the qualitative process used for reflection on and assessment of this particular participatory method is also provided . ten students in the grade 912 cohort were trained as researchers and conducted interviews with students in grades 212 at the klemi dene school and students in grades 26 at the neighbouring kaw tay whee school ( fig . 1 ) . ethical permission to conduct the research was obtained through the health research ethics board ( panel b ) of the university of alberta . in addition , a northwest territories ( nwt ) scientific research licence was obtained through the aurora research institute . research training was done by members of the research team ( including academic , community and government members ) and school staff ( teacher and principal ) . information was provided on the research process , from concept through to analysis and interpretation . this included the fundamentals of research ethics , creating interview questions , conducting interviews ( including providing information to participants and obtaining consent ) and using the digital recording equipment . the class collectively developed the script for the initial interview on smoking knowledge and behaviours and the briefing for the photovoice method . the high school students then conducted  practice  interviews with the researchers and teachers to make all participants more comfortable with the process and equipment . at the start of the interview , the student researchers described the project for the participants and informed them that the interviews would be audio recorded , how their confidentiality would be maintained and how the information would be used . even though parental / guardian permission was obtained , further oral assent to participate in the research was sought from the students . the interview questions , as developed by the youth researchers , are shown in table i. interview questions designed by youth researchers have you smoked in the past?yes : when did you quit ? how much money do you spend on smokes ? where do you get the money for smokes ? a total of 48 students ranging in age from 7 to 19 years were interviewed . most of the students were dene , although a few students were of other ethnicity . the students all spoke english : although dogrib is taught in the school , few if any of the students are fluent in this language . all students attending school during the 2 days in which interviews were conducted and who assented to being part of the project participated in the research . at the end of the interview they were given the general assignment to take pictures of tobacco use in their community . the photovoice briefing involved ensuring that ethical issues related to the use of photovoice were addressed ( 30 ) and was based on the following instructions to the researchers about advising the participants of specific considerations : ask people 's permission before you take their picture . make sure you know their name in case we need to ask them later if we can use the picture in a presentation or report.do not put yourself and anyone else in danger to take a picture . for example , do not stand on a wobbly chair to take a picture.do not take pictures that might embarrass someone or make them feel bad . make sure you know their name in case we need to ask them later if we can use the picture in a presentation or report . do not put yourself and anyone else in danger to take a picture . for example , do not stand on a wobbly chair to take a picture . do not take pictures that might embarrass someone or make them feel bad . of the 48 cameras distributed , the student researchers again collectively decided on the semistructured guide for the photovoice interviews ( table ii ) . some very innovative questions for coaxing shyer younger students to discuss their pictures were developed by the student researchers , including can you give me 2 words to describe this picture ?  photovoice interview questions designed by youth researchers why did you take this picture ? ? would looking at this picture make you want to smoke ? what does this _ _ _ _ _ _ _ _ _ _ _ mean to you ? give me 2 words to describe this picture ? ( can you describe this picture ? ) can you tell me a story about this picture ? ? is there something you wanted to take a picture of but could n't ? the pictures and accompanying words were assembled and presented back to the student researchers for discussion and analysis . relevant themes were determined through iterative discussions between the students , teachers and researchers on the meaning and relevance of the photographs . it was collectively decided to assemble a book to showcase the student pictures and words . one student precociously pointed out that all of the pictures involved negative aspects of each theme and that perhaps the final portrayal of the results should pair the  negative  photos with  positive  depictions related to that theme . for example , pictures for the theme  smoking is unhealthy  were paired with pictures on  healthy  activities ( fig . 2 ) . based on their experiences and understanding ( both as members of an aboriginal community and as youth ) , the students also decided that 2 further themes were needed for the book : one showing the traditional use of tobacco and one on why students choose to smoke or not to smoke . the additional pictures required for the positive portrayals and for the new themes were either taken by the student researchers or obtained from school photograph galleries . all decisions on the photographs to be used in the book were made jointly between the academic researcher and the student researchers . an example of the pairing of a  negative  theme and  positive  theme in the results booklet  youth voices on tobacco  . the final book of pictures with selected accompanying words was produced as an ibook on an apple computer . a student researcher worked with the academic researcher to select the pictures for the book