scotland is consistently ranked as having one of the worst records for malignant cancers , lung cancer and respiratory disease in europe ( gillis et al .
the west of scotland , in particular , is known for its high rates of coronary mortality and morbidity which has earned the city of glasgow titles such as the  sick man of europe and the  heart attack capital of the world ( bbc may 7 1999 , fracassini january 9 2005 ) .
scottish men are reported to have the lowest life expectancy in the uk ( gros 20042006 ) .
social inequalities have been shown to be particularly striking in glasgow ( mccloone and boddy 1994 , dorling 1997 , shaw et al .
this may explain why the  long - established male disadvantage in health seems particularly marked in this part of the world ( watson 2000 , p. 22 ) . however , higher morbidity and mortality rates among men in scotland ( who 2006 ) have also been attributed to an : 
  unhealthy lifestyle , one that involves little exercise , a heavy alcohol intake and a propensity to smoke .
in addition , the caledonian diet , which is often deep fried , fat soaked and lacking in fruit and vegetables , contributes to one in every five scottish men dying of heart disease before he reaches the age of 75   each day ( health professionals ) face the results of the average scottish men 's poor health(leishman and dalziel 2003 , p. 92 ) . 

encouraging men ,  even scottish men , to care for their health has been presented as a particular  challenge for health professionals ( leishman and dalziel 2003 ) .
however , few studies have explored in detail how scottish men view their own health or their health - related beliefs and behaviours ( mullen 1993 , watson 2000 , o'brien et al .
consequently , it is difficult to establish whether scottish men 's experiences and descriptions of their own health - related behaviours bear any resemblance to the social and cultural construction of the  average scottish man.  unhealthy lifestyle , one that involves little exercise , a heavy alcohol intake and a propensity to smoke .
in addition , the caledonian diet , which is often deep fried , fat soaked and lacking in fruit and vegetables , contributes to one in every five scottish men dying of heart disease before he reaches the age of 75   each day ( health professionals ) face the results of the average scottish men 's poor health the concerns that have been expressed about scottish men 's health behaviours are located within a wider discussion about the  state of men 's health ( baker 2001 ) .
large - scale empirical studies and analyses of men 's health across europe ( white and cash 2003 ) , australia ( van buynder and smith 1995 ) and the united states ( verbrugge 1985 ) suggest that higher mortality rates for men compared to women is a pattern that is common to most societies ( see also tsuchiya and williams 2005 , barford et al . 2006 , white and holmes 2006 ) .
fragile or vulnerable to injury , disease and death at every stage of the lifespan from conception to old age ( stillon 1995 , kraemer 2000 ) . men 's apparent resistance to recommended health practices and their engagement with 
high - risk behaviours has long been considered to be one of the main explanatory factors ( waldron 1988 , waldron 1995 , waldron 2000 , courtenay 2000a , courtenay 2000b , watson 2000 , courtenay 2002 ) .
such discussions have prompted health promotion strategies aimed at  bringing home to men the dangers of living up to a 
macho image and engaging in  risk - taking behaviours which are typically presented to be influenced by the  knowledge , attitudes and beliefs of men ( doh 2003 ) .
more recent work highlights the need to think critically about the health - related behaviours that men appear unwilling to engage in , as well as examining those they embrace , and explore the gendered meanings that men attribute to their beliefs and behaviours ( wight 1999 , courtenay 2000 , white and johnson 2000 , emslie et al .
developments in sociological theories of gender , and masculinities in particular , have focussed more attention on the empirical study of how male bodies are experienced by men in every day life ( watson 2000 , chapple and ziebland 2002 , robertson 2003 , oliffe 2005 ) and the  social practices of masculinity ( connell 1995 , sabo and gordon 1995 , connell 2000 , haywood and mac an ghaill 2003 , payne 2004 ) and their relationship to men 's health . the theory of gender as social practice is derived from theorists such as goffman ( 1977 ) and bourdieu ( 1990 ) and suggests that gender identity and the gendered body are socially constructed and : 
  produced and expressed through our movements , gestures , facial expressions , manners , ways of walking , and ways of looking at the world  even basic activities such as teaching children how to move , dress , and eat are thoroughly political , in that they impose on them an unspoken understanding of legitimate ways to ( re)present their body to themselves and others(moi 1991 , p. 10301031 ) .  produced and expressed through our movements , gestures , facial expressions , manners , ways of walking , and ways of looking at the world  even basic activities such as teaching children how to move , dress , and eat are thoroughly political , in that they impose on them an unspoken understanding of legitimate ways to ( re)present their body to themselves and others rather than conceiving of gender as being socially acquired through fixed social norms which  prescribe and proscribe ( thompson and pleck 1986 ) how men and women should behave , gender is increasingly recognised as a  recurring accomplishment ( west and zimmerman 1991 ) .
gender identity is understood to emerge from social interaction as the process of  doing gender ( west and zimmerman 1991 , see also saltonstall 1993 , williams 2000 ) . in applying this theoretical work to the study of men 's health
, courtenay has argued that : 
 many men and boys define their masculinity against positive health behaviours and beliefs  the carrying out of any one healthy behaviour can require a man to dismiss multiple constructions of masculinity.(courtenay 2000b , p. 11 ) .
many men and boys define their masculinity against positive health behaviours and beliefs  the carrying out of any one healthy behaviour can require a man to dismiss multiple constructions of masculinity .
such discussions have been influential in encouraging a shift away from the reductionism which has presented 
it is now commonplace to view masculinities as multiple , contested and dynamic ( hearn and morgan 1990 , brod and kaufman 1994 , kimmel 1994 )
. empirical work , which has drawn on theoretical work on masculinities , has explored some of the complex ways in which health - related behaviours might be used to construct and negotiate masculinities ( e.g. saltonstall 1993 , robertson 2006a , o'brien et al .
thus heavy drinking ( de visser and smith 2006 , 2007 ) or smoking ( hilton 1996 , hunt et al .
2004 , elliot 2008 ) may articulate a particular meaning for men with regard to what is considered acceptable behaviour ( courtenay 2000 ) .
similarly men 's engagement with sports ( messner 1987 ) and studies of their dietary beliefs and behaviours have also been revealing about practices of masculinity ( roos et al .
this article presents discussions with men living in scotland about their health - related beliefs and behaviours . through analysis of focus group discussions ,
we question to what extent and in what ways health - related beliefs and behaviours are connected to the social construction of masculinities .
we also consider whether the gendered practices that men describe may have particular cultural meanings for participants given the social , historical and geographical context in which the research was located ( jackson 1991 ) .
we sought diversity within the sample by age ( range 1572 years ) , occupational status , socio - economic background and current health status .
everyday or unremarkable experiences of masculinity and health ( largely by accessing men in a range of occupations , such as gas workers , fire fighters ) and groups of men that we anticipated may have had 
this included groups with men who had prostate cancer , coronary heart disease , mental health problems and me .
the remaining groups included : men who shared experiences of recent health - related changes ( principally diet and exercise ) , full - time carers for wives with serious health problems , students and long - term unemployed men .
the majority of participants lived in central scotland ( glasgow , edinburgh , dundee , lanarkshire and perthshire ) and just one group was conducted with men of asian origin reflecting the ( relatively limited ) ethnic diversity in this part of britain .
there is debate about whether groups of strangers are preferable to  naturally occurring groups , such as friends or work colleagues ( kitzinger 1994 , morgan 1997 , wilkinson 1993 ) .
because of our aim to achieve particular dimensions of diversity , our fieldwork included both pre - existing groups ( n = 10 ) and specially convened groups ( n = 5 ) .
drawing a group of strangers together was the only way to access people with certain experiences ( e.g. men acting as carers , men with me ) .
the research was presented to gatekeepers and prospective participants as a project on men 's health , and information leaflets and invitation letters emphasised a general interest in men 's health , and men 's lives , but did not overtly highlight the issue of masculinity .
ethical approval for the study was granted by the university 's ethics committee for research on human subjects .
the focus group was used to engage men in prolonged discussion about the relationship between health - related beliefs and behaviours and masculinity .
discussion was facilitated using broad questions exploring participants general views on men 's health ( e.g. how do you view your health ? what prevents / facilitates men achieving optimal health ? ) .
any passing mention of health - related behaviours ( e.g. smoking , drinking , exercise ) or beliefs ( e.g.  i drink twenty pints , it 's expected , it 's a man thing ) were probed in detail . in the latter stages of the discussion
, materials were used to focus participants on the area of masculinity and health and encourage them to explore explicitly their own health - related beliefs , behaviours and experiences in relation to their masculinities . the use of a card with a recent newspaper headline  masculinity is dangerous for men 's health was particularly effective at encouraging men to explore what masculinity was and how it related to men 's health .
participants were prompted by the researcher and by other group members to provide examples of their own behaviours and to state how they might position themselves in relation to the  masculinity referred to in this statement .
indeed , questions posed by group members were  perhaps more searching than the researcher might have dared to ask ( wilkinson 1998 , p. 118 ) .
consequently , the data collected from these focus groups contain explicit accounts regarding the social construction of masculinity ( in contrast to accounts generated in different contexts , for example through individual interviews ) and 
tapped into men 's talk around health - related beliefs and behaviours more effectively by exploiting the  co - construction of meaning between participants ( wilkinson 1998 ) , using  their language and concepts , their frameworks for understanding the world ( kitzinger 1994 ) , author 's emphasis ) .
we believe , as morgan ( 1997 ) suggests , that this method was useful for generating data on subjects that are 
habit ridden ( such as health practices ) or would not ordinarily be considered in such detail ( masculinity ) .
all group discussions were taped with participants consent , fully transcribed , then cross - checked with the tapes for accuracy by ro .
the first stage of analysis , which involved identifying and interpreting themes to be developed in subsequent interviews , took place during data collection .
all of the authors engaged in regular discussions about the data as fieldwork progressed to ensure that the themes developed in the research remained  responsive to the context and the participants ( morse and richards 2002 , p. 74 ) . once all the focus groups were completed , all authors reread the transcripts and separately identified the common themes they observed across interviews .
a more detailed analysis was then undertaken by ro using the  constant comparative method ( strauss and corbin 1990 , 1997 ) .
this is an iterative process of identifying themes from the text and ascribing relevant text to that theme .
this process results in a number of themes that are organised into a coding framework ( assisted in this instance by the use of nvivo 2 ) .
ro then further examined the major themes by undertaking a horizontal analysis ( or cross - group analysis ) as well as a vertical analysis ( or individual case analysis ) ( miles and huberman 1994 ) .
the exploration of novel areas in interview , together with this process of analysis generated a number of substantive areas for analysis .
others , for example the impact of ill - health on men 's identities ( o'brien et al .
