Gender differences in smoking cessation

Men and women have traditionally consumed cigarettes very differently, demonstrating widely varying patterns of prevalence during the past eight decades. For example, though the prevalence of smoking among men increased dramatically soon after the turn of the century, an analogous though less dramatic increase among women was not observed for another 25-30 years. Similarly, when a dramatic decrease in smoking prevalence among men was observed following the 1964 Surgeon General's Report, a comparable decrease among women was not seen until 15 years later. Such differences in smoking patterns have led to the widespread belief that giving up smoking is more difficult for women than it is for men. This paper reviews various studies which address this issue and suggests areas in which further research is needed.     

Gender differences among general practitioners in smoking cessation counseling practices

OBJECTIVES: To describe gender differences in smoking cessation counseling practices among general practitioners (GPs), and to investigate the association between training for cessation counseling and counseling practices according to gender. METHODS: Data were collected in two cross-sectional mail surveys conducted in independent random samples of GPs in Montreal, the first in 1998, and the second in 2000. RESULTS: Respondents included 653 GPs (71% of 916 eligible). All indicators of smoking cessation counseling practices were more favorable among female GPs. Higher proportions of female GPs had received training (28% vs. 17%, p=0.002), and were aware of mailed print educational materials related to cessation counseling (81% vs. 57%, p<0.0001). Training among male GPs was associated with higher scores for ascertainment of smoking status (odds ratio (OR) (95% confidence interval)=1.69 (0.97, 2.96)), provision of advice (OR=2.20 (1.23, 3.95)), and provision of adjunct support (OR=2.86 (1.58, 5.16)). Training was not associated with counseling practices among female GPs. CONCLUSIONS: Female GPs may not benefit from formal cessation counseling training to the same extent as male GPs, possibly because they read and integrate the content of (easily available) print educational materials into their clinical practice to a greater extent than male GPs. The gender-specific impact of print educational material and formal training on cessation counseling should be evaluated among GPs.     

Gender differences in smoking cessation after 3 years in the Lung Health Study.

OBJECTIVES. An analysis of gender differences in smoking cessation was conducted among 3923 participants in the Special Intervention group of the Lung Health Study. This report focuses on gender differences in sustained quit rates at 12 and 36 months. METHODS. Special Intervention participants were offered a 12-session, 12-week smoking cessation program using nicotine gum and were followed for 3 years. Self-reported smoking status was validated with carbon monoxide and salivary cotinine. RESULTS. Men had higher sustained quit rates at 12 and 36 months; gender differences were found in baseline variables that also predicted sustained abstinence; and controlling for selected baseline variables reduced the association between gender and sustained abstinence. When other variables were controlled, gender predicted sustained abstinence at 36 months (odds ratio [OR] = 1.24, 95% confidence interval [CI] = 1.04, 1.48) but not 12 months (OR = 1.08, 95% CI = 0.92, 1.27), reflecting more late relapse among women. CONCLUSIONS. Demographics and smoking history were more important than gender per se in sustained smoking cessation in the Lung Health Study. Programs tailoring smoking cessation by gender need to include coping skills for problems associated with less education and social support and for improving persistence with quit attempts.     

Gender differences in predictors for long-term smoking cessation following physician advice and nicotine replacement therapy.

We evaluated gender differences in demographic, smoking history, nicotine dependence, transtheoretical, and perceived stress variables as predictors of smoking cessation. Participants (n = 381) smoked at least 15 cigarettes per day and were motivated to quit. The outcome variable was 7-day abstinence at 1-year follow-up. Predictor variables included: age, education level, number of years smoking, cigarettes per day, quit attempts, nicotine dependence, stage of change, decisional balance, processes of change, self-efficacy, and perceived stress. Logistic regression analysis was used to derive predictive models for women and men. In women, lower scores for pre- and mid-treatment perceived stress significantly increased the likelihood of being abstinent at follow-up. For men, a higher level of education or number of quit attempts lasting > 24 hours in the past year, along with less frequent use of behavioural processes of change at baseline increased the probability of being abstinent at follow-up.     

江苏省男性吸烟者戒烟行为与接受戒烟服务现状调查

目的了解江苏省男性吸烟者戒烟行为及接受戒烟服务现状。方法在江苏省14个慢性病监测点采用多阶段随机整群抽样方法和KISH表法确定调查对象,用问卷调查方法收集相关信息。结果被调查成年男性戒烟率为11.3％,平均戒烟年龄为46.5岁,有58.3％的是在45岁以后开始戒烟;现在吸烟者打算戒烟率和过去12个月内尝试戒烟率分别为15.9％和16.2％,30岁以下年龄组这两个率均为最高;过去12个月内吸过烟者接受卫生保健服务时医生询问吸烟情况和劝戒烟的比例分别为23.8％和19.3％,吸烟者使用过戒烟方法的比例为5.0％。结果提供给吸烟者的戒烟服务资源不足,应加强对医生控烟技能培训和开设戒烟门诊,有效指导吸烟者戒烟.提高戒烟成功率。     

