biostudies-literatureAryee LNABill and Melinda Gates Foundation2978https://www.ebi.ac.uk/biostudies/studies/S-EPMC11514744biostudies-literatureUnknown24(1)<h4>Background</h4>Tobacco use is a global public health threat and a leading preventable cause of death in the world. While cigarette use among youth has been decreasing in high-income countries, low- and middle-income countries have contrastingly high rates of adolescent smoking. In Ghana, smoking prevalence is lower than in other parts of the African continent and more common among men than women; however the gender gap in tobacco use among adolescents has narrowed, with shisha use among girls recently surpassing boys. These trends toward increased relative use among adolescent girls are a cause for concern and highlight the need for interventions to prevent and/or reduce tobacco use in this population.<h4>Methods</h4>We conducted in-depth interviews with girls aged 13-20 (n = 148) and BMC public healthSocial norms and social opportunities: a qualitative study of influences on tobacco use among urban adolescent girls in Ghana.PMC11514744INV005809Flanagan SVTrupe LAryee LNASmith JYucel MfalseSocial norms and social opportunities: a qualitative study of influences on tobacco use among urban adolescent girls in Ghana.<h4>Background</h4>Tobacco use is a global public health threat and a leading preventable cause of death in the world. While cigarette use among youth has been decreasing in high-income countries, low- and middle-income countries have contrastingly high rates of adolescent smoking. In Ghana, smoking prevalence is lower than in other parts of the African continent and more common among men than women; however the gender gap in tobacco use among adolescents has narrowed, with shisha use among girls recently surpassing boys. These trends toward increased relative use among adolescent girls are a cause for concern and highlight the need for interventions to prevent and/or reduce tobacco use in this population.<h4>Methods</h4>We conducted in-depth interviews with girls aged 13-20 (n = 148) and 2024-01-01T00:00:00Z2024 Oct2026-07-15T14:45:40.924Z2026-07-06T03:08:39.373ZS-EPMC115147443946850310.1186/s12889-024-20413-z