2007 ) and the relationship between masculinity and help - seeking ( o'brien et al . 2005 ) have been explored elsewhere .
the data capture the experiences both of men who felt pressured to engage in potentially health - damaging behaviours in order to appear masculine and of those who felt freer to embrace salutogenic health practices .
the diversity within the sample also allowed some exploration of how men re - negotiated their masculinity and health in response to critical events over the lifecourse or in relation to their perceptions of age - appropriate behaviours .
participants most frequently linked masculinity and health in their descriptions of health - related behaviours , for example by describing a  macho beer drinking kind of culture ( sean , 47 , student group ) , which appeared to be recognisable to most participants across groups and a wide age range . however , this practice ( or at least participant 's presentation of their adherence to this accepted practice within group discussions ) appeared to be most prevalent among younger participants .
regimes that were described appeared to be less about the consumption of alcohol per se and more about the enactment of a particular kind of masculinity .
he described how his ability to  handle his drink provided him with an identity he felt was desirable and earned him a particular status among his peers : 
 why do i go out and drink competitively with my friends ?
let 's see who can drink the most  that trend has carried on through all of our sort of drinking lives basically .
it 's like  let 's go out and we 're going to drink twenty five pints each and the first person to be sick  that 's it
colm 's a drinker  i feel as though people are watching me and i 've got to do so much you know ( for them to say ) 
oh colm can handle his drink  i feel if i do n't i 'm letting them down ( laughs).colm , 32 , gas worker 's group why do i go out and drink competitively with my friends ? i do n't know why  we started it at sixteen years old .
let 's see who can drink the most  that trend has carried on through all of our sort of drinking lives basically .
it 's like  let 's go out and we 're going to drink twenty five pints each and the first person to be sick  that 's it
colm 's a drinker  i feel as though people are watching me and i 've got to do so much you know ( for them to say ) 
oh colm can handle his drink  i feel if i do n't i 'm letting them down ( laughs ) .
a group of younger participants ( who elsewhere in the discussion had emphasised how health conscious they were with regard to diet ) also described how their regular binge drinking was viewed as a  masculinity competition that enabled them to construct an informal hierarchy of masculinities (  pussy vs  the main man ) in their group : 
 rajiv ( 22 ) : it 's like there 's a bit of competition involved there , who 's going to drink the most and still stand up.sam ( 21 ) : without puking.rajiv : like vikram got a lot of abuse off folk for being feeble 
after a few drinks he was away with the fairies.ro : what would it say about you if you could n't drink much?rajiv : you 're weak.sam : you 're a pussy . if you 're more tolerant , you 're the main man.asian men 's group rajiv ( 22 ) : it 's like there 's a bit of competition involved there , who 's going to drink the most and still stand up .
sam : you 're a pussy . if you 're more tolerant , you 're the main man .
it was clear that this group of participants felt that there was considerable pressure to engage in heavy drinking to avoid being exposed as  weak ( synonymous with being 
less of a man ) and to avoid the kind of censure to which vikram had been subjected .
accounts given by participants who wished to avoid engaging in such behaviours were revealing of the very real pressures some felt to reject salutogenic health practices in order to appear masculine .
weight loss was a common reason that men provided for making changes to a long - established pattern of heavy drinking .
the men who seemed to find it relatively easy to replace their old routine (  ten pints ( then )  now i sit there with my diet coke ( howie , 31 , slimming group ) ) were exceptional .
you go to the boozers with your pals and it 's a habit you get into .
it 's hard to get out of it ( jake , 33 , slimming group ) .
a participant in another group suggested that his masculinity was repeatedly challenged when he chose to avoid drinking heavily :  you can get a certain amount of stick for  saying no to going out drinking and for turning down options ,  you get a lot of stick for that ( paul , 30 , health change group ) .
his solution was to give up alcohol in the short term to enable him to achieve his weight loss goal .
once he had reached a weight he considered to be healthier , he described how he used 
balance allowed him to continue to  drink whatever i want. he described this as the  ying and yang of fitness. this also enabled him to  balance his desire for a healthier body with his need to appear acceptably masculine to his peers .
it seemed particularly difficult for the men whose identity rested on being perceived as a  drinker to sustain a more moderate level of drinking .
participants who identified themselves as highly motivated with regard to their own health and fitness were typically a minority within a group that did not share the same zeal .
challenge for himself to follow an intensive exercise program and eat a low - fat diet ( even though he was in the normal weight range when embarking on this ) ( ross , 30 , health change group ) .
however , others in the group seemed to find this behaviour challenging ; another group member implied that men who engaged in regular physical activity when they  did not need to exercise or worry about their diet ( i.e. if they were thought to be a normal weight ) were less masculine than men who showed little regard for their bodies .
ross clearly felt a need to defend his interest in building a body he felt happier in ( viewed as 
vanity by his peers ) : 
 steve ( 29 ) : ( describing a gym ) some guys are just looking looking looking in the mirror  ross ( 29 ) : ( interrupts ) no you see i agree with you.steve :  all the time .
you 're not automatically spending time in front of a mirror    ro : but why should n't you?steve : yeah but it 's just narcissistic .
you know you 're looking after yourself and that 's fine.ross : i mean i 've looked in the mirror but i do n't go about going ( pretends to admire himself in the mirror).health change group 
 the majority of the participants in the health change group shared a common interest in engaging in sports such as football or running . however , there was the suggestion that participating in these activities had less to do with the health and appearance of their bodies and more to do with being seen to engage in a key practice of masculinity ; competition with other men .
while ross clearly had felt able to continue with his routine regardless of how his peers viewed it , he was required to provide the group with an assurance that he was not involved in any practices that would jeopardise his own , or the group 's , sense of masculine identity .
steve ( 29 ) : ( describing a gym ) some guys are just looking looking looking in the mirror  ross ( 29 ) : ( interrupts ) no you see i agree with you .
you 're not automatically spending time in front of a mirror    ro : but why should n't you ?
i mean i 've looked in the mirror but i do n't go about going ( pretends to admire himself in the mirror ) .
it is easy to see why enthusiasm for such healthy practices could wane , even for highly motivated men , in the face of such challenges from peers .
seen to be engaged with , or indeed rejecting of , health - related behaviours depending on what was deemed to be 
as one stated :  you do n't want to feel ostracised ( jake , 33 , slimming group ) .
when discussing the acceptability of certain behaviours among men , another said : 
 it becomes the thing to do for that group .
as i was saying earlier on  in a certain environment it becomes the thing to do to go to a sports club , to eat the right kind of food , to take care of your health .
it 's acceptable for men in some walks of life to be quite fastidious about what they eat and what they do .
in other areas you 're just sort of looked on as some kind of fruitcake for fussing about it too much.liam , 43 , mental health group 
 one man described how the same behaviour might take on different meanings in different social contexts depending on the kind of masculine practices privileged within particular groups .
he described instances where he had felt he was being ridiculed by other men if he expressed a concern about the shape of his body or if he was seen to be actively monitoring his diet : 
 i watched what i was eating and that was n't a problem for me .
i didnae care.nathan , 34 , slimming group it becomes the thing to do for that group .
as i was saying earlier on  in a certain environment it becomes the thing to do to go to a sports club , to eat the right kind of food , to take care of your health .
it 's acceptable for men in some walks of life to be quite fastidious about what they eat and what they do .
in other areas you 're just sort of looked on as some kind of fruitcake for fussing about it too much .
however , despite such challenges from his peers nathan felt able to seek support from another male group who had similar goals with regard to weight loss and healthy eating . similarly , jake described the camaraderie of belonging to such a group : 
 the patter 's good .
hearing the way they carry on  they 've been coming since the year dot.jake , 33 , slimming group 
 membership of this group enabled participants to share a common goal with other men within an environment that had been negotiated as 
male. this appeared to help them to deal with other social encounters in which their concern about food might be constructed as  feminine and therefore challenging to their identities as men .
hearing the way they carry on  they 've been coming since the year dot .
the discussions also included , albeit to a lesser extent , some accounts of peer groups that encouraged men to have an open regard for their health with regard to diet or activity ( including the fire fighter 's group , asian men 's group , gay men 's group , prostate cancer group and the gp 's group ) .
the group of fire fighters were probably the most notable for their shared interest in achieving healthy and fit bodies .
swap recipes and compare notes about the physical activities they did to maintain their fitness ( see also o'brien et al .
although some acknowledged that there were men in the fire service who were less interested in fitness and would  slag you for coming into the gym ;  what do you want to do that for? ( denny , 26 , fire fighters group ) , it was clear that their immediate team shared a common belief that care and concern about their health 
the subject of scotland 's poor record of health , viewed by many participants as  the worst  in the world ( chris , 30 , fire fighter 's group ) , was raised spontaneously in the majority of groups .
participants expressed a mix of horror , disgust and amusement in discussions of the excesses of the  junk food diet ( particularly the deep - fried mars bar ) and other poor lifestyle 
a number of participants believed that the unhealthy practices and inequalities that were perceived to be inherent in glaswegian culture were compounded for men by pressures to live up to the 
macho image of the male glaswegian or the  west of scotland man. participants constructions of masculinity in the west of scotland predominantly presented images of working - class glaswegian men ( as opposed to descriptions of their own masculinity or of the masculinities of men they knew ) .
one of the presentations of the  west of scotland man included : 
 the average scottish man is overweight , he smokes , he 's no got a car .
( citing a headline in local paper , the evening times ) they had a cigarette hanging out of his mouth   lying there with a poke of chips.sam , 34 , mental health group 
 a number of participants cited examples that exaggerated the 
some older participants alluded to violent masculine practices relating to male territory in glasgow as exhibited through the  gang warfare of the  razor years ( 1950 's )  ( where ) you could n't go out in certain streets because you  were afraid they ( other men ) would ( attack ) you ( bill , 62 , unemployed and retired men 's group ) .
tough masculinity to the heavily industrialised city that glasgow once was , where  men used to do tough physical labour ( sean , 47 , student group ) .
younger participants who had grown up expecting to do these kinds of jobs ( predominantly in the youth , student and gas worker 's group ) did appear to retain an idea that a particular kind of masculinity was exalted in their culture :  if  you 're dead hard , you 're masculine ( colm , 32 , gas worker 's group ) .
the average scottish man is overweight , he smokes , he 's no got a car .
