The need for gender-relevant tobacco cessation programs

An understanding of women and tobacco-related issues, as well as the need for gender-relevant smoking cessation efforts, have been highlighted as priorities in landmark guiding documents (e.g., WHO FCTC).

In order to address women and tobacco-related issues, we have established a Network for Tobacco Control among Women in Paraná, Brazil with the purpose of building and sustaining community and institutional capacity to promote gender-relevant tobacco control efforts among women. Through the network, community representatives set the research priorities.

One of the initial goals of the network was to better understand the prevalence of tobacco use among women as well as the particularities in the different regions within this tobacco growing state.

In order to facilitate comparisons with the national data, we conducted the GATS (Global Adult Tobacco Survey) among adult women in all regions of the state (seven representative towns) using the same methodology as the national survey (i.e., cluster sampling, door-to-door).

Although the overall prevalence of cigarette smoking in Paraná was consistent with national data, it varied greatly across towns (10% in Cascavel to 19.1% in Irati – a town that relies heavily on tobacco growing). Over 70% of women in the study reported smoking £ 10 cigarettes/day (“light smokers”). [1]

National GATS – Women 2 Paraná – Women
Current cigarette smokers

Daily

13.1%

11.5%

13.4%

12.3%

Current use of other forms of smoked tobacco products .7% 1.7% (1.5% hand-rolled cigarettes, .2% narguile)
Current use of smokeless tobacco products .3% .1%
Quit attempt in the last 12 months 49.5% 49%
Current smokers seen by a health care professional in the past year 58.8% 58.4%
Current smokers who were asked by a health care professional about their smoking status* 71% 76.5%

(range 7 towns: 66.7%-82.4%

Current smokers who were advised to quit by a health care professional  – overall **, ***

Within the public health system **

57.1% 83.1%

(range 7 towns: 68.8%-100%)

65.7%

* Only includes current smokers who reported seeing a health care professional in the past 12 months,** Only includes current smokers who reported seeing a health care professional in the past 12 months and that they were about their smoking status, *** “Overall” – encompasses the private and public health care system

In another qualitative study among adult women in Curitiba (capital of the State of Paraná), we identified gender-specific issues associated with cigarette smoking initiation/cessation. Relevant to this application were the most salient negative factors associated with cessation:

  • stress/anxiety-relieving benefits
  • weight control
  • access/low-cost of cigarettes
  • being around smokers
  • risk exempting beliefs (the belief that engaging in other healthy behaviors such as healthy eating would protect them from the hazards of smoking).

Positive factors for quitting included: smoking restrictions at home and the workplace, and concerns about appearance.

Current and former smokers did not rely on treatment programs or aids to stop smoking or believe in their effectiveness, and they reported never having received assistance from their health care providers to quit smoking. [3]

Based on these findings we are currently conducting a group randomized controlled trial to assess the efficacy of a theory-based, culturally- and gender-relevant Community Health Worker intervention for Brazilian women “light smokers” that will augment the smoking cessation offered through the public health system (R01TW009272).

This work has been support by a grant from NIDA (R01DA024875) and a grant from the Research for International Tobacco Control (RITC)

About the Author: Isabel C. Scarinci, PhD, MPH is a Professor in the Division of Preventive Medicine at the University of Alabama at Birmingham, Birmingham, AL.


  1. Scarinci IC, Bittencourt L, Person S, Cruz RC, Moysés ST (2012). Prevalence of tobacco use and associated factors among women in Paraná state, Brazil. Cadernos de Saúde Pública, 28, 1450-8.
  2. Instituto Nacional do Câncer /Organização Pan-Americana da Saúde (2011). Pesquisa Especial de Tabagismo – PETab: Relatório Brasil. Rio de Janeiro, INCA.
  3. Scarinci IC, Silveira AF, dos Santos DF, Beech BM (2007). Sociocultural factors associated with cigarette smoking among Brazilian worksites: a qualitative study. Health Promotion International, 22, 146-54.