and decide how these should be portrayed . at least 1 picture from every student who participated in the photovoice project was included . the book was distributed to all students of the klem dene school and the kaw tay whee school . books were also distributed to every family in the communities of ndilo and dettah through a regular band council mail out . the methods used for research evaluation must be appropriate to the research paradigm ( 31 ) . traditional quantitative conceptualizations of evaluation are generally acknowledged to be unsuitable for the assessment of qualitative research ( 32 ) . instead , qualitative evaluations are more aptly based on established qualitative methods such as reflection , observation and interpretation of meaning . within a participatory research process , this type of evaluation must be both an individual and cooperative undertaking : while the assessment may be subject to analysis and interpretation by the researcher , it must also remain true to the information provided by and understanding of the other research participants ( 33 ) . the assessment of the benefits and limitations of conducting community - based participatory research using youth as researchers was based on this type of qualitative evaluation approach . the researcher 's reflections on the process were based on observations of the student researchers , student participants , teachers and community members . these observations were evaluated using  member checking ,  whereby students , teachers and community partners were given the opportunity to agree or disagree with the researcher 's interpretation through informal one - on - one and class discussions . it is considered analogous to an evaluation of internal validity in quantitative assessment , only instead of seeking to establish confidence in the  truth  of the findings , the intent is to focus on the degree to which findings  make sense  ( 34 ) . the student researchers and teachers were further asked to informally share their own reflections and observations on this process , thus making the assessment process reciprocal and dialogic . in this assessment , comparisons are inevitably made against assumptions of an alternative process ( i.e. if the academic researchers had planned and conducted the research without student involvement ) . although it is obviously impossible to know definitively  what would have happened if   , it is possible to use experiential knowledge to make reasonable assumptions about the potential outcomes under this alternate scenario . these assumptions were generally shared by the research participants in discussions about benefits and limitations of this process , adding legitimacy to the comparisons and conclusions . ten students in the grade 912 cohort were trained as researchers and conducted interviews with students in grades 212 at the klemi dene school and students in grades 26 at the neighbouring kaw tay whee school ( fig . 1 ) . ethical permission to conduct the research was obtained through the health research ethics board ( panel b ) of the university of alberta . in addition , a northwest territories ( nwt ) scientific research licence was obtained through the aurora research institute . research training was done by members of the research team ( including academic , community and government members ) and school staff ( teacher and principal ) . information was provided on the research process , from concept through to analysis and interpretation . this included the fundamentals of research ethics , creating interview questions , conducting interviews ( including providing information to participants and obtaining consent ) and using the digital recording equipment . the class collectively developed the script for the initial interview on smoking knowledge and behaviours and the briefing for the photovoice method . the high school students then conducted  practice  interviews with the researchers and teachers to make all participants more comfortable with the process and equipment . at the start of the interview , the student researchers described the project for the participants and informed them that the interviews would be audio recorded , how their confidentiality would be maintained and how the information would be used . even though parental / guardian permission was obtained , further oral assent to participate in the research was sought from the students . the interview questions , as developed by the youth researchers , are shown in table i. interview questions designed by youth researchers have you smoked in the past?yes : when did you quit ? how much money do you spend on smokes ? where do you get the money for smokes ? a total of 48 students ranging in age from 7 to 19 years were interviewed . most of the students were dene , although a few students were of other ethnicity . the students all spoke english : although dogrib is taught in the school , few if any of the students are fluent in this language . all students attending school during the 2 days in which interviews were conducted and who assented to being part of the project participated in the research . at the end of the interview , participants were briefed on the photovoice method and provided with disposable cameras . they were given the general assignment to take pictures of tobacco use in their community . the photovoice briefing involved ensuring that ethical issues related to the use of photovoice were addressed ( 30 ) and was based on the following instructions to the researchers about advising the participants of specific considerations : ask people 's permission before you take their picture . make sure you know their name in case we need to ask them later if we can use the picture in a presentation or report.do not put yourself and anyone else in danger to take a picture . for example , do not stand on a wobbly chair to take a picture.do not take pictures that might embarrass someone or make them feel bad . 