( citing a headline in local paper , the evening times ) they had a cigarette hanging out of his mouth   lying there with a poke of chips .
working class felt that the decline in heavy industries in glasgow presented them with fewer opportunities to engage in practices that enabled them to enact a masculine toughness they perceived to be desirable in glasgow .
some ( particularly the younger men ) suggested that by engaging in certain health - related behaviours , such as excessive drinking or being seen to flagrantly flout dietary guidelines , men could continue to construct and demonstrate masculinities that many felt were exalted in the social world they inhabited .
a query remains as to whether these data relating to men 's constructions of masculinities merely reflect cultural ideals held by men in glasgow and the west of scotland or if the practices men describe are representative of ideals of masculinity in other regions in britain .
welsh ,  northern depending on the social context and time of the interview ( balarajan and mcdowall 1988 , scanlon et al .
2006 ) . as well as references to masculinities that were socially located in specific parts of the west of scotland
there were also references to wider culturally held notions of masculinity which were perceived by some participants to be undergoing change .
some participants described how they felt men still had the option to construct their masculinity along traditional lines but felt that they would be considered 
stupid if they did so given the perceived consequences for their health : 
 we are in a changing world 
they 're not as stupid to be masculine now as they were twenty years ago , thirty years ago , where it would have been a death sentence.nathan , 34 , slimming group 
 participants considered men who continued to resist alternative ways of constructing their masculinity to be a  dying breed. one group described such men as belonging to the
one younger man felt that some images of masculinity that men had once aspired to were now considered to be 
dated. he describes how contemporary images of men and masculinity might encourage a  new breed of men who embrace a different way of enacting masculinity through their engagement with more 
positive health - related behaviours : 
 if you look at  john wayne and his big beer gut .
whereas now if you look at the kind of guys that are ( role ) models and stuff all of them practically have a six pack 
i think that younger people are wanting to be more like them ( newer role models ) and they kind of see the older stereotypes of maleness as being 
a bit dated  so with these new role models come the way to look like that which is to go down to the gym 
debu , 22 , student group 
 there was some indication that certain health behaviours , such as smoking and drinking to excess , had been strongly associated with these 
one group were particularly scornful of the idea that smoking could continue to be perceived as 
macho because the men who had embodied this kind of masculinity were now viewed as 
extinct : 
 ( following a discussion about the advertisement of smokers and how smokers are often depicted as sexually attractive).doug ( 47 ) : are you talking about marlborough man?keiron ( 36 ) : no ! that dinosaur ? no thanks  marlborough man has lung cancer.rob ( 25 ) : well maybe in the past smoking ( was ) seen as a pretty masculine thing.gay men 's group 
 although john wayne and marlborough man appeared to represent an archetypal masculinity for those who mentioned them , it was one that was associated with ill health ;  marlborough man has lung cancer ( keiron , 36 , gay men 's group ) .
it was acknowledged that smoking and heavy drinking  still went on and continued to be associated with masculinity for some ( particularly for alcohol ) .
however , one participant believed that many men would now prioritise their health over the need to appear masculine by engaging in known high - risk behaviours : 
i think more and more ( men ) are becoming aware that you need to look after yourself ( denny , 26 , fire fighter 's group ) .
they 're not as stupid to be masculine now as they were twenty years ago , thirty years ago , where it would have been a death sentence .
physically fit specimens . whereas now if you look at the kind of guys that are ( role ) models and stuff all of them practically have a six pack  they 're all exercising like mad
i think that younger people are wanting to be more like them ( newer role models ) and they kind of see the older stereotypes of maleness as being 
a bit dated  so with these new role models come the way to look like that which is to go down to the gym  ( following a discussion about the advertisement of smokers and how smokers are often depicted as sexually attractive ) .
keiron ( 36 ) : no ! that dinosaur ? no thanks  marlborough man has lung cancer .
rob ( 25 ) : well maybe in the past smoking ( was ) seen as a pretty masculine thing .
most older participants also reflected on how their views on masculinity and health had changed over the lifecourse .
some pinpointed the start of working life as having a positive effect on their health practices . for several men , adult responsibilities that came with working , owning their own home or starting a family , with all of the accompanying money pressures , was also the need to 
the slimming group equated heavy drinking with demonstrating masculinity in their youth but described how they felt that it was no longer appropriate : 
 howie ( 31 ) : there 's the going out and putting twenty pints down your neck every friday , saturday and sunday night.nathan ( 34 ) : aye . until you mature.howie : aye . but some people never mature obviously you know things like that or the boy racer thing.slimming group 
 there was a strong suggestion that men whose health - related beliefs and practices indicated that they had  never mature ( d) because they continued to  behave like an eighteen year old regardless of family or work commitments , were frowned upon by some participants ( howie , 31 , slimming group ) .
one participant expressed anger at men who he perceived as being able to hang on to their 
hunter gatherers attitude ( and related behaviours ) unchallenged as they aged : 
 when you 're a daft laddy you drink all weekend and you do all the things that you 're meant to do as a teenager
 then you grow up and you realise well that was then , this is now .
they 're not being honest with themselves.nathan , 34 , slimming group 
 several participants appeared to share the expectation that men should place less emphasis on the need to appear masculine as they aged .
one described how he felt there was less pressure to enact a particular kind of masculinity as an older man : 
 i think it 's a stage you get through in life .
i mean i took my trade in the north sea on an oil platform for five or six years and one of the guys i know he still calls me tiger ,
you know the north sea tiger that was me back in the seventies , eighties and it boosts your ego i suppose but i think it 's when you 're in your thirties and your twenties and thirties you want to be macho that is the way you are.callum , 52 , prostate cancer group 
 there was perhaps less incentive for older men who had remained single to challenge their behaviours or beliefs about masculinity .
one man who had separated from his wife described his heavy drinking and said  if an eighteen year old is doing it , i can do it ( colm , 32 , gas worker 's group ) .
he viewed his lifestyle , which predominantly involved heavy drinking , as an escape from the responsibilities and monotony of married life and a way of preserving his youth ; he was doing what a single man 
another man in the same group who had recently divorced and described how much he enjoyed being single also felt that the reason why one of his friends was  on at him about his health practices ( particularly heavy drinking ) was  probably ( because ) he 's married and settled down ( angus , 41 , gas worker 's group ) .
howie ( 31 ) : there 's the going out and putting twenty pints down your neck every friday , saturday and sunday night .
but some people never mature obviously you know things like that or the boy racer thing .
when you 're a daft laddy you drink all weekend and you do all the things that you 're meant to do as a teenager  then you grow up and you realise well that was then , this is now .
life moves on . but a lot of people  ( have ) this  hunter gatherers attitude .
i mean i took my trade in the north sea on an oil platform for five or six years and one of the guys i know he still calls me tiger ,
you know the north sea tiger that was me back in the seventies , eighties and it boosts your ego i suppose but i think it 's when you 're in your thirties and your twenties and thirties you want to be macho that is the way you are . however , as the majority of participants neared middle age , health and longevity became a much more central concern to them ;  you tend to consider health issues more  as you get a bit older ( sean , 47 , student ) .
one participant was approaching his father 's age at death and this had caused him to reflect on what he believed was the cause of his death ( heavy drinking ) .
he discusses how the need to alter his own drinking habits had preoccupied him as he grew older : 
 when i was in my twenties i was a real headcase 
but now as i 've got older i 'm beginning to think about heart trouble  that 's what my father got 
but a big part of cutting back on drink is only because of the beer belly , which develops in later years  that 's health for me at the moment ; beer belly.aidan , 35 , student group 
 aidan seemed to be aware that the prevention of heart trouble might require a general overhaul of his approach to health , but the beer belly was the thing to tackle  at the moment. signs of ageing appeared to act as a visual reminder that their bodies might require greater care as they got older .
there ( are ) more things dropping off you and things sagging ( aidan , 35 , student group ) .
but now as i 've got older i 'm beginning to think about heart trouble  that 's what my father got 
but a big part of cutting back on drink is only because of the beer belly , which develops in later years  that 's health for me at the moment ; beer belly .
however , those who had experienced serious health problems found it necessary to make more drastic changes to their behaviours
. for one participant , being weighed at the doctor 's had  scared the shite out of me and that was it .
the diet started basically the following week ( jake , 33 , slimming group ) .
as the risks of being morbidly obese had been made clear to him , he felt he had no choice but to take action : 
 it 's half by choice ( and ) half i need to lose weight .
if i do n't lose weight i wo n't see them going to college or whatever they decide to do with their life .
it 's a simple choice - do i want to live or do i pack up?jake , 33 , slimming group 
 similarly , one of the youngest participants to suffer a health scare described how discovering a tumour ( which proved to be non - cancerous ) had  woken him up and prompted him to re - evaluate his diet and levels of physical activity : 
 before christmas i found out that i had  a tumourous growth in my back  that changed things for me and since then i 've been  into healthy stuff and i 'm eating fruit and all that stuff  it 's just the shock .
it 's not life threatening , ( but ) it woke me up.vikram , 21 , asian men 's group 
 another man expressed similar fears after experiencing chest pains at the age of 31 . having resisted change for so long , the prospect that his lifestyle could kill him became a reality .
he spoke about his motivation to change for the sake of his daughter : 
 the thing that 's most encouraging me is ( that ) my daughter 's twelve years old .
i want to live to see her get married and ( have ) children  when i had chest pains i should have really done it then .
but unfortunately  ( with ) people saying  you 've got to watch what you 're doing now and i 've never been one to go on advice that other people give , it pushed ( me ) in the opposite light.colm , 32 , gas worker 's group 
 colm had earlier described how he had almost been initiated into practising masculinity in a particular way through the  rites of passage he had shared with his cousin and he seemed reluctant to relinquish the behaviours he associated with being 
manly. however , following his own health scare and that of his cousin , he seemed to recognise that the lifestyle he viewed as being symbolic of his status as a man may have contributed to them both becoming ill .