Gender differences in teenage smoking

This study analyzes the patterns and correlates of gender differences in cigarette smoking in a national sample of white high school seniors in 1985. More females than males were smokers, because females had higher rates for the early stages of smoking adoption. Specifically, females were more likely to have tried smoking at least once and, among those who had tried smoking, females were more likely to have smoked more than once or twice. Gender differences in smoking varied, depending on the students' characteristics. For example, the female excess in the early stages of smoking adoption was small or absent among rural students or very religious students, apparently because traditional values inhibit smoking adoption more among females than among males. We estimated the contributions of gender differences in students' characteristics to gender differences in smoking adoption. For example, males were more involved in sports, and this appears to be one reason why males had lower rates of smoking adoption than females. On the other hand, males had more deviant behavior and attitudes, and this would be expected to contribute to greater smoking adoption by males. The findings of this study indicate important gender differences in the determinants of smoking adoption.     

Gender differences in smoking behavior

This paper investigates gender differences in smoking behavior using data from the German Socio-economic Panel (SOEP). We develop a Blinder-Oaxaca decomposition method for count data models, which allows to isolate the part of the gender differential in the number of cigarettes daily smoked that can be explained by differences in observable characteristics from the part attributable to differences in coefficients. Our results reveal that the major part of the gender smoking differential is attributable to differences in coefficients indicating substantial differences in the smoking behavior between men and women.     

The relation of tobacco use during hospitalization to post-discharge smoking cessation among US veterans

ObjectiveThe objective of this study was to determine if tobacco use while in the hospital was associated with post-discharge cessation rates.MethodsDuring 2006–2008, smokers from three Veterans Affairs hospitals (n = 354) were surveyed during their hospitalization and again 6 months later. Data analysis was conducted in 2009.ResultsWhile veterans smoked an average of 19 cigarettes per day, prior to admission, the average was 6–7 cigarettes per day during hospitalization. About 40% (n = 140) were able to quit smoking for more than 24 h and the median days quit was 29. The 6-month self-reported quit rate was 15% (n = 53). Multivariate analyses showed that veterans who quit tobacco use during their hospitalization had nearly 4 times increased odds of quitting smoking for more than 24 h and 2.7 times increased odds of quitting at 6 months post-hospitalization as compared to veterans that did not quit using tobacco during hospitalization.ConclusionMany veterans quit tobacco use during hospital admissions and those who do not quit, tended to decrease their use. Veterans who quit tobacco use were more likely to be abstinent at 6-month follow-up. State-of-the-art cessation interventions need to be provided to smokers hospitalized in Veterans Affairs hospitals.     

Gender and determinants of smoking cessation: a longitudinal study.

BACKGROUND: The less favorable trend in smoking prevalence in women compared to men may be due to lower cessation rates. We analyzed determinants of spontaneous smoking cessation with particular reference to gender differences. METHODS: Data on smoking were collected by questionnaire in three samples of the adult population, examined for the first time at intervals between 1976 and 1984. In total 11,802 (59%) subjects were smokers, and 9085 of them attended a reexamination after 5 years. Ten to 16 years later 6053 were examined once again. Logistic regression was performed to study the relation of determinants to having quit after 5 and 10-16 years. RESULTS: The prevalence of quitting was 12 and 22% at first and second follow-up, respectively. At both reexaminations, quitting smoking was positively associated with male sex and cigar smoking and negatively associated with the amount of tobacco smoked, inhalation, and alcohol consumption. Furthermore, in women, smoking cessation was positively associated with level of education and body mass index (BMI). Smoking cessation was not affected by cohabitation status, leisure activity, or bronchitis symptoms. CONCLUSIONS: Smoking cessation initiatives should be targeted at heavy cigarette smokers, and at women, in particular the lean and poorly educated.     

Gender differences in the relationship between physical activity and smoking among psychiatrically hospitalized adolescents

Physical activity has been identified as a protective factor with regard to tobacco use, such that physically active adolescents are less likely to initiate smoking, and smokers are less physically active than non-smokers. These findings, along with the well-documented benefits of exercise on mood and well-being in adults, have stimulated interest in exercise-based smoking cessation interventions. However, little research has explored the relationship between physical activity and smoking characteristics within adolescent smokers. Also, gender differences in adolescents' motives for smoking and exercise may have implications for intervention development, especially in clinical populations. The current study explored the relationship between physical activity and smoking in a sample of adolescent smokers (N = 191) and non-smokers (N = 48) receiving inpatient psychiatric treatment (61% female, mean age 15.3 years). Results indicated that smokers were less likely to be physically active than non-smokers. Additionally, there was a consistent pattern of gender differences in the relationship between smoking and physical activity within smokers. Specifically, physically active male smokers were less nicotine dependent and less prone to withdrawal symptoms, and had a trend toward greater motivation to quit, than their non-active counterparts. In contrast, physically active female smokers did not differ in dependence or withdrawal and were less motivated to quit than non-active female smokers. Taken together, these results suggest that within clinical populations of adolescent females, smoking and exercise may be used jointly as weight control strategies. Exercise-based interventions for smoking cessation for adolescent females, especially clinical populations, should address weight and body image concerns.     