  ask people 's permission before you take their picture . make sure you know their name in case we need to ask them later if we can use the picture in a presentation or report . do not put yourself and anyone else in danger to take a picture . do not take pictures that might embarrass someone or make them feel bad . of the 48 cameras distributed , the student researchers again collectively decided on the semistructured guide for the photovoice interviews ( table ii ) . some very innovative questions for coaxing shyer younger students to discuss their pictures were developed by the student researchers , including can you give me 2 words to describe this picture ?  photovoice interview questions designed by youth researchers why did you take this picture ? _ _ _ _ _ _ _ _ _ _ mean to you ? give me 2 words to describe this picture ? what do you think is going to happen next ? is there something you wanted to take a picture of but could n't ? the pictures and accompanying words were assembled and presented back to the student researchers for discussion and analysis . relevant themes were determined through iterative discussions between the students , teachers and researchers on the meaning and relevance of the photographs . it was collectively decided to assemble a book to showcase the student pictures and words . one student precociously pointed out that all of the pictures involved negative aspects of each theme and that perhaps the final portrayal of the results should pair the  negative  photos with  positive  depictions related to that theme . for example , pictures for the theme  smoking is unhealthy  were paired with pictures on  healthy  activities ( fig . 2 ) . based on their experiences and understanding ( both as members of an aboriginal community and as youth ) , the students also decided that 2 further themes were needed for the book : one showing the traditional use of tobacco and one on why students choose to smoke or not to smoke . the additional pictures required for the positive portrayals and for the new themes were either taken by the student researchers or obtained from school photograph galleries . all decisions on the photographs to be used in the book were made jointly between the academic researcher and the student researchers . an example of the pairing of a  negative  theme and  positive  theme in the results booklet  youth voices on tobacco  . the final book of pictures with selected accompanying words was produced as an ibook on an apple computer . a student researcher worked with the academic researcher to select the pictures for the book and decide how these should be portrayed . at least 1 picture from every student who participated in the photovoice project was included . the book was distributed to all students of the klem dene school and the kaw tay whee school . books were also distributed to every family in the communities of ndilo and dettah through a regular band council mail out . the methods used for research evaluation must be appropriate to the research paradigm ( 31 ) . traditional quantitative conceptualizations of evaluation are generally acknowledged to be unsuitable for the assessment of qualitative research ( 32 ) . instead , qualitative evaluations are more aptly based on established qualitative methods such as reflection , observation and interpretation of meaning . within a participatory research process , this type of evaluation must be both an individual and cooperative undertaking : while the assessment may be subject to analysis and interpretation by the researcher , it must also remain true to the information provided by and understanding of the other research participants ( 33 ) . the assessment of the benefits and limitations of conducting community - based participatory research using youth as researchers was based on this type of qualitative evaluation approach . the researcher 's reflections on the process were based on observations of the student researchers , student participants , teachers and community members . these observations were evaluated using  member checking ,  whereby students , teachers and community partners were given the opportunity to agree or disagree with the researcher 's interpretation through informal one - on - one and class discussions . it is considered analogous to an evaluation of internal validity in quantitative assessment , only instead of seeking to establish confidence in the  truth  of the findings , the intent is to focus on the degree to which findings  make sense  ( 34 ) . the student researchers and teachers were further asked to informally share their own reflections and observations on this process , thus making the assessment process reciprocal and dialogic . in this assessment , comparisons are inevitably made against assumptions of an alternative process ( i.e. if the academic researchers had planned and conducted the research without student involvement ) . although it is obviously impossible to know definitively  what would have happened if   , it is possible to use experiential knowledge to make reasonable assumptions about the potential outcomes under this alternate scenario . these assumptions were generally shared by the research participants in discussions about benefits and limitations of this process , adding legitimacy to the comparisons and conclusions . using youth to research other youth within a participatory research framework had many benefits for the quality of the research , the youth researchers and the community . from a research perspective , more valid and credible results were obtained . students were obviously more comfortable talking with older , familiar students instead of adult  outsider researchers , and were consequently more candid about talking about smoking behaviours without the anticipated disapproval of an authority figure . although this result is obviously very difficult to prove empirically ( particularly in a qualitative study ) , it is substantiated by comments made by the student researchers and through observations made by the academic researchers in reviewing the audio transcripts . the research design and implementation benefited greatly from the collective approach between research team members and youth researchers . as a result of the overall participatory process , one of the community research team members even quit smoking to act as a role model for the project . the research instruments designed by the youth researchers provided unique interview approaches and questions that were better suited to both the age and cognitive processing of the participants . the final book on youth voices on tobacco was significantly enhanced by the youth researchers ideas and the