A City Guide To Tianjin for Snow and Bruce Snow and Bruce found female smokers to have less self-confidence, to feel less liked by their families, and to have lower physical and social self-concepts, while their peer self-concept surprisingly did not differ from that of non-smokers. In relation to becoming pregnant as a teenager, low self-esteem and a negative self-concept may again be implicated, as teenage mothers often show a history of dysfunctional relationships and social and financial strain. Alcohol appears to play a significant role in early sexual activity likely to lead to becoming pregnant, rather than being necessarily a problem during pregnancy. For example, alcohol consumption and being drunk’ or stoned’ is a commonly cited reason for first having sex when a teenager e.g. Duncan et al. Wellings et al. A City Guide To Tianjin 2016.