Children's and Adolescents' Awareness of the Physical and Mental Health Risks Associated with Tattooing: A Focus Group Study

Article excerpt

Recent research demonstrates that tattoos or body marking practices are increasingly prevalent among adolescents. Many of these tattoos are self-administered or are obtained from friends or amateur tattooists (Houghton & Durkin, 1993). Medical literature dating back to at least the 1920s points to recurring problems of infection and tissue damage due to unprofessionally administered tattoos, including venereal diseases, tuberculosis, skin diseases and injuries, allergic reactions, warts (Beerman & Lane, 1954; Cohen, 1927; Scutt, 1972; Stokes, Beerman, & Ingraham, 1954), and even leprosy (Rook & Thomas, 1952). Contemporary risks of Hepatitis B and C and HIV transmission indicate that body marking practices are potentially lethal. These diseases can be transmitted by shared needles, and shared tattooing equipment has been recognized for some time as a cause of hepatitis transmission (Smith, 1950) and HIV (Dolan, 1990).

In addition to physical and mental health risks, amateur tattoos and related body marking practices pose risks of stigmatization. Markings on visible parts of the body such as hands, forearms, and face are often regarded unfavorably by nontattooed people (Grumet, 1983). As a result, unsightly markings obtained during adolescence may seriously reduce a young person's employability. Further, it has been reported that delinquent youths themselves interpret the presence of tattoos on peers as indicators that such individuals belong to the same subculture, and attempt to coerce them into antisocial or criminal activities (Taylor, 1968; 1970).

Body markings reflect transient adolescent interests and emotions, but their consequences are permanent. For example, in a retrospective study conducted by Grumet (1983), half of a sample of 819 tattooed military recruits surveyed saw their body marks as a handicap reflecting rashness, intoxication, foolishness, and identity struggles. Many wished to erase their tattoos because of personal discomfort with the image' conveyed, the reactions of others (potential employers, wives) or because they wished to distance themselves from aspects of their past. Hamburger and Lacovara (1963) report several instances of institutionalized youths trying to remove tattoos themselves, typically using rudimentary and potentially injurious methods.

Despite the short- and long-term risks associated with amateur tattoos and body-marking practices, little is known about the development of attitudes toward them or about children's and adolescents' awareness of the health and social consequences. The purpose of the present investigation was to obtain data by addressing the topic directly with groups of young people in a cross-sectional focus group study. This approach is based on the premise that in opening an investigation of a hitherto neglected area it is vital to listen first to the subjects. The information obtained will also provide a guide to future research in terms of choice of vocabulary and other aspects of instrumentation.

The focus group interview is a qualitative methodology frequently used to obtain data about feelings and opinions of small groups of participants about a given problem, experience, service or phenomenon (Basch, 1987). This usually involves a small group of subjects being asked a series of progressively more difficult open-ended questions by a trained person in a nonthreatening supportive climate that encourages all group members to share their views. Focus group methodology has been widely used to generate ideas and solutions pertaining to various social problems, and for encouraging participants to disclose behavior and attitudes that they might not consciously reveal in an individual interview situation (Basch, 1987).

In the area of traffic safety Basch, DeCicco, and Malfetti (1989) utilized focus group format discussions to identify feelings and opinions of small groups about drinking and driving. Hedlund, Arnold, and Cerelli (1983) used a similar procedure to explore young people's opinions and feelings toward the efficacy of seatbelts. …