additional photographs they provided . students , teachers and community partners commented that pairing the negative pictures with positive depictions of  how things should be  greatly increased the impact of the book by providing a constructive and optimistic perspective on each theme . psychological theories of knowledge , attitudes and behaviours support the concept that the favourability of messages , as determined through past experiences and worldviews , may affect the type and tendency of cognitive processing used to determine thoughts and actions ( 35,36 ) . negative messages that elicit unfavourable thinking , while sometimes necessary to increase knowledge and consideration of tobacco issues , may actually decrease persuasion to change smoking behaviours or community conditions , even if the message is understood ( 37 ) . coupling of negative and positive messages thus provides both information and affective cues that are more likely to result in desired attitude and/or behaviour changes related to smoking . in addition , a book based on youth - generated pictures with obvious youth input was of more compelling interest for the community . many people commented that viewing the stories created by their youth and situated in their own environment resulted in a very relevant and powerful message . everyone involved described the research as a positive experience . it has led to pursuing options for additional collaborative research in this area , using a new cohort of students as researchers . additionally , as a result of the youth researchers interacting within their community , it has raised awareness of tobacco use and helped both the youth researchers and the community to consider possible steps towards changing to healthier lifestyle choices . youth researchers benefited from exposure to the research process and the wonders of exploration and learning . they developed research skills and leadership abilities , which empowered several of them in terms of their future success  3 of the 4 student researchers who graduated that year returned to work with the school the next year as teacher aides . as true participants in the research , the students exhibited a definite sense of ownership of both the research process and the final research product . these qualities have the potential for encouraging sustained interest in contributing to changes in community tobacco use  individual skill building , participation and empowerment were shown to facilitate active youth involvement in a long - term , tobacco - related community change in another study ( 38 ) . finally , there was evidence from the class discussions of the pictures and words that participation in this research encouraged student critical appraisal of an apparent shared cognitive dissonance ( 39 ) between smoking knowledge and smoking behaviours ( while all students knew and understood the health implications of smoking , the majority of the grade 912 cohort participating as youth researchers smoked ) . this is the first step in evoking personal self - examination of motivations and awareness of individual power to make positive health choices , which may in turn lead to changed behaviours and community action . 
 for the community , viewing smoking through their children 's eyes was stated by many to be a much more powerful and potentially influential message than a report generated by outside researchers . the photographs and words produced by the youth are known to have garnered community interest . these visual messages will hopefully result in raised awareness of the community conditions that are contributing to the high prevalence of smoking amongst youth , as has been demonstrated in other youth photovoice projects ( 8) . in general , it was found that smoking was ubiquitous in the community and that most students had family members and friends who smoked . the long standing cycle of addiction related to smoking is very strong in many northern communities : if youth see everyone around them smoking , they are more likely to view smoking as a normal behaviour . this research project and the resulting book of photographs is the first step in prompting community recognition that a prevalent smoking environment will only lead to the negative outcome of more and younger new smokers ( 40 ) . despite the fact that having youth researchers undoubtedly increased the accuracy of the results , there was still an obvious response bias in the research , with many students providing the  correct  response that they do not smoke regardless of their actual behaviour . while only 6 of the participants indicated they currently smoke in the interviews , at least 9 of 12 students in the grade 912 cohort this discrepancy may be related to the desire to provide the researchers with the  acceptable  answer that would meet with the approval of the teachers . to accommodate school scheduling , students were given 12 days to take pictures , thereby limiting opportunities and possible creativity . the younger participants tended to take pictures that were  convenient  ; it was amusing to see swarms of children taking pictures of cigarette butts on the ground in the area around the school on the day the cameras were distributed . this is consistent with behaviours of young participants in other photovoice projects ( 8,17,19 ) . time restrictions also limited relationship building with the youth researchers and the academic research team , which would have led to more open and honest opportunities to discuss some complex and sensitive issues in more depth . based on their experiences with a related youth photovoice project on childhood obesity , findholt et al . ( 8) recommend a thorough project orientation that goes beyond a discussion of cameras and photographic ethics and helps youth to understand how community context can affect health . this type of discussion might have been useful in this study to further explore the interpretation of the pictures and the possibilities for community action . even though the research was deemed a success  by everyone , it did fail to completely address the research study objective related to student decision making on smoking or not smoking . this objective had arisen from a comment made by a yellowknife teacher on  how does it go from being  gross and yucky to students in grade 4 , to having students in grade 5 smoking in the schoolyard ?  