he described how he had begun to make a concerted effort to cut down on drinking and  eat healthier and  i 'm back playing football again ( colm , 32 , gas worker 's group ) .
if i do n't lose weight i wo n't see them going to college or whatever they decide to do with their life .
it 's a simple choice - do i want to live or do i pack up ? before christmas i found out that i had  a tumourous growth in my back  that changed things for me and since then i 've been  into healthy stuff and i 'm eating fruit and all that stuff  it 's just the shock .
the thing that 's most encouraging me is ( that ) my daughter 's twelve years old .
i want to live to see her get married and ( have ) children  when i had chest pains i should have really done it then .
but unfortunately  ( with ) people saying  you 've got to watch what you 're doing now and i 've never been one to go on advice that other people give , it pushed ( me ) in the opposite light .
the data capture the experiences both of men who felt pressured to engage in potentially health - damaging behaviours in order to appear masculine and of those who felt freer to embrace salutogenic health practices .
the diversity within the sample also allowed some exploration of how men re - negotiated their masculinity and health in response to critical events over the lifecourse or in relation to their perceptions of age - appropriate behaviours .
participants most frequently linked masculinity and health in their descriptions of health - related behaviours , for example by describing a  macho beer drinking kind of culture ( sean , 47 , student group ) , which appeared to be recognisable to most participants across groups and a wide age range . however , this practice ( or at least participant 's presentation of their adherence to this accepted practice within group discussions ) appeared to be most prevalent among younger participants .
regimes that were described appeared to be less about the consumption of alcohol per se and more about the enactment of a particular kind of masculinity .
he described how his ability to  handle his drink provided him with an identity he felt was desirable and earned him a particular status among his peers : 
 why do i go out and drink competitively with my friends ?
let 's see who can drink the most  that trend has carried on through all of our sort of drinking lives basically .
it 's like  let 's go out and we 're going to drink twenty five pints each and the first person to be sick  that 's it
colm 's a drinker  i feel as though people are watching me and i 've got to do so much you know ( for them to say ) 
oh colm can handle his drink  i feel if i do n't i 'm letting them down ( laughs).colm , 32 , gas worker 's group why do i go out and drink competitively with my friends ? i do n't know why  we started it at sixteen years old .
let 's see who can drink the most  that trend has carried on through all of our sort of drinking lives basically .
it 's like  let 's go out and we 're going to drink twenty five pints each and the first person to be sick  that 's it
colm 's a drinker  i feel as though people are watching me and i 've got to do so much you know ( for them to say ) 
oh colm can handle his drink  i feel if i do n't i 'm letting them down ( laughs ) .
a group of younger participants ( who elsewhere in the discussion had emphasised how health conscious they were with regard to diet ) also described how their regular binge drinking was viewed as a  masculinity competition that enabled them to construct an informal hierarchy of masculinities (  pussy vs  the main man ) in their group : 
 rajiv ( 22 ) : it 's like there 's a bit of competition involved there , who 's going to drink the most and still stand up.sam ( 21 ) : without puking.rajiv : like vikram got a lot of abuse off folk for being feeble  after a few drinks he was away with the fairies.ro : what would it say about you if you could n't drink much?rajiv : you 're weak.sam : you 're a pussy
. if you 're more tolerant , you 're the main man.asian men 's group rajiv ( 22 ) : it 's like there 's a bit of competition involved there , who 's going to drink the most and still stand up .
rajiv : like vikram got a lot of abuse off folk for being feeble  after a few drinks he was away with the fairies .
sam : you 're a pussy . if you 're more tolerant , you 're the main man . it was clear that this group of participants felt that there was considerable pressure to engage in heavy drinking to avoid being exposed as 
less of a man ) and to avoid the kind of censure to which vikram had been subjected .
accounts given by participants who wished to avoid engaging in such behaviours were revealing of the very real pressures some felt to reject salutogenic health practices in order to appear masculine . weight loss was a common reason that men provided for making changes to a long - established pattern of heavy drinking .
the men who seemed to find it relatively easy to replace their old routine (  ten pints ( then )  now i sit there with my diet coke ( howie , 31 , slimming group ) ) were exceptional .
you go to the boozers with your pals and it 's a habit you get into .
it 's hard to get out of it ( jake , 33 , slimming group ) .
a participant in another group suggested that his masculinity was repeatedly challenged when he chose to avoid drinking heavily :  you can get a certain amount of stick for  saying no to going out drinking and for turning down options ,  you get a lot of stick for that ( paul , 30 , health change group ) .
his solution was to give up alcohol in the short term to enable him to achieve his weight loss goal .
once he had reached a weight he considered to be healthier , he described how he used 
balance allowed him to continue to  drink whatever i want. he described this as the  ying and yang of fitness. this also enabled him to  balance his desire for a healthier body with his need to appear acceptably masculine to his peers .
it seemed particularly difficult for the men whose identity rested on being perceived as a 
participants who identified themselves as highly motivated with regard to their own health and fitness were typically a minority within a group that did not share the same zeal .
challenge for himself to follow an intensive exercise program and eat a low - fat diet ( even though he was in the normal weight range when embarking on this ) ( ross , 30 , health change group ) .
however , others in the group seemed to find this behaviour challenging ; another group member implied that men who engaged in regular physical activity when they  did not need to exercise or worry about their diet ( i.e. if they were thought to be a normal weight ) were less masculine than men who showed little regard for their bodies .
ross clearly felt a need to defend his interest in building a body he felt happier in ( viewed as 
vanity by his peers ) : 
 steve ( 29 ) : ( describing a gym ) some guys are just looking looking looking in the mirror  ross ( 29 ) : ( interrupts ) no you see i agree with you.steve :  all the time .
you 're not automatically spending time in front of a mirror    ro : but why should n't you?steve : yeah but it 's just narcissistic .
you know you 're looking after yourself and that 's fine.ross : i mean i 've looked in the mirror but i do n't go about going ( pretends to admire himself in the mirror).health change group 
 the majority of the participants in the health change group shared a common interest in engaging in sports such as football or running . however , there was the suggestion that participating in these activities had less to do with the health and appearance of their bodies and more to do with being seen to engage in a key practice of masculinity ; competition with other men .
while ross clearly had felt able to continue with his routine regardless of how his peers viewed it , he was required to provide the group with an assurance that he was not involved in any practices that would jeopardise his own , or the group 's , sense of masculine identity .
steve ( 29 ) : ( describing a gym ) some guys are just looking looking looking in the mirror 
you 're not automatically spending time in front of a mirror    ro : but why should n't you ?
ross : i mean i 've looked in the mirror but i do n't go about going ( pretends to admire himself in the mirror ) . it is easy to see why enthusiasm for such healthy practices could wane , even for highly motivated men , in the face of such challenges from peers .
seen to be engaged with , or indeed rejecting of , health - related behaviours depending on what was deemed to be 
as one stated :  you do n't want to feel ostracised ( jake , 33 , slimming group ) .
when discussing the acceptability of certain behaviours among men , another said : 
 it becomes the thing to do for that group .
as i was saying earlier on  in a certain environment it becomes the thing to do to go to a sports club , to eat the right kind of food , to take care of your health .
it 's acceptable for men in some walks of life to be quite fastidious about what they eat and what they do .
in other areas you 're just sort of looked on as some kind of fruitcake for fussing about it too much.liam , 43 , mental health group 
 one man described how the same behaviour might take on different meanings in different social contexts depending on the kind of masculine practices privileged within particular groups .
he described instances where he had felt he was being ridiculed by other men if he expressed a concern about the shape of his body or if he was seen to be actively monitoring his diet : 
 i watched what i was eating and that was n't a problem for me .
i didnae care.nathan , 34 , slimming group it becomes the thing to do for that group . as i was saying earlier on  in a certain environment
it becomes the thing to do to go to a sports club , to eat the right kind of food , to take care of your health .
it 's acceptable for men in some walks of life to be quite fastidious about what they eat and what they do .
in other areas you 're just sort of looked on as some kind of fruitcake for fussing about it too much .
however , despite such challenges from his peers nathan felt able to seek support from another male group who had similar goals with regard to weight loss and healthy eating . similarly , jake described the camaraderie of belonging to such a group : 
 the patter 's good .
you 'd just wet yourself just listening to them . hearing the way they carry on  they 've been coming since the year dot.jake , 33 , slimming group 
 membership of this group enabled participants to share a common goal with other men within an environment that had been negotiated as 
male. this appeared to help them to deal with other social encounters in which their concern about food might be constructed as 
hearing the way they carry on  they 've been coming since the year dot .
the discussions also included , albeit to a lesser extent , some accounts of peer groups that encouraged men to have an open regard for their health with regard to diet or activity ( including the fire fighter 's group , asian men 's group , gay men 's group , prostate cancer group and the gp 's group ) .
the group of fire fighters were probably the most notable for their shared interest in achieving healthy and fit bodies .
the fire fighters described a culture where they were actively encouraged to  swap recipes and compare notes about the physical activities they did to maintain their fitness ( see also o'brien et al .
although some acknowledged that there were men in the fire service who were less interested in fitness and would 
slag you for coming into the gym ;  what do you want to do that for? ( denny , 26 , fire fighters group ) , it was clear that their immediate team shared a common belief that care and concern about their health
the subject of scotland 's poor record of health , viewed by many participants as  the worst  in the world ( chris , 30 , fire fighter 's group ) , was raised spontaneously in the majority of groups .
participants expressed a mix of horror , disgust and amusement in discussions of the excesses of the  junk food diet ( particularly the deep - fried mars bar ) and other poor lifestyle 
a number of participants believed that the unhealthy practices and inequalities that were perceived to be inherent in glaswegian culture were compounded for men by pressures to live up to the 
macho image of the male glaswegian or the  west of scotland man. participants constructions of masculinity in the west of scotland predominantly presented images of working - class glaswegian men ( as opposed to descriptions of their own masculinity or of the masculinities of men they knew ) .
one of the presentations of the  west of scotland man included : 
 the average scottish man is overweight , he smokes , he 's no got a car .
