yet few studies have explored children’s perspectives on SHS and smoking in the home and car. Comprising a qualitative exploration of the views and experiences of 38, 10- to 15-year-olds of SHS in the home and car, this thesis begins to address this gap. It addresses the nature and extent of children’s involvement in negotiating smoking restrictions, compares the understandings, experiences and involvement among participants living in communities of contrasting socioeconomic profiles and considers the implications for health promotion interventions aimed at reducing children’s exposure to SHS in the home and car. Informed by a Childhood Studies perspective, the study focuses, both in methods and content, on the voices and agency of the participants. Recruited from two Edinburgh communities with contrasting socioeconomic profiles, the participants were interviewed either individually, in pairs or in small focus groups about their understandings of SHS, smoking restrictions in their homes and cars and their role in negotiating them. Home floor plans constructed by the participants were used to prompt discussion and also served to identify spatial and temporal home smoking restrictions. Both discursive and thematic techniques were used in analysis. The thesis details the participants’ overt and covert strategies to resist family members’ smoking, demonstrating the active roles that participants describe in their accounts. While acknowledging SHS as a health risk and using an embodied language of disgust to describe it, the participants’ main concern was for their smoking family members’ health, rather than their own. Many participants also challenged the stigma surrounding smoking parents by detailing the ways in which their parents restricted where, how much and with whom they smoked. Parents were described as especially careful in protecting small children from SHS. While most participants described such protective practices, those from the disadvantaged area reported less stringent smoking restrictions that were more challenging to negotiate. Participants’ resistant (to smoking) and defensive (of parents who smoke) accounts may stem from the growing stigma associated with smoking, particularly smoking in the presence of children. Such findings highlight the importance of a sensitive and asset based public health response that acknowledges parents’ attempts to protect their children from SHS and recognises the potential of the active role of children in family negotiations around smoking in the home and car.

The study at hand explores Greek problematic drug users’ perceptions of the progression of their drug using careers and family responses towards drug affected children in Greece. The methodology of the study entailed the use of semi-structured in depth-interviews. In total, 40 interviews with problematic drug users (PDUs) were conducted as well as 8 interviews with parents of PDUs. Participating drug users were asked to reflect on all stages of their problematic drug using careers, from initial contact with drugs to entering treatment facilities where they were contacted. Furthermore, they were asked to reflect on the role their families played in influencing the progression of those careers and on the impact they felt their drug use had on their families. Parents’ accounts were also collected to provide a fuller picture of the issues in question. The results of the study put forth the vital role of self perception, whether this derives from sense of self through practice or participation in social groups, in relation to drug use onset and escalation. It is suggested that drug use may resemble a learning curve where drug using peers are ascribed the role of ‘aids’. The perception of one’s use as problematic was for the most part related to heroin infringing upon all life domains. Entering treatment was found to be sometimes unrelated to the decision to quit drug use. When the two were synonymous, reported reasons behind such decisions centred on issues of self perception, sense of obligation towards the family and a desire to return to pre-drug use life styles and selves. Reported factors either promoting or hindering change are also discussed. The hugely influential role of the Greek family in the progression of problematic drug using careers is a further proposal made by the current study. The experience of living with addiction in the family home and the reported impact on families is also presented. The specific cultural context of Greece was also shown to be shaping family reactions as well as drug using participants’ choices of course of action and perception of self. The overall suggestion based on the findings of the study is that the experiences of both Greek problematic drug users and Greek families of drug affected relatives form a ‘variform universal’. The conveyed picture is similar to that portrayed in the global literature, albeit coloured by the specific cultural context within which these experiences were lived through.