while it had been thought this theme might arise naturally in the choice of pictures taken by the participants , it was not directly apparent in the original set of pictures . although the youth researchers decided to explore this theme specifically for the book with additional pictures , it still proved difficult to fully understand motivations for smoking and not smoking . in hindsight , participants should have been provided with more specific instructions to take pictures related to this theme . research involving children and youth raises specific ethical issues , primarily related to concerns regarding competence , autonomy and vulnerability . although the school had obtained blanket parental consent for school activities ( allowing all students to participate in the research ) , specific consent was required to use the research results . obtaining written consent is problematic in many northern aboriginal communities as it  may be seen as contrary to respecting aboriginal approaches to research initiatives  ( 42 , p. 21 ) . determining who is responsible for granting consent for minors is also difficult in communities where current guardianship is often not formally recognized . information sheets and consent forms were sent home with all student participants , and written consent was obtained from approximately one - third of the parents / guardians . the teacher then phoned all other parents / guardians to explain the study and obtain verbal consent for the remaining students . verbal assent was also obtained from each student participant prior to conducting the interviews , as the researchers strongly believed that this was necessary to respect the rights of the individual . it had originally been planned to use digital cameras that could be deployed successively amongst the students . the teacher made the very compelling case that the research should foster feelings of success in the students ; if a valuable camera was lost or stolen , requiring an investigation and possible blame , success could be quickly compromised and the positive experience of the research negated . 
 a final ethical concern involved representation . it was considered very important that all participants should be able to  see  themselves in the final research product . care was thus taken that at least 1 photograph from each participant was included in the final book youth voices on tobacco . using youth to research other youth within a participatory research framework had many benefits for the quality of the research , the youth researchers and the community . from a research perspective , more valid and credible results were obtained . students were obviously more comfortable talking with older , familiar students instead of adult  outsider researchers , and were consequently more candid about talking about smoking behaviours without the anticipated disapproval of an authority figure . although this result is obviously very difficult to prove empirically ( particularly in a qualitative study ) , it is substantiated by comments made by the student researchers and through observations made by the academic researchers in reviewing the audio transcripts . the research design and implementation benefited greatly from the collective approach between research team members and youth researchers . as a result of the overall participatory process , one of the community research team members even quit smoking to act as a role model for the project . the research instruments designed by the youth researchers provided unique interview approaches and questions that were better suited to both the age and cognitive processing of the participants . the final book on youth voices on tobacco was significantly enhanced by the youth researchers ideas and the additional photographs they provided . students , teachers and community partners commented that pairing the negative pictures with positive depictions of  how things should be  greatly increased the impact of the book by providing a constructive and optimistic perspective on each theme . psychological theories of knowledge , attitudes and behaviours support the concept that the favourability of messages , as determined through past experiences and worldviews , may affect the type and tendency of cognitive processing used to determine thoughts and actions ( 35,36 ) . negative messages that elicit unfavourable thinking , while sometimes necessary to increase knowledge and consideration of tobacco issues , may actually decrease persuasion to change smoking behaviours or community conditions , even if the message is understood ( 37 ) . coupling of negative and positive messages thus provides both information and affective cues that are more likely to result in desired attitude and/or behaviour changes related to smoking . in addition , a book based on youth - generated pictures with obvious youth input was of more compelling interest for the community . many people commented that viewing the stories created by their youth and situated in their own environment resulted in a very relevant and powerful message . everyone involved described the research as a positive experience . it has led to pursuing options for additional collaborative research in this area , using a new cohort of students as researchers . additionally , as a result of the youth researchers interacting within their community , it has raised awareness of tobacco use and helped both the youth researchers and the community to consider possible steps towards changing to healthier lifestyle choices . youth researchers benefited from exposure to the research process and the wonders of exploration and learning . they developed research skills and leadership abilities , which empowered several of them in terms of their future success  3 of the 4 student researchers who graduated that year returned to work with the school the next year as teacher aides . as true participants in the research , the students exhibited a definite sense of ownership of both the research process and the final research product . these qualities have the potential for encouraging sustained interest in contributing to changes in community tobacco use  individual skill building , participation and empowerment were shown to facilitate active youth involvement in a long - term , tobacco - related community change in another study ( 38 ) . finally , there was evidence from the class discussions of the pictures and words that participation in this research encouraged student critical appraisal of an apparent shared cognitive dissonance ( 39 ) between smoking knowledge and smoking behaviours ( while all students knew and understood the health implications of smoking , the majority of the grade 912 cohort participating as youth researchers smoked ) . this is the first step in evoking personal self - examination of motivations and awareness of individual power to make positive health choices , which may in turn lead to changed behaviours and community action . 