( citing a headline in local paper , the evening times ) they had a cigarette hanging out of his mouth   lying there with a poke of chips.sam , 34 , mental health group 
 a number of participants cited examples that exaggerated the 
some older participants alluded to violent masculine practices relating to male territory in glasgow as exhibited through the  gang warfare of the  razor years ( 1950 's )  ( where ) you could n't go out in certain streets because you  were afraid they ( other men ) would ( attack ) you ( bill , 62 , unemployed and retired men 's group ) .
tough masculinity to the heavily industrialised city that glasgow once was , where  men used to do tough physical labour ( sean , 47 , student group ) .
younger participants who had grown up expecting to do these kinds of jobs ( predominantly in the youth , student and gas worker 's group ) did appear to retain an idea that a particular kind of masculinity was exalted in their culture :  if  you 're dead hard , you 're masculine ( colm , 32 , gas worker 's group ) .
the average scottish man is overweight , he smokes , he 's no got a car .
( citing a headline in local paper , the evening times ) they had a cigarette hanging out of his mouth   lying there with a poke of chips .
working class felt that the decline in heavy industries in glasgow presented them with fewer opportunities to engage in practices that enabled them to enact a masculine toughness they perceived to be desirable in glasgow .
some ( particularly the younger men ) suggested that by engaging in certain health - related behaviours , such as excessive drinking or being seen to flagrantly flout dietary guidelines , men could continue to construct and demonstrate masculinities that many felt were exalted in the social world they inhabited .
a query remains as to whether these data relating to men 's constructions of masculinities merely reflect cultural ideals held by men in glasgow and the west of scotland or if the practices men describe are representative of ideals of masculinity in other regions in britain .
welsh ,  northern depending on the social context and time of the interview ( balarajan and mcdowall 1988 , scanlon et al .
2006 ) . as well as references to masculinities that were socially located in specific parts of the west of scotland
there were also references to wider culturally held notions of masculinity which were perceived by some participants to be undergoing change .
some participants described how they felt men still had the option to construct their masculinity along traditional lines but felt that they would be considered 
stupid if they did so given the perceived consequences for their health : 
 we are in a changing world 
they 're not as stupid to be masculine now as they were twenty years ago , thirty years ago , where it would have been a death sentence.nathan , 34 , slimming group 
 participants considered men who continued to resist alternative ways of constructing their masculinity to be a  dying breed. one group described such men as belonging to the 
one younger man felt that some images of masculinity that men had once aspired to were now considered to be 
dated. he describes how contemporary images of men and masculinity might encourage a  new breed of men who embrace a different way of enacting masculinity through their engagement with more  positive health - related behaviours : 
 if you look at  john wayne and his big beer gut .
whereas now if you look at the kind of guys that are ( role ) models and stuff all of them practically have a six pack 
i think that younger people are wanting to be more like them ( newer role models ) and they kind of see the older stereotypes of maleness as being 
a bit dated  so with these new role models come the way to look like that which is to go down to the gym 
debu , 22 , student group 
 there was some indication that certain health behaviours , such as smoking and drinking to excess , had been strongly associated with these 
one group were particularly scornful of the idea that smoking could continue to be perceived as 
macho because the men who had embodied this kind of masculinity were now viewed as 
extinct : 
 ( following a discussion about the advertisement of smokers and how smokers are often depicted as sexually attractive).doug ( 47 ) : are you talking about marlborough man?keiron ( 36 ) : no ! that dinosaur ? no thanks  marlborough man has lung cancer.rob ( 25 ) : well maybe in the past smoking ( was ) seen as a pretty masculine thing.gay men 's group 
 although john wayne and marlborough man appeared to represent an archetypal masculinity for those who mentioned them , it was one that was associated with ill health ;  marlborough man has lung cancer ( keiron , 36 , gay men 's group ) .
it was acknowledged that smoking and heavy drinking  still went on and continued to be associated with masculinity for some ( particularly for alcohol ) .
however , one participant believed that many men would now prioritise their health over the need to appear masculine by engaging in known high - risk behaviours : 
i think more and more ( men ) are becoming aware that you need to look after yourself ( denny , 26 , fire fighter 's group ) .
they 're not as stupid to be masculine now as they were twenty years ago , thirty years ago , where it would have been a death sentence . if you look at  john wayne and his big beer gut .
physically fit specimens . whereas now if you look at the kind of guys that are ( role ) models and stuff all of them practically have a six pack  they 're all exercising like mad !
i think that younger people are wanting to be more like them ( newer role models ) and they kind of see the older stereotypes of maleness as being 
a bit dated  so with these new role models come the way to look like that which is to go down to the gym  ( following a discussion about the advertisement of smokers and how smokers are often depicted as sexually attractive ) .
rob ( 25 ) : well maybe in the past smoking ( was ) seen as a pretty masculine thing .
most older participants also reflected on how their views on masculinity and health had changed over the lifecourse .
some pinpointed the start of working life as having a positive effect on their health practices . for several men , adult responsibilities that came with working , owning their own home or starting a family , with all of the accompanying money pressures , was also the need to 
the slimming group equated heavy drinking with demonstrating masculinity in their youth but described how they felt that it was no longer appropriate : 
 howie ( 31 ) : there 's the going out and putting twenty pints down your neck every friday , saturday and sunday night.nathan ( 34 ) : aye . until you mature.howie : aye .
but some people never mature obviously you know things like that or the boy racer thing.slimming group 
 there was a strong suggestion that men whose health - related beliefs and practices indicated that they had 
never mature ( d) because they continued to  behave like an eighteen year old regardless of family or work commitments , were frowned upon by some participants ( howie , 31 , slimming group ) .
one participant expressed anger at men who he perceived as being able to hang on to their 
hunter gatherers attitude ( and related behaviours ) unchallenged as they aged : 
 when you 're a daft laddy you drink all weekend and you do all the things that you 're meant to do as a teenager
 then you grow up and you realise well that was then , this is now .
they 're not being honest with themselves.nathan , 34 , slimming group 
 several participants appeared to share the expectation that men should place less emphasis on the need to appear masculine as they aged .
one described how he felt there was less pressure to enact a particular kind of masculinity as an older man : 
 i think it 's a stage you get through in life .
i mean i took my trade in the north sea on an oil platform for five or six years and one of the guys i know he still calls me tiger ,
you know the north sea tiger that was me back in the seventies , eighties and it boosts your ego i suppose but i think it 's when you 're in your thirties and your twenties and thirties you want to be macho that is the way you are.callum , 52 , prostate cancer group 
 there was perhaps less incentive for older men who had remained single to challenge their behaviours or beliefs about masculinity .
one man who had separated from his wife described his heavy drinking and said  if an eighteen year old is doing it , i can do it ( colm , 32 , gas worker 's group ) .
he viewed his lifestyle , which predominantly involved heavy drinking , as an escape from the responsibilities and monotony of married life and a way of preserving his youth ; he was doing what a single man 
another man in the same group who had recently divorced and described how much he enjoyed being single also felt that the reason why one of his friends was  on at him about his health practices ( particularly heavy drinking ) was  probably ( because ) he 's married and settled down ( angus , 41 , gas worker 's group ) .
howie ( 31 ) : there 's the going out and putting twenty pints down your neck every friday , saturday and sunday night .
but some people never mature obviously you know things like that or the boy racer thing .
when you 're a daft laddy you drink all weekend and you do all the things that you 're meant to do as a teenager  then you grow up and you realise well that was then , this is now .
i mean i took my trade in the north sea on an oil platform for five or six years and one of the guys i know he still calls me tiger , you know the north sea tiger that was me back in the seventies , eighties and it boosts your ego i suppose but i think it 's when you 're in your thirties and your twenties and thirties you want to be macho that is the way you are .
however , as the majority of participants neared middle age , health and longevity became a much more central concern to them ;  you tend to consider health issues more  as you get a bit older ( sean , 47 , student ) .
one participant was approaching his father 's age at death and this had caused him to reflect on what he believed was the cause of his death ( heavy drinking ) .
he discusses how the need to alter his own drinking habits had preoccupied him as he grew older : 
 when i was in my twenties i was a real headcase 
but now as i 've got older i 'm beginning to think about heart trouble  that 's what my father got 
but a big part of cutting back on drink is only because of the beer belly , which develops in later years  that 's health for me at the moment ; beer belly.aidan , 35 , student group 
 aidan seemed to be aware that the prevention of heart trouble might require a general overhaul of his approach to health , but the beer belly was the thing to tackle  at the moment. signs of ageing appeared to act as a visual reminder that their bodies might require greater care as they got older .
there ( are ) more things dropping off you and things sagging ( aidan , 35 , student group ) .
but now as i 've got older i 'm beginning to think about heart trouble  that 's what my father got 
so i 'm beginning to think maybe i should cut back on the drink . but
a big part of cutting back on drink is only because of the beer belly , which develops in later years  that 's health for me at the moment ; beer belly .
however , those who had experienced serious health problems found it necessary to make more drastic changes to their behaviours
. for one participant , being weighed at the doctor 's had  scared the shite out of me and that was it .
the diet started basically the following week ( jake , 33 , slimming group ) .
as the risks of being morbidly obese had been made clear to him , he felt he had no choice but to take action : 
 it 's half by choice ( and ) half i need to lose weight .
if i do n't lose weight i wo n't see them going to college or whatever they decide to do with their life .
it 's a simple choice - do i want to live or do i pack up?jake , 33 , slimming group 
 similarly , one of the youngest participants to suffer a health scare described how discovering a tumour ( which proved to be non - cancerous ) had  woken him up and prompted him to re - evaluate his diet and levels of physical activity : 
 before christmas i found out that i had  a tumourous growth in my back  that changed things for me and since then i 've been  into healthy stuff and i 'm eating fruit and all that stuff  it 's just the shock .
it 's not life threatening , ( but ) it woke me up.vikram , 21 , asian men 's group 
 another man expressed similar fears after experiencing chest pains at the age of 31 . having resisted change for so long , the prospect that his lifestyle could kill him became a reality .
he spoke about his motivation to change for the sake of his daughter : 
 the thing that 's most encouraging me is ( that ) my daughter 's twelve years old .
i want to live to see her get married and ( have ) children  when i had chest pains i should have really done it then .