Much has been written about drug-taking during the nineteenth century, particularly in relation to opium. However, the early twentieth century has received considerably less attention, despite being a crucial period in the history of drug-taking within Britain. During 1916, the Defence of the Realm Act Regulation 40b made it an offence to supply or to possess particular drugs without authorisation. This was a fundamental shift in government thinking that presaged the modern era in which the legal status of particular drugs continues to be an issue of public debate. Previous research focused on changes in the law and analysed the relationships between key individuals and influential groups with an interest in drug control. In part, this reflects the significance of the decision to alter the law but also the lack of available evidence concerning drug-takers of the era. This study seeks to address this gap in understanding and develops a new perspective on drug-taking, that of the participants. The study developed an innovative and, at times, speculative approach to tracing drug-takers of that era. This led to the use of articles from The Times identified from systematic searches of The Times Digital Archive. These articles by their nature were mediated accounts of drug-related activity but no other source could offer such a range of drug-takers over the selected time period (1900-1922). Furthermore, the large number of articles identified meant that it was easier to detect press influences and take these into account when analysing their content. The wealth of information that emerged from the articles was beyond initial expectations and led to an additional piece of analysis concerning the geographical spread of drug-taking activity within the period. Although the evidence did not allow the development of many in-depth accounts as had been the intention at the outset, it did provide insight to particular aspects of drug-taking activity. For example, the collated information regarding female participants suggested specific behavioural traits that possibly made female consumers harder to detect compared to their male counterparts. Drug-taking among military personnel and the operation of supply networks were other aspects illuminated by the articles. An association emerged between military conflicts and increased drug-taking by military personnel. It indicated, too, that periods of conflict could have implications for domestic prevalence from the cessation of hostilities. Geographical analysis illuminated the supply networks both in terms of drug procurement and relationships between drug-takers within their areas of settlement. Furthermore, some of the areas associated with drug-taking during the early twentieth century remain linked to drugs in the present day raising questions about how and why specific areas might become drug hot-spots. Further research arising from this thesis would involve the replication of the method during the later period, 1923 to 1950. This period would allow the female narrative of drug-related activity begun by this thesis to be developed further and to establish whether the First World War was a unique period for female participation or whether their participation evolved. Similarly, considering the articles from this later period could help illuminate further the subsequent spread and operation of supply networks. Replicating the method would also test whether it is transferable to other periods or whether changes to reporting style made the method era specific.

In post-industrial societies, drug using conducts have increased exponentially in the last decades and virtually all psychoactive substances are now easily accessible via the Internet. Although drug use has been assimilated in mainstream lifestyles, and involves significant portions of the population, the legal status of drugs maintains the phenomenon submersed. In this work, which comprises of four major studies and two additional experiments, the issue is addressed by using both quantitative and qualitative methods to address methodological issues and provide insight regarding the novel developments of the phenomenon. Two experiments within an ecological setting using a known group of recreational cocaine users and a verified abstinent comparison group found strong evidence that questioned the validity of autobiographical Implicit Association Test (aIAT). In Chapter 2 Study 1 (n=46), the cocaine and heroin aIATs identified 61% drug users in the abstinent control group. The aIAT outcomes are heavily influenced by social knowledge and currently the test cannot be used to assess an individual’s drug using status. Results from Study 2 (n=41) and Study 4 (n=31) make a significant contribution to the understanding of the aIAT mechanism by highlighting its malleability to stimuli framing and instructions. The high accuracy (97%) of the gender aIAT (Study 3, n= 41) reassures that the aIAT is accurate when the target concept (i.e., gender identification) is deeply engrained. Chapters 3 and 4 used mixed methodologies (IATs, questionnaires, vignettes and interviews) to explore the social-psychological aspects related to the misuse of prescription psychostimulants. In Chapter 3, it was found that university students (n=98) hold functional views towards chemical enhancement. In Chapter 4 through qualitative interviews (n=13), it was confirmed that prescription psychostimulant abuse is a novel trend reflecting a generalized tendency to view drugs as instrumental for the adaptation to contemporary social contexts. These attitudes are partially forged by previous experiences with other mind-altering substances. Outcomes of this work suggest that employing mixed methodologies is advisable in substance use research and that progressive public policies should move away from viewing drug use as deviance and confront the issue acknowledging its consolidated presence in post-industrial societies.