 for the community , viewing smoking through their children 's eyes was stated by many to be a much more powerful and potentially influential message than a report generated by outside researchers . the photographs and words produced by the youth are known to have garnered community interest . these visual messages will hopefully result in raised awareness of the community conditions that are contributing to the high prevalence of smoking amongst youth , as has been demonstrated in other youth photovoice projects ( 8) . in general , it was found that smoking was ubiquitous in the community and that most students had family members and friends who smoked . the long standing cycle of addiction related to smoking is very strong in many northern communities : if youth see everyone around them smoking , they are more likely to view smoking as a normal behaviour . this research project and the resulting book of photographs is the first step in prompting community recognition that a prevalent smoking environment will only lead to the negative outcome of more and younger new smokers ( 40 ) . despite the fact that having youth researchers undoubtedly increased the accuracy of the results , there was still an obvious response bias in the research , with many students providing the  correct  response that they do not smoke regardless of their actual behaviour . while only 6 of the participants indicated they currently smoke in the interviews , at least 9 of 12 students in the grade 912 cohort this discrepancy may be related to the desire to provide the researchers with the  acceptable  answer that would meet with the approval of the teachers . to accommodate school scheduling , students were given 12 days to take pictures , thereby limiting opportunities and possible creativity . the younger participants tended to take pictures that were  convenient  ; it was amusing to see swarms of children taking pictures of cigarette butts on the ground in the area around the school on the day the cameras were distributed . this is consistent with behaviours of young participants in other photovoice projects ( 8,17,19 ) . time restrictions also limited relationship building with the youth researchers and the academic research team , which would have led to more open and honest opportunities to discuss some complex and sensitive issues in more depth . based on their experiences with a related youth photovoice project on childhood obesity , findholt et al . ( 8) recommend a thorough project orientation that goes beyond a discussion of cameras and photographic ethics and helps youth to understand how community context can affect health . this type of discussion might have been useful in this study to further explore the interpretation of the pictures and the possibilities for community action . even though the research was deemed a success  by everyone , it did fail to completely address the research study objective related to student decision making on smoking or not smoking . this objective had arisen from a comment made by a yellowknife teacher on  how does it go from being  gross and yucky to students in grade 4 , to having students in grade 5 smoking in the schoolyard ?  while it had been thought this theme might arise naturally in the choice of pictures taken by the participants , it was not directly apparent in the original set of pictures . although the youth researchers decided to explore this theme specifically for the book with additional pictures , it still proved difficult to fully understand motivations for smoking and not smoking . in hindsight , participants should have been provided with more specific instructions to take pictures related to this theme . research involving children and youth raises specific ethical issues , primarily related to concerns regarding competence , autonomy and vulnerability . although the school had obtained blanket parental consent for school activities ( allowing all students to participate in the research ) , specific consent was required to use the research results . obtaining written consent is problematic in many northern aboriginal communities as it  may be seen as contrary to respecting aboriginal approaches to research initiatives  ( 42 , p. 21 ) . determining who is responsible for granting consent for minors is also difficult in communities where current guardianship is often not formally recognized . information sheets and consent forms were sent home with all student participants , and written consent was obtained from approximately one - third of the parents / guardians . the teacher then phoned all other parents / guardians to explain the study and obtain verbal consent for the remaining students . verbal assent was also obtained from each student participant prior to conducting the interviews , as the researchers strongly believed that this was necessary to respect the rights of the individual . it had originally been planned to use digital cameras that could be deployed successively amongst the students . however , at the request of the teacher , disposable cameras were used instead . the teacher made the very compelling case that the research should foster feelings of success in the students ; if a valuable camera was lost or stolen , requiring an investigation and possible blame , success could be quickly compromised and the positive experience of the research negated . 