but unfortunately  ( with ) people saying  you 've got to watch what you 're doing now and i 've never been one to go on advice that other people give , it pushed ( me ) in the opposite light.colm , 32 , gas worker 's group 
 colm had earlier described how he had almost been initiated into practising masculinity in a particular way through the  rites of passage he had shared with his cousin and he seemed reluctant to relinquish the behaviours he associated with being 
manly. however , following his own health scare and that of his cousin , he seemed to recognise that the lifestyle he viewed as being symbolic of his status as a man may have contributed to them both becoming ill .
he described how he had begun to make a concerted effort to cut down on drinking and  eat healthier and  i 'm back playing football again ( colm , 32 , gas worker 's group ) .
if i do n't lose weight i wo n't see them going to college or whatever they decide to do with their life .
it 's a simple choice - do i want to live or do i pack up ? before christmas i found out that i had  a tumourous growth in my back  that changed things for me and since then i 've been  into healthy stuff and i 'm eating fruit and all that stuff  it 's just the shock .
the thing that 's most encouraging me is ( that ) my daughter 's twelve years old .
i want to live to see her get married and ( have ) children  when i had chest pains i should have really done it then .
but unfortunately  ( with ) people saying  you 've got to watch what you 're doing now and i 've never been one to go on advice that other people give , it pushed ( me ) in the opposite light .
participants most frequently linked masculinity and health in their descriptions of health - related behaviours , for example by describing a  macho beer drinking kind of culture ( sean , 47 , student group ) , which appeared to be recognisable to most participants across groups and a wide age range . however , this practice ( or at least participant 's presentation of their adherence to this accepted practice within group discussions ) appeared to be most prevalent among younger participants .
regimes that were described appeared to be less about the consumption of alcohol per se and more about the enactment of a particular kind of masculinity .
he described how his ability to  handle his drink provided him with an identity he felt was desirable and earned him a particular status among his peers : 
 why do i go out and drink competitively with my friends ?
let 's see who can drink the most  that trend has carried on through all of our sort of drinking lives basically .
it 's like  let 's go out and we 're going to drink twenty five pints each and the first person to be sick  that 's it
colm 's a drinker  i feel as though people are watching me and i 've got to do so much you know ( for them to say ) 
oh colm can handle his drink  i feel if i do n't i 'm letting them down ( laughs).colm , 32 , gas worker 's group why do i go out and drink competitively with my friends ?
let 's see who can drink the most  that trend has carried on through all of our sort of drinking lives basically .
it 's like  let 's go out and we 're going to drink twenty five pints each and the first person to be sick  that 's it
colm 's a drinker  i feel as though people are watching me and i 've got to do so much you know ( for them to say ) 
oh colm can handle his drink  i feel if i do n't i 'm letting them down ( laughs ) .
a group of younger participants ( who elsewhere in the discussion had emphasised how health conscious they were with regard to diet ) also described how their regular binge drinking was viewed as a  masculinity competition that enabled them to construct an informal hierarchy of masculinities (  pussy vs  the main man ) in their group : 
 rajiv ( 22 ) : it 's like there 's a bit of competition involved there , who 's going to drink the most and still stand up.sam ( 21 ) : without puking.rajiv : like vikram got a lot of abuse off folk for being feeble 
after a few drinks he was away with the fairies.ro : what would it say about you if you could n't drink much?rajiv : you 're weak.sam : you 're a pussy . if you 're more tolerant , you 're the main man.asian men 's group rajiv ( 22 ) : it 's like there 's a bit of competition involved there , who 's going to drink the most and still stand up .
rajiv : like vikram got a lot of abuse off folk for being feeble  after a few drinks he was away with the fairies .
sam : you 're a pussy . if you 're more tolerant , you 're the main man .
it was clear that this group of participants felt that there was considerable pressure to engage in heavy drinking to avoid being exposed as 
less of a man ) and to avoid the kind of censure to which vikram had been subjected .
accounts given by participants who wished to avoid engaging in such behaviours were revealing of the very real pressures some felt to reject salutogenic health practices in order to appear masculine . weight loss was a common reason that men provided for making changes to a long - established pattern of heavy drinking .
the men who seemed to find it relatively easy to replace their old routine (  ten pints ( then )  now i sit there with my diet coke ( howie , 31 , slimming group ) ) were exceptional .
you go to the boozers with your pals and it 's a habit you get into .
it 's hard to get out of it ( jake , 33 , slimming group ) .
a participant in another group suggested that his masculinity was repeatedly challenged when he chose to avoid drinking heavily :  you can get a certain amount of stick for  saying no to going out drinking and for turning down options ,  you get a lot of stick for that ( paul , 30 , health change group ) .
his solution was to give up alcohol in the short term to enable him to achieve his weight loss goal .
once he had reached a weight he considered to be healthier , he described how he used 
balance allowed him to continue to  drink whatever i want. he described this as the  ying and yang of fitness. this also enabled him to  balance his desire for a healthier body with his need to appear acceptably masculine to his peers .
it seemed particularly difficult for the men whose identity rested on being perceived as a 
participants who identified themselves as highly motivated with regard to their own health and fitness were typically a minority within a group that did not share the same zeal .
challenge for himself to follow an intensive exercise program and eat a low - fat diet ( even though he was in the normal weight range when embarking on this ) ( ross , 30 , health change group ) .
however , others in the group seemed to find this behaviour challenging ; another group member implied that men who engaged in regular physical activity when they  did not need to exercise or worry about their diet ( i.e. if they were thought to be a normal weight ) were less masculine than men who showed little regard for their bodies .
ross clearly felt a need to defend his interest in building a body he felt happier in ( viewed as  vanity by his peers ) : 
 steve ( 29 ) : ( describing a gym ) some guys are just looking looking looking in the mirror 
ross ( 29 ) : ( interrupts ) no you see i agree with you.steve :  all the time .
you 're not automatically spending time in front of a mirror    ro : but why should n't you?steve : yeah but it 's just narcissistic .
you know you 're looking after yourself and that 's fine.ross : i mean i 've looked in the mirror but i do n't go about going ( pretends to admire himself in the mirror).health change group 
 the majority of the participants in the health change group shared a common interest in engaging in sports such as football or running . however , there was the suggestion that participating in these activities had less to do with the health and appearance of their bodies and more to do with being seen to engage in a key practice of masculinity ; competition with other men . while ross clearly had felt able to continue with his routine regardless of how his peers viewed it , he was required to provide the group with an assurance that he was not involved in any practices that would jeopardise his own , or the group 's , sense of masculine identity .
steve ( 29 ) : ( describing a gym ) some guys are just looking looking looking in the mirror  ross ( 29 ) : ( interrupts ) no you see i agree with you .
you 're not automatically spending time in front of a mirror    ro : but why should n't you ?
ross : i mean i 've looked in the mirror but i do n't go about going ( pretends to admire himself in the mirror ) .
it is easy to see why enthusiasm for such healthy practices could wane , even for highly motivated men , in the face of such challenges from peers .
seen to be engaged with , or indeed rejecting of , health - related behaviours depending on what was deemed to be 
as one stated :  you do n't want to feel ostracised ( jake , 33 , slimming group ) .
when discussing the acceptability of certain behaviours among men , another said : 
 it becomes the thing to do for that group .
as i was saying earlier on  in a certain environment it becomes the thing to do to go to a sports club , to eat the right kind of food , to take care of your health .
it 's acceptable for men in some walks of life to be quite fastidious about what they eat and what they do .
in other areas you 're just sort of looked on as some kind of fruitcake for fussing about it too much.liam , 43 , mental health group 
 one man described how the same behaviour might take on different meanings in different social contexts depending on the kind of masculine practices privileged within particular groups .
he described instances where he had felt he was being ridiculed by other men if he expressed a concern about the shape of his body or if he was seen to be actively monitoring his diet : 
 i watched what i was eating and that was n't a problem for me .
i didnae care.nathan , 34 , slimming group it becomes the thing to do for that group . as i was saying earlier on  in a certain environment
it becomes the thing to do to go to a sports club , to eat the right kind of food , to take care of your health .
it 's acceptable for men in some walks of life to be quite fastidious about what they eat and what they do .
in other areas you 're just sort of looked on as some kind of fruitcake for fussing about it too much .
however , despite such challenges from his peers nathan felt able to seek support from another male group who had similar goals with regard to weight loss and healthy eating . similarly , jake described the camaraderie of belonging to such a group : 
 the patter 's good .
hearing the way they carry on  they 've been coming since the year dot.jake , 33 , slimming group 
 membership of this group enabled participants to share a common goal with other men within an environment that had been negotiated as 
male. this appeared to help them to deal with other social encounters in which their concern about food might be constructed as  feminine and therefore challenging to their identities as men .
hearing the way they carry on  they 've been coming since the year dot .
the discussions also included , albeit to a lesser extent , some accounts of peer groups that encouraged men to have an open regard for their health with regard to diet or activity ( including the fire fighter 's group , asian men 's group , gay men 's group , prostate cancer group and the gp 's group ) .
the group of fire fighters were probably the most notable for their shared interest in achieving healthy and fit bodies .
swap recipes and compare notes about the physical activities they did to maintain their fitness ( see also o'brien et al .
although some acknowledged that there were men in the fire service who were less interested in fitness and would  slag you for coming into the gym ;  what do you want to do that for? ( denny , 26 , fire fighters group ) , it was clear that their immediate team shared a common belief that care and concern about their health 
the subject of scotland 's poor record of health , viewed by many participants as  the worst  in the world ( chris , 30 , fire fighter 's group ) , was raised spontaneously in the majority of groups .
participants expressed a mix of horror , disgust and amusement in discussions of the excesses of the  junk food diet ( particularly the deep - fried mars bar ) and other poor lifestyle 
a number of participants believed that the unhealthy practices and inequalities that were perceived to be inherent in glaswegian culture were compounded for men by pressures to live up to the 
macho image of the male glaswegian or the  west of scotland man. participants constructions of masculinity in the west of scotland predominantly presented images of working - class glaswegian men ( as opposed to descriptions of their own masculinity or of the masculinities of men they knew ) .
one of the presentations of the  west of scotland man included : 
 the average scottish man is overweight , he smokes , he 's no got a car .
