“I believe once I’m happy within myself I won’t need to Smoke”: An exploration of Women Smokers’ Views on Smoking, Tobacco Control and Cessation.

Abstract

Women’s smoking is emerging as a significant global public health issue and has been acknowledged as an epidemic unlikely to reach its peak until well into the 21st century. Within developed countries, including New Zealand, smoking is increasingly patterned according to social disadvantage and inequality, and is therefore a particularly significant issue for women already marginalised due to their ethnicity or socioeconomic position. These women not only suffer from disproportionate rates of smoking and the associated health outcomes, they have also become further marginalised in society as a result of smoker-stigmatisation.

Previous literature has indicated the importance of examining the unintended burdens that tobacco de-normalisation strategies may impose on vulnerable smokers and that examining contextual factors that influence smoking inequalities may be the key to eliminating them. Therefore, the aim of this exploratory study was to examine women smokers’ views and perceptions of smoking, tobacco control and cessation within a context in which tobacco de-normalisation is high on the social and political agenda.

In-depth qualitative interviews were conducted with twelve adult female smokers living in Hornby, Christchurch. A thematic analysis revealed that smoking was intrinsically linked to the lived circumstances of the women, determined by wider social structures that undermined their adaptive capacity to quit. Within this context smoking was valued and relied on as a companion, a coping mechanism and an activity to deal with feelings of stress, loneliness and boredom. For these women, tobacco de-normalisation and smoker-stigmatisation appeared to foster resistance and opposition to the intensification of tobacco control, which was often viewed as a threat to their autonomy. Resistant responses to smoker-stigmatisation also influenced the women’s attitudes towards utilising and accessing cessation resources, reflected in their rejection of the influence of external pressures to quit smoking, their emphasis of the importance of will power and their preference for autonomous and self-directed methods of cessation.