 a final ethical concern involved representation . it was considered very important that all participants should be able to  see  themselves in the final research product . care was thus taken that at least 1 photograph from each participant was included in the final book youth voices on tobacco . using youth to research youth proved to be a successful strategy for exploring youth knowledge of the health concerns related to smoking and the role of tobacco use in their community . perhaps more importantly , the research proved valuable in providing the community with a lens through which to view how youth see smoking in their environment . unfortunately , the traditional use of tobacco for spiritual purposes has been radically changed to the modern addiction to tobacco , which has caused negative health issues for many youth and community members ( 43 ) . this research methodology was thus an effective way to reach the community , have them reflect on the changes in tobacco use and promote awareness of the need for environmental change , while simultaneously engendering development of youth research skills and abilities ( 8) . the research approach was also important in promoting the view of  youth as resources  as opposed to the commonly portrayed image of  youth as problems  ( 44 ) . this asset - based perspective has to be strengthened as a methodology to work with youth if any changes are to continue . if the adult expectations of youth ( which are inevitably reflected in youth behaviours ) can be changed , youth may come to believe in themselves as agents of change rather than troublemakers ( 43 ) . however , realizing this vision will require a commitment to creating openings , opportunities and obligations for continued youth participation in the issues that affect their lives ( 4 ) . it must also be accompanied by a continued focus on enabling youth action through involvement in decisions and policy making ( 45 ) . having youth actively involved in research that affects their lives and opens their eyes to tobacco - related health issues provides them with potential opportunities to pursue real community change . as the future generation , they are also the carriers of the traditions and culture and need to bring forth healthy attitudes towards tobacco 's spiritual purposes , not its negative effects related to addictions and adverse health outcomes ( 43 ) . finally , this approach successfully met the specific requirements of community - based participatory research ( 46 ) . the youth researchers learned research skills , while the research team partners learned valuable lessons on structuring research and dissemination products that were more appropriate , effective and powerful for the student participants and community . shared decision - making was an integral part of the research , ranging from initial decisions on the research concept and design to the final decisions on dissemination . based on this research , youth assuming a partnership role in research activities presents fruitful ground for continued advances in making positive health changes in northern aboriginal communities . the authors have not received any personal funding or benefits from industry or elsewhere to conduct this research .
objectivesto examine the benefits , limitations and ethical issues associated with conducting participatory research on tobacco use using youth to research other youth.study designcommunity - based participatory research.methodsresearch on tobacco use was conducted with students in the klem dene school and kaw tay whee school in the northwest territories , canada , using photovoice . 
 the grade 912 students acted as researchers . 
 researcher reflections and observations were assessed using 
 member checking ,  whereby students , teachers and community partners could agree or disagree with the researcher 's interpretation . 
 the students and teachers were further asked informally to share their own reflections and observations on this process.results and conclusionsusing youth to research other youth within a participatory research framework had many benefits for the quality of the research , the youth researchers and the community . 
 the research was perceived by the researchers and participants to be more valid and credible . 
 the approach was more appropriate for the students , and the youth researchers gained valuable research experience and a sense of ownership of both the research process and results . viewing smoking through their children 's eyes 
 was seen by the community to be a powerful and effective means of creating awareness of the community environment . 
 limitations of the approach were residual response bias of participants , the short period of time to conduct the research and failure to fully explore student motivations to smoke or not to smoke . 
 ethical considerations included conducting research with minors , difficulties in obtaining written parental consent , decisions on cameras ( disposable versus digital ) and representation of all participants in the final research product .