Understanding smoking and cessation among Hmong smokers

This qualitative study was designed to explore beliefs and experiences related to smoking and cessation among the Hmong population in the United States. Three separate focus groups were conducted with male and female Hmong smokers. Analysis revealed that the Hmong viewed smoking as prevalent in their community and perceived numerous barriers to cessation. Barriers to cessation differed based on gender and acculturation. For instance, women were concerned about having their smoking status revealed if they were to seek help, because of cultural prohibitions against female smokers. Less acculturated Hmong believed U.S. commercial tobacco to be more addictive than the homegrown tobacco they were used to. This formative research suggests that smoking is becoming an increasing problem among the Hmong in the United States and points to a need for additional research to inform the development of effective tobacco control strategies for this community.     

天津市戒烟门诊158名就诊吸烟者戒烟状况调查

目的 了解天津市戒烟门诊就诊吸烟者的人群特点、吸烟情况、戒烟情况,为更有效的开展戒烟门诊服务提供科学依据。方法 调查前来三家戒烟门诊就诊的158名吸烟者,并于一个月后进行随访。结果 就诊吸烟者中50%(79/158)是通过医生推荐或转诊至戒烟门诊,47.5%(75/158)决定戒烟的原因是自身患病,59.5%(94/158)的人尝试过戒烟;就诊吸烟者的平均烟龄为19.5年,平均每日吸烟量为16.3支;一个月随访的应答率为86.7%(137/158),一个月随访的时点戒烟率为43.1%(59/137),未戒烟者的一个月时点减烟率为56.4%(44/78);27.0%(37/137)的人认为医生或药物对其戒烟帮助最大。结论 天津市戒烟门诊能提高吸烟者的戒烟率,但目前就诊人数较少,还应继续加大戒烟门诊的宣传力度。     

Sex/gender differences in smoking cessation: A review

Data from treatment studies tends to show women are less likely to quit smoking than men, but these findings have been disputed, typically based on contradictory evidence from epidemiological investigations. The purpose of this review was to shed light on this conflict. We conducted a qualitative review in January 2016 to examine sources of variation in sex/gender differences for smoking cessation. We identified 214 sex/gender difference tests from 190 studies through Medline and studies were categorized into efficacy trials (k = 37), effectiveness trials (k = 77), prospective observational studies of cessation (k = 40; current smokers transitioning to former smokers), prospective observational studies of relapse (k = 6; former smokers transitioning to current smokers), cross-sectional investigations of former smoker prevalence (k = 32), and community-based interventions (k = 4). We also summarized evidence across time periods, countries, outcome assessments, study sample, and treatment. Evidence from efficacy and effectiveness trials, as well as prospective observational studies of relapse, demonstrated that women have more difficulty maintaining long-term abstinence than men. Findings from prospective observational studies and cross-sectional investigations were mixed and demonstrated that bio-psycho-social variation in samples across place and time may determine whether or not women or men are less likely to quit smoking. Based on these findings, we consider whether sex/gender differences in quitting meet criteria for a disparity and outline directions for further research.     

Smoking, smoking cessation, and use of smoking cessation aids and support services in South Derbyshire, England

OBJECTIVES: To describe smoking behaviour, motivation to quit and quit rates, and the effect of advice and support for smoking cessation among smokers from more and less disadvantaged socio-economic groups in South Derbyshire, a mixed urban and rural area of central England. STUDY DESIGN: Cross-sectional study. METHODS: A cross-sectional study with a random, stratified sample of people aged 25-44 years and people aged 65-74 years with over-sampling of populations living in disadvantaged areas. Main outcome measures included the proportion of smokers wishing to quit and quitting in the last year; reported advice to quit from family and friends and health professionals; and awareness and use of NHS smoking-cessation services. RESULTS: Over half of smokers aged 25-44 years, about one-third of women smokers and 40% of male smokers aged 65-74 years wished to quit. This varied little by socio-economic status. Quit rates were generally lower among smokers of lower socio-economic status (SES), especially among people aged 25-44 years. Smokers of lower SES reported slightly less advice to quit from family and friends, and more so from health professionals. Awareness and use of cessation services was about 30% and 5%, respectively, among smokers and recent quitters. Awareness varied little but accessing services was generally higher among smokers of lower SES. CONCLUSIONS: Despite evidence that health professionals and cessation services were targeting smokers with lower SES and of similar motivation to quit, quit rates were lower. Broader tobacco control interventions targeting the social and environmental contexts that create and maintain socio-economic differentials in smoking are required.     

How place matters for smoking cessation: Barriers to smoking cessation among low-income Black women

African Americans start smoking later in life, yet they are less likely to quit smoking than other racial/ethnic groups. Drawing upon 40 in-depth interviews with former and current Black women smokers in the South Side of Chicago, this study examines external barriers to successful smoking cessation among socioeconomically disadvantaged Black women smokers. Beyond individual factors (e.g., stressors), this study finds interpersonal and structural factors that influence Black women's cessation efforts, including the high prevalence and normality of smoking and access to cheaper, loose cigarettes in their communities. Findings highlight the importance of considering local contexts for future tobacco research and policies.