Reviewer ’s report  
 
Title: Young Australian women's accounts of smoking and quitting: A qualitative study using 
visual methods  
 
Version: 1 Date: 06 Nov 2017  
 
Reviewer: Sarah Ashton  
 
Reviewer's report:  
 
I am pleased to review this paper exploring young Australian women's experiences of quitting 
smoking, utilising qualitative methods. The results of the autho rs' Foucauldian discourse analysis 
make an important contribution to understanding the role of identity and discourse in women's 
smoking cessation and its implications for health interventions.  
Overall, I think that the analysis could be enhanced through a more direct acknowledgement that 
smoking and addiction have physiological, neurological, psychological, social and cultural 
components and that women's utilisation of discourses to position themselves in relation to 
smoking, can further this understandin g. This is especially important given that the authors 
conclude the article by recommending that their results are integrated into therapeutic strategies. 
Acknowledging how their analysis fits into other models of smoking and addiction is important 
for pra ctical application in this context. Further, providing a brief outline of biological and 
psychological components of smoking may assist in clarifying comments in the results and 
discussion that explain the impact of discourses on cessation. For example, if  a women utilises 
the discourse 'smoking as a choice' this does not acknowledge other factors that contribute to 
addictive behaviour, and may therefore present a barrier to cessation.  
 
Background:  
Given that poststructural theory is the framework utilised to interpret your data, it is important to 
outline smoking behaviour from this perspective in the introduction.  
I think the background section could briefly acknowledge smoking and addiction from a 
biological and psychological perspective and explain how discourse analysis could make an 
important contribution to understanding this experience.  
 
Methods  
Descriptions of participants was included in the methods section - this may be better placed in 
results.  
Under participant information, it may also be useful to include how long participants had 
engaged in smoking, or their age of first use, as this is important information in the context of 
smoking cessation. If information regarding the participants' use of other substances was 
collected this may also be usef ul to consider including, particularly if they paired smoking with 
another addictive behaviour, eg coffee or alcohol.  
 
Results:  
Page 9, line 15 - I think the first sentence needs reworking or further elaboration. The paragraph 
is referring to the opinions about the self and self -value and the first sentence could state this.  
Page 11, line 49 - Your comment related to 'addictive personality' appears dismissive of the 
potential role of personality traits and psychological states. Concluding that this participa nt is 
making this statement to distance herself, while valid in the context of your analysis, may 
simultaneously be diminishing her insight into her psychology.  
Page 18, line 51 - 'lack of immediate health impacts' does not seem accurate. Perhaps clarify this.   
 
Discussion:  
On page 19, line 20, and once again on page 21, line 34 you mention the 'physiological and the 
psychological aspects of addiction' however have not stated what these are. It may be useful to 
outline these in the introduction if you are  going to make reference to them in the discussion.  
On page 20, line 19, you suggest that these finding could have implications for smoking 
cessation programs. I think it would be clearer to acknowledge existing approaches and then 
discuss how these resul ts could provide alternatives or additions. This may also provide context 
for the next paragraph.  
On Page 20, line 39 you state that placing emphasis on personal responsibility may be a barrier 
to quitting. Without understanding the process or a model of successful quitting, it is difficult to 
understand why this is the case.  
Page 22, line 11 states that a limitation of the study was that the data were mostly collected from 
Anglo -Australians and is therefore not transferable to other cultural backgrounds ( the same 
statement was also made with reference to sexual identity). Maybe contextualise this so that it 
does not sound as though you are endeavouring to generalise results of qualitative research.   
 
 
Minor changes:  
Page 2, Line 15 - 'cause' should be 'ca uses'  
Page 2, Line 36 - unclear why this needed to be a quoted rather than summarised - "dearth of 
intervention data on young adults".  
Page 6, Line 50 -'designed' needs to be deleted  
Page 12, Line 38, - 'Neurological' may be more appropriate than 'brain -based' (also used on page 
13, line 7; page 19, line 37)  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, plea se specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stock s or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing  interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
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