Addressing smoking cessation among women in substance use treatment: A qualitative approach to guiding tailored interventions

Isabel Martinez Leal, Matthew Taing, Virmarie Correa-Fernandez, Ezemenari M. Obasi, Bryce Kyburz, Kathy Le, Litty Koshy, Tzuan A. Chen, Teresa Williams, Kathleen Casey, Daniel P. O’connor, Lorraine R. Reitzel

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Intersecting socially marginalized identities and unique biopsychosocial factors place women with substance use disorders (SUDs) experiencing myriad disadvantages at higher risk for smoking and stigmatization. Here, based on our work with women receiving care for SUDs in four participating treatment/women-serving centers (N = 6 individual clinics), we: (1) describe the functions of smoking for women with SUDs; and (2) explore participants’ experiences of a comprehensive tobacco-free workplace (TFW) program, Taking Texas Tobacco-Free (TTTF), that was implemented during their SUD treatment. Ultimately, information gleaned was intended to inform the development of women-tailored tobacco interventions. Data collection occurred pre-and post-TTTF implementation and entailed conducting client (7) and clinician (5) focus groups. Using thematic analysis, we identified four main themes: “the social context of smoking,” “challenges to finding support and better coping methods,” “addressing underlying conditions: building inner and outer supportive environments,” and “sustaining support: TFW program experiences.” Women reported that: smoking served as a “coping mechanism” for stress and facilitated socialization; stigmatization hindered quitting; non-stigmatizing counseling cessation support provided alternative coping strategies; and, with clinicians, the cessation opportunities TTTF presented are valuable. Clinicians reported organizational support, or lack thereof, and tobacco-related misconceptions as the main facilitator/barriers to treating tobacco addiction. Effective tobacco cessation interventions for women with SUDs should be informed by, and tailored to, their gendered experiences, needs, and recommendations. Participants recommended replacing smoking with healthy stress alleviating strategies; the importance of adopting non-judgmental, supportive, cessation interventions; and the support of TFW programs and nicotine replacement therapy to aid in quitting.

Original languageEnglish (US)
Article number5764
JournalInternational Journal of Environmental Research and Public Health
Volume18
Issue number11
DOIs
StatePublished - Jun 1 2021

Keywords

  • Health disparities
  • Intersectionality
  • Polysubstance use
  • Tobacco-free workplace
  • Women-tailored smoking interventions

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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