( citing a headline in local paper , the evening times ) they had a cigarette hanging out of his mouth 
 lying there with a poke of chips.sam , 34 , mental health group 
 a number of participants cited examples that exaggerated the  legendary toughness of glaswegian masculinities .
some older participants alluded to violent masculine practices relating to male territory in glasgow as exhibited through the  gang warfare of the  razor years ( 1950 's )  ( where ) you could n't go out in certain streets because you  were afraid they ( other men ) would ( attack ) you ( bill , 62 , unemployed and retired men 's group ) .
tough masculinity to the heavily industrialised city that glasgow once was , where  men used to do tough physical labour ( sean , 47 , student group ) .
younger participants who had grown up expecting to do these kinds of jobs ( predominantly in the youth , student and gas worker 's group ) did appear to retain an idea that a particular kind of masculinity was exalted in their culture :  if  you 're dead hard , you 're masculine ( colm , 32 , gas worker 's group ) .
the average scottish man is overweight , he smokes , he 's no got a car .
( citing a headline in local paper , the evening times ) they had a cigarette hanging out of his mouth   lying there with a poke of chips .
working class felt that the decline in heavy industries in glasgow presented them with fewer opportunities to engage in practices that enabled them to enact a masculine toughness they perceived to be desirable in glasgow .
some ( particularly the younger men ) suggested that by engaging in certain health - related behaviours , such as excessive drinking or being seen to flagrantly flout dietary guidelines , men could continue to construct and demonstrate masculinities that many felt were exalted in the social world they inhabited .
a query remains as to whether these data relating to men 's constructions of masculinities merely reflect cultural ideals held by men in glasgow and the west of scotland or if the practices men describe are representative of ideals of masculinity in other regions in britain .
welsh ,  northern depending on the social context and time of the interview ( balarajan and mcdowall 1988 , scanlon et al .
as well as references to masculinities that were socially located in specific parts of the west of scotland there were also references to wider culturally held notions of masculinity which were perceived by some participants to be undergoing change .
some participants described how they felt men still had the option to construct their masculinity along traditional lines but felt that they would be considered 
stupid if they did so given the perceived consequences for their health : 
 we are in a changing world 
they 're not as stupid to be masculine now as they were twenty years ago , thirty years ago , where it would have been a death sentence.nathan , 34 , slimming group 
 participants considered men who continued to resist alternative ways of constructing their masculinity to be a  dying breed. one group described such men as belonging to the  old school of masculinity ( fire fighter 's group ) .
one younger man felt that some images of masculinity that men had once aspired to were now considered to be 
dated. he describes how contemporary images of men and masculinity might encourage a  new breed of men who embrace a different way of enacting masculinity through their engagement with more 
positive health - related behaviours : 
 if you look at  john wayne and his big beer gut .
whereas now if you look at the kind of guys that are ( role ) models and stuff all of them practically have a six pack 
i think that younger people are wanting to be more like them ( newer role models ) and they kind of see the older stereotypes of maleness as being 
a bit dated  so with these new role models come the way to look like that which is to go down to the gym 
debu , 22 , student group 
 there was some indication that certain health behaviours , such as smoking and drinking to excess , had been strongly associated with these 
one group were particularly scornful of the idea that smoking could continue to be perceived as 
macho because the men who had embodied this kind of masculinity were now viewed as 
extinct : 
 ( following a discussion about the advertisement of smokers and how smokers are often depicted as sexually attractive).doug ( 47 ) : are you talking about marlborough man?keiron ( 36 ) : no ! that dinosaur ? no thanks  marlborough man has lung cancer.rob ( 25 ) : well maybe in the past smoking ( was ) seen as a pretty masculine thing.gay men 's group 
 although john wayne and marlborough man appeared to represent an archetypal masculinity for those who mentioned them , it was one that was associated with ill health ;  marlborough man has lung cancer ( keiron , 36 , gay men 's group ) .
it was acknowledged that smoking and heavy drinking  still went on and continued to be associated with masculinity for some ( particularly for alcohol ) .
however , one participant believed that many men would now prioritise their health over the need to appear masculine by engaging in known high - risk behaviours : 
i think more and more ( men ) are becoming aware that you need to look after yourself ( denny , 26 , fire fighter 's group ) .
they 're not as stupid to be masculine now as they were twenty years ago , thirty years ago , where it would have been a death sentence .
whereas now if you look at the kind of guys that are ( role ) models and stuff all of them practically have a six pack  they 're all exercising like mad
i think that younger people are wanting to be more like them ( newer role models ) and they kind of see the older stereotypes of maleness as being 
so with these new role models come the way to look like that which is to go down to the gym 
( following a discussion about the advertisement of smokers and how smokers are often depicted as sexually attractive ) .
doug ( 47 ) : are you talking about marlborough man ? keiron ( 36 ) : no ! that dinosaur ? no thanks 
rob ( 25 ) : well maybe in the past smoking ( was ) seen as a pretty masculine thing .
most older participants also reflected on how their views on masculinity and health had changed over the lifecourse .
some pinpointed the start of working life as having a positive effect on their health practices . for several men , adult responsibilities that came with working , owning their own home or starting a family , with all of the accompanying money pressures , was also the need to 
the slimming group equated heavy drinking with demonstrating masculinity in their youth but described how they felt that it was no longer appropriate : 
 howie ( 31 ) : there 's the going out and putting twenty pints down your neck every friday , saturday and sunday night.nathan ( 34 ) : aye . until you mature.howie : aye . but some people never mature obviously you know things like that or the boy racer thing.slimming group 
 there was a strong suggestion that men whose health - related beliefs and practices indicated that they had  never mature ( d) because they continued to  behave like an eighteen year old regardless of family or work commitments , were frowned upon by some participants ( howie , 31 , slimming group ) .
one participant expressed anger at men who he perceived as being able to hang on to their 
hunter gatherers attitude ( and related behaviours ) unchallenged as they aged : 
 when you 're a daft laddy you drink all weekend and you do all the things that you 're meant to do as a teenager  then you grow up and you realise well that was then , this is now .
they 're not being honest with themselves.nathan , 34 , slimming group 
 several participants appeared to share the expectation that men should place less emphasis on the need to appear masculine as they aged .
one described how he felt there was less pressure to enact a particular kind of masculinity as an older man : 
 i think it 's a stage you get through in life .
i mean i took my trade in the north sea on an oil platform for five or six years and one of the guys i know he still calls me tiger ,
you know the north sea tiger that was me back in the seventies , eighties and it boosts your ego i suppose but i think it 's when you 're in your thirties and your twenties and thirties you want to be macho that is the way you are.callum , 52 , prostate cancer group 
 there was perhaps less incentive for older men who had remained single to challenge their behaviours or beliefs about masculinity .
one man who had separated from his wife described his heavy drinking and said  if an eighteen year old is doing it , i can do it ( colm , 32 , gas worker 's group ) .
he viewed his lifestyle , which predominantly involved heavy drinking , as an escape from the responsibilities and monotony of married life and a way of preserving his youth ; he was doing what a single man 
another man in the same group who had recently divorced and described how much he enjoyed being single also felt that the reason why one of his friends was  on at him about his health practices ( particularly heavy drinking ) was  probably ( because ) he 's married and settled down ( angus , 41 , gas worker 's group ) .
howie ( 31 ) : there 's the going out and putting twenty pints down your neck every friday , saturday and sunday night .
but some people never mature obviously you know things like that or the boy racer thing .
when you 're a daft laddy you drink all weekend and you do all the things that you 're meant to do as a teenager  then you grow up and you realise well that was then , this is now .
i mean i took my trade in the north sea on an oil platform for five or six years and one of the guys i know he still calls me tiger , you know the north sea tiger that was me back in the seventies , eighties and it boosts your ego i suppose but i think it 's when you 're in your thirties and your twenties and thirties you want to be macho that is the way you are .
however , as the majority of participants neared middle age , health and longevity became a much more central concern to them ;  you tend to consider health issues more  as you get a bit older ( sean , 47 , student ) .
one participant was approaching his father 's age at death and this had caused him to reflect on what he believed was the cause of his death ( heavy drinking ) .
he discusses how the need to alter his own drinking habits had preoccupied him as he grew older : 
 when i was in my twenties i was a real headcase 
but now as i 've got older i 'm beginning to think about heart trouble  that 's what my father got 
but a big part of cutting back on drink is only because of the beer belly , which develops in later years  that 's health for me at the moment ; beer belly.aidan , 35 , student group 
 aidan seemed to be aware that the prevention of heart trouble might require a general overhaul of his approach to health , but the beer belly was the thing to tackle  at the moment. signs of ageing appeared to act as a visual reminder that their bodies might require greater care as they got older .
there ( are ) more things dropping off you and things sagging ( aidan , 35 , student group ) .
now as i 've got older i 'm beginning to think about heart trouble  that 's what my father got 
but a big part of cutting back on drink is only because of the beer belly , which develops in later years  that 's health for me at the moment ; beer belly .
however , those who had experienced serious health problems found it necessary to make more drastic changes to their behaviours .
for one participant , being weighed at the doctor 's had  scared the shite out of me and that was it .
the diet started basically the following week ( jake , 33 , slimming group ) .
as the risks of being morbidly obese had been made clear to him , he felt he had no choice but to take action : 
 it 's half by choice ( and ) half i need to lose weight .
if i do n't lose weight i wo n't see them going to college or whatever they decide to do with their life .
it 's a simple choice - do i want to live or do i pack up?jake , 33 , slimming group 
 similarly , one of the youngest participants to suffer a health scare described how discovering a tumour ( which proved to be non - cancerous ) had  woken him up and prompted him to re - evaluate his diet and levels of physical activity : 
 before christmas i found out that i had  a tumourous growth in my back  that changed things for me and since then i 've been  into healthy stuff and i 'm eating fruit and all that stuff  it 's just the shock .
it 's not life threatening , ( but ) it woke me up.vikram , 21 , asian men 's group 
 another man expressed similar fears after experiencing chest pains at the age of 31 . having resisted change for so long , the prospect that his lifestyle could kill him became a reality .
he spoke about his motivation to change for the sake of his daughter : 
 the thing that 's most encouraging me is ( that ) my daughter 's twelve years old .
i want to live to see her get married and ( have ) children  when i had chest pains i should have really done it then .
