Introduction:
Our research shows that Chinese youth begin smoking by pretending to smoke among peers (not inhaling or exhaling smoke from a lit cigarette; this process is termed “fake smoking”), and then learn how to inhale and exhale cigarette smoke (“real smoking”). However, “fake smoking” has been neglected in research even though it could have important implications for tobacco control.

Objectives:
To explore the meanings of “fake smoking” among young people in China, and to identify strategies for tobacco control.

Methods:
Twenty-four Chinese late adolescent smokers (ages 18–19) were interviewed in Kunming, Southwest China, to understand the meanings and identities that were associated with smoking. The qualitative data were analysed with inductive thematic analysis.

Results:
“Fake smoking” incentivised beginner smokers to perceive benefits of smoking (e.g., coolness, social interaction with smoker peers) while avoiding its pernicious effects (e.g., addiction, ill-health, physical discomfort of cigarettes). Disapproval of “fake smoking” by smoker peers, based on a hierarchy of smoking technique (wherein fakers had the lowest status and were not regarded as “true smokers”, and “real smoking” was a means to judge smoking as authentic), encouraged newcomers to learn how to inhale and exhale cigarette smoke. “Real smoking” epitomised an identity change from “non-smoker” to “smoker”, and permitted admittance into peer smoker groups. The transition from “fake smoking” to “real smoking” also involved reinterpreting the meanings of smoking, addiction, increased cigarette consumption, regret about smoking, and learning appropriate social smoking-related behaviors in smoking scenarios.

Conclusion(s):
Fake smoking seems to be a no-man’s-land in-between the opposing identities of “smoker” and “non-smoker”, an unexplored terrain in tobacco research. Yet it is critical in smoking initiation and smoker identity formation, and should be considered in tobacco control for adolescent populations.