The association between gender roles and smoking initiation among women and adolescent girls

ABSTRACT

Smoking cigarettes is a leading global cause of preventable death and disease. Men historically smoke more than women, but the prevalence of smoking among women in low and middle-income countries is increasing at an alarming rate. Understanding the factors that influence smoking initiation among women and girls is needed to address the growing epidemic of women smokers and the looming impact on women’s health worldwide. We assume that smoking initiation is embedded in socio-culturally influenced gendered context and use a social cognitive model with a gendered lens as a framework for organizing and synthesizing the research. Guided by this framework, we identified gaps in the literature and make recommendations for future research in this review paper. The results suggest that psychological and environmental determinants are rooted in fluctuating cultural influences and values, but few research studies provide a gendered analysis or systematically examine these factors in the context of gender and culture. Sex/gender is a significant construct through which women and girls experience the psychological, environmental, and other influences on smoking initiation. Much more research is needed to understand the psychological and environmental influences as well as the intersection of gender roles and other social categories on female smoking initiation.

KEYWORDS:

• Women
• girls
• smoking
• tobacco
• gender
• gender roles

Acknowledgments

This research is supported by the National Cancer Institute under Grant P20CA192993 and P20CA192991. The authors have no conflicts of interest to disclose.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Cancer Institute [P20CA192993].

Notes on contributors

Nurbanu Ozbay

Nurbanu Ozbay, received her BA degree from Hacettepe University, Turkey (2013) and her MA from the General Psychology Program at City College New York (2017). She worked as a research assistant on Dr. Lesia Ruglass’ (CCNY) and Dr. James Root’s (MSKCC) pilot research project examining increased cue reactivity to smoking-related cues among Black Americans. Her research interests include female psychology, trauma, tobacco disparities and culture.

Alina Shevorykin

Alina Shevorykin, is a PhD student in Mental Health Counseling at Pace University and she completed the Master’s degrees in Mental Health Counseling and General Psychology at The City College of New York. Her undergraduate study included Economics and Linguistics. Alina’s research focuses primarily on the links between trauma, resiliency and substance use. Currently, she is studying interventions aimed at tobacco cessation, understanding how traumatic experiences can influence substance use and treatment outcomes, as well as electrophysiological and cognitive mechanisms underlining tobacco and cannabis addictions.

Philip H. Smith

Philip H. Smith, PhD, is an Assistant Professor with the Miami University Department of Kinesiology and Health. His research focuses on behavioral mechanisms of addiction and tobacco use disparities from an intersectional framework.

Christine E. Sheffer

Christine E. Sheffer, PhD, is a Clinical Psychologist and an Associate Professor of Oncology at Roswell Park Comprehensive Cancer Center. She is also the President of the Council for Tobacco Treatment Training Programs and the Director of Research and Evaluation for Roswell Park Cessation Services, which provides tobacco treatment Quitline services for the state of New York, New Jersey, and several health care insurance providers. As a clinician, researcher, and educator, her goals include contributing to incremental increases in the efficacy and uptake of high-quality evidence-based treatments for tobacco dependence, enabling individuals to obtain the help they need to achieve and maintain good health. Her research examines bio-behavioral mechanisms that initiate and sustain tobacco dependence, and methods to improve the efficacy and uptake of empirically-supported treatments for tobacco use, particularly among groups that experience tobacco-related health disparities. Dr. Sheffer previously served as faculty in the City University of New York Medical School and the University of Arkansas for Medical Sciences.