but unfortunately  ( with ) people saying  you 've got to watch what you 're doing now and i 've never been one to go on advice that other people give , it pushed ( me ) in the opposite light.colm , 32 , gas worker 's group 
 colm had earlier described how he had almost been initiated into practising masculinity in a particular way through the  rites of passage he had shared with his cousin and he seemed reluctant to relinquish the behaviours he associated with being 
manly. however , following his own health scare and that of his cousin , he seemed to recognise that the lifestyle he viewed as being symbolic of his status as a man may have contributed to them both becoming ill .
he described how he had begun to make a concerted effort to cut down on drinking and  eat healthier and  i 'm back playing football again ( colm , 32 , gas worker 's group ) .
if i do n't lose weight i wo n't see them going to college or whatever they decide to do with their life .
it 's a simple choice - do i want to live or do i pack up ? before christmas i found out that i had  a tumourous growth in my back  that changed things for me and since then i 've been  into healthy stuff and i 'm eating fruit and all that stuff  it 's just the shock .
the thing that 's most encouraging me is ( that ) my daughter 's twelve years old .
i want to live to see her get married and ( have ) children  when i had chest pains i should have really done it then . but
unfortunately  ( with ) people saying  you 've got to watch what you 're doing now and i 've never been one to go on advice that other people give , it pushed ( me ) in the opposite light .
the data presented here support findings reported elsewhere which suggest that the adoption of particular health - related behaviours , for example the  competitive drinking described here ( see also lemle and mishkind 1989 , de visser and smith 2006 , 2007 , emslie et al . in press ) may be understood as a way of  doing gender ( saltonstall 1993 , williams 2000 ) .
men who , for complex reasons , persisted in engaging in potentially health - damaging behaviours in order to construct their masculinities clearly present the greatest challenge for healthcare providers and those working in health promotion .
less is known about the circumstances that encourage men to re - think performances of masculinity that have potentially detrimental health effects .
however , the data presented here suggest that ageing , illness and fatherhood were some of the experiences that prompted men who may have previously prioritised a particular construction of masculinity to re - evaluate their health practices .
it was rare , in the context of these all - male discussions at least , for younger men in particular to critically examine their views on hegemonic masculinity and reflect on how these may have interfered with engaging in recommended health practices unless this met with their group 's collective representation of masculine identity . some of the data presented here suggest , in line with other findings , that for young men  male peer group networks are one of the most oppressive arenas for the production and regulation of masculinities ( haywood and mac an ghaill 1996 , p. 54 ) .
there was a suggestion , reminiscent of foucault 's model of the panoptican ( foucault 1995 ) , that some men monitored and corrected their behaviours without active social pressure because they had learnt to view their masculinity and masculinising practices through the eyes of other men .
as these and possibly other processes could clearly affect men 's willingness to engage in certain health - related practices , it seems particularly urgent to gain further insights into how men 's masculinities are policed and negotiated through everyday interactions ( kehily and nayak 1997 ) .
many men felt there was continual pressure to present themselves in conversation with other men as  uncaring about their health in conversation with other men .
taken at face value such data would seem to lend weight to arguments that men can appear to be  indifferent and resistant ( doh 1993 ) to health promotion messages . however , robertson ( 2003 ) has highlighted the need to be cautious when interpreting men 's representations of their health .
he argues that how men actually behave may differ from how they say they behave .
it is important to highlight that participants in this study presented accounts of their health - related beliefs and practices for the consumption , and sometimes approval , of other men in their group .
the accounts therefore included : ( 1 ) the group 's collective constructions of masculinities with reference to what was acceptable practice within their group and beyond ( e.g. accepted practice in the west of scotland and wider culturally held notions of masculinity ) and ( 2 ) men 's reflections on their actual practices ( past and present ) . while we do not doubt the very real pressures that men in our study described , we acknowledge that there is a need to be critical when reporting men 's accounts of their 
poor health practices . however , this study is rare in capturing experiences of men whose sense of masculinity and membership of their peer group depended on them demonstrating their concern about their health by engaging in  healthy practices .
it appeared that the groups of men who were united in either conforming to ( e.g. the youth group ) or rejecting traditional 
all were motivated to align themselves to the kind of masculinity that was valorised by their peers in order to avoid feeling  ostracised. it is rare to find accounts of men 's health which include men who do not conform to traditional notions of masculinity or men who have previously conformed but subsequently found it necessary to depart from those at particular times in their lives ( carrigan et al .
those who had felt ostracised by their peers ( e.g. the slimming group ) described seeking out other social groups where their behaviour was viewed positively and could be re - negotiated as 
similar findings that relate to the influence of peer group social norms in shaping individual behaviour have been discussed elsewhere ( berkowitz 2003 , courtenay 2004 ) .
however , these accounts rarely consider the positive influence that social norms may have on men 's health - related behaviours
. theoretical work on masculinities in the last decade has emphasised the importance of exploring the dynamic ways in which male identities are negotiated ( hearn and morgan 1990 , morgan 1992 , brod and kaufman 1994 , connell 1995 ) .
the findings presented here raise questions about how men of different ages , life stages and differing experiences construct their masculinity in relation to their health . a number of participants described  growing out of the worst excesses of masculinity that they associated with their youth and appeared critical of those who had not followed suit .
others have also suggested that there are widely held lay beliefs about the kind of behaviours considered appropriate at different stages of the lifecourse ( backett et al .
some men who presented themselves as reluctant to health promotion guidance described how fatherhood was the only event that had encouraged them to adapt their lifestyle .
this corresponds with other data that suggest that fatherhood might be beneficial to men 's health ( bartlett 2004 ) .
the obligations of a father  child relationship and a committed partnership have been viewed as  replacing the more 
our data lend support to arguments that a life - course approach might be particularly illuminating in understanding men 's health ( arber and cooper 2000 , lohan 2007 ) .
the data also raise interesting questions with regard to the negotiation of masculinity and health - related behaviour in light of social change .
writers who have discussed the  crisis of masculinity have examined the critical events that they believe have led to the emergence of new masculinities ( kimmel 1987 , macinnes 2001 , beynon 2002 ) .
however , few have explored the contradictions and challenges these co - existing models of masculinities present to men or how these  new ways of articulating masculinity have impacted on men 's health .
crawshaw 's analysis of the magazine men 's health highlights the ways in which this medium departs from traditional constructions of masculinity and health ( in constructing the male reader as  interested in managing their own health and engaging in an ongoing body project ( crawshaw 2007 , p. 1616 ) ) .
however , clearly men like ross ( health change group ) who have an interest in engaging with such practices still live with challenges from other men who fear they are taking 
other writers have commented that the muscular body can simultaneously be viewed positively as a symbol of masculine attainment and as a source of suspicion as  anything less than functional physicality ( is ) suspect ( klein 1995 ) .
however , in different social contexts such pursuits may be viewed positively , as was the case with the gay men 's group ( fawkner and mcmurray 2002 ) . in the fire fighter 's group work on the body
was related to notions of masculine responsibility that echoed the way some participants had referred to their masculine responsibilities as 
mishkind and colleagues have suggested that : 
 men arrange themselves along a continuum , from unconcerned with body at one end to extremely concerned at the other .
this conceptualization may help predict the type and degree of behaviour in which individuals engage to change their physical appearance and come closer to the masculine ideal(mishkind et al .
however , it is clear from this study that the  masculine ideal may be understood by men to be related to appearance or to ideals about appropriate social practice for men depending on what is considered most important in their social group or in the light of circumstances thrust upon them ( such as a serious threat to their health ( o'brien et al .
men arrange themselves along a continuum , from unconcerned with body at one end to extremely concerned at the other .
this conceptualization may help predict the type and degree of behaviour in which individuals engage to change their physical appearance and come closer to the masculine ideal participants appeared sensitive to changes in the way in which gendered images of smoking have been presented ( elliot 2008 ) .
although smoking was described as having been an important means of expressing a particular kind of masculinity in the past , many men expressed strong views regarding the  death of the image of the macho smoker .
other researchers have highlighted how the  morass of complex gendered imagery surrounding smoking has become increasingly feminised ( hunt et al .
some of the men in this study certainly reject the idea of smoking as a masculine practice forcefully .
however , there were many others , such as the youth group , in which smoking from a young age ( in this case from the age of nine or 10 ) was a sign of masculine toughness and presented as a badge of honour to others in their group .
courtenay has expressed the hope that social change might create a climate where  men will begin to see  that following good health habits can be manly as well as lifesaving ( courtenay 2004 , p. 276 ) . in this study , 
healthy behaviours ( e.g. healthy diet and regular physical activity ) were constructed as both manly and lifesaving within particular contexts where this was permissible ( e.g. the fire fighters group ) .
many who showed awareness of changes at a cultural level described the practical constraints they continued to feel in everyday life to behave in traditionally masculine ways , particularly with regard to diet ( see gough and conner 2006 , gough 2007 ) .
further research might provide a more detailed examination of the social circumstances and characteristics of those men who appear able to embrace the idea that a concern with men 's health is 
manly. however , there is a need to explore the inequalities between men that currently mean that only some are free to embrace 
new ways of articulating their masculinity which bring health benefits while others feel pressured to continue engaging in practices of masculinity that are likely to be harmful to their health .
 men 's apparent resistance to recommended health practices and their engagement with  
 high - risk behaviours has been associated with an increased risk of morbidity or mortality . 
 recent work has highlighted the need to think critically about the health - promoting behaviours that men appear reluctant to engage in , as well as examining those they embrace , and explore the gendered meanings that men attribute to their beliefs and behaviours . 
 this article presents men 's discussions of the  practices of masculinity and examines their relation to , and implications for , men 's health - related behaviours as articulated in 15 focus group discussions ( 59 participants in total ) . 
 the data capture both the experiences of men who felt pressured to engage in behaviours that may be harmful to their health in order to appear masculine and the accounts of those who regarded themselves as freer to embrace salutogenic health practices . 
 less is known about the circumstances that might encourage men to re - think their engagement in performances of masculinity that have potentially detrimental effects on their health . 
 the data presented here suggest that ageing , illness , and fatherhood were some of the experiences that prompted men to re - evaluate their health practices . 
Introduction
Method
Summary of findings
Prioritising masculinity over health: examples of competitive drinking
The challenges presented to men who embraced salutogenic practices
Linking masculinities, health and place: the West of Scotland man
Masculinity and health-related beliefs and practices across time and the lifecourse: prospects for change?
Discussion and conclusion