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Addressing Smoking Cessation among Women in Substance Use Treatment: A Qualitative Approach to Guiding Tailored Interventions

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  • Isabel Martinez Leal

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA)

  • Matthew Taing

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
    Department of Health & Human Performance, The University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204, USA)

  • Virmarie Correa-Fernández

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

  • Ezemenari M. Obasi

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

  • Bryce Kyburz

    (Integral Care, Austin, TX 78704, USA)

  • Kathy Le

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
    Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA)

  • Litty Koshy

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

  • Tzuan A. Chen

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

  • Teresa Williams

    (Integral Care, Austin, TX 78704, USA)

  • Kathleen Casey

    (Integral Care, Austin, TX 78704, USA)

  • Daniel P. O’Connor

    (Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
    Department of Health & Human Performance, The University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204, USA)

  • Lorraine R. Reitzel

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

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.

Suggested Citation

  • Isabel Martinez Leal & Matthew Taing & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Kathy Le & Litty Koshy & Tzuan A. Chen & Teresa Williams & Kathleen Casey & Daniel P. O’Connor & , 2021. "Addressing Smoking Cessation among Women in Substance Use Treatment: A Qualitative Approach to Guiding Tailored Interventions," IJERPH, MDPI, vol. 18(11), pages 1-25, May.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5764-:d:563554
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    References listed on IDEAS

    as
    1. Lorraine Greaves, 2015. "The Meanings of Smoking to Women and Their Implications for Cessation," IJERPH, MDPI, vol. 12(2), pages 1-17, January.
    2. Christine E. Sheffer & Abdulmohsen Al-Zalabani & Andrée Aubrey & Rasha Bader & Claribel Beltrez & Susan Bennett & Ellen Carl & Caroline Cranos & Audrey Darville & Jennifer Greyber & Maher Karam-Hage &, 2021. "The Emerging Global Tobacco Treatment Workforce: Characteristics of Tobacco Treatment Specialists Trained in Council-Accredited Training Programs from 2017 to 2019," IJERPH, MDPI, vol. 18(5), pages 1-17, March.
    3. Williams, J.M. & Steinberg, M.L. & Griffiths, K.G. & Cooperman, N., 2013. "Smokers with behavioral health comorbidity should be designated a tobacco use disparity group," American Journal of Public Health, American Public Health Association, vol. 103(9), pages 1549-1555.
    4. Bowleg, L., 2012. "The problem with the phrase women and minorities: Intersectionality-an important theoretical framework for public health," American Journal of Public Health, American Public Health Association, vol. 102(7), pages 1267-1273.
    5. Richter, K.P. & Gibson, C.A. & Ahluwalia, J.S. & Schmelzle, K.H., 2001. "Tobacco use and quit attempts among methadone maintenance clients," American Journal of Public Health, American Public Health Association, vol. 91(2), pages 296-299.
    6. Dinno, Alexis & Glantz, Stanton, 2009. "Tobacco control policies are egalitarian: A vulnerabilities perspective on clean indoor air laws, cigarette prices, and tobacco use disparities," Social Science & Medicine, Elsevier, vol. 68(8), pages 1439-1447, April.
    7. Matthew Taing & Bryce Kyburz & Isabel Martinez Leal & Kathy Le & Tzu-An Chen & Virmarie Correa-Fernandez & Teresa Williams & Daniel P. O’Connor & Ezemenari M. Obasi & Kathleen Casey & Litty Koshy & Lo, 2020. "Clinician Training in the Adaptation of a Comprehensive Tobacco-Free Workplace Program in Agencies Serving the Homeless and Vulnerably Housed," IJERPH, MDPI, vol. 17(17), pages 1-15, August.
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    Cited by:

    1. Brian J. Carter & Ammar D. Siddiqi & Tzuan A. Chen & Maggie Britton & Isabel Martinez Leal & Virmarie Correa-Fernández & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Kathleen Casey & Lorraine R, 2023. "Educating Substance Use Treatment Center Providers on Tobacco Use Treatments Is Associated with Increased Provision of Counseling and Medication to Patients Who Use Tobacco," IJERPH, MDPI, vol. 20(5), pages 1-17, February.
    2. Ammar D. Siddiqi & Tzuan A. Chen & Maggie Britton & Isabel Martinez Leal & Brian J. Carter & Virmarie Correa-Fernández & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Kathleen Casey & Lorraine R, 2023. "Changes in Substance Use Treatment Providers’ Delivery of the 5A’s for Non-Cigarette Tobacco Use in the Context of a Comprehensive Tobacco-Free Workplace Program Implementation," IJERPH, MDPI, vol. 20(3), pages 1-16, February.
    3. Catherine O. Egbe & Portia Nevhungoni & Mukhethwa Londani, 2024. "Disparities in Tobacco Smoking by Sex and Employment Status: Results from South Africa’s First Global Adult Tobacco Survey," Social Sciences, MDPI, vol. 13(10), pages 1-15, October.
    4. David, Jean-Charles & Fonte, David & Sutter-Dallay, Anne-Laure & Auriacombe, Marc & Serre, Fuschia & Rascle, Nicole & Loyal, Deborah, 2024. "The stigma of smoking among women: A systematic review," Social Science & Medicine, Elsevier, vol. 340(C).
    5. Ammar D. Siddiqi & Maggie Britton & Tzuan A. Chen & Brian J. Carter & Carol Wang & Isabel Martinez Leal & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Mayuri Patel & Lorraine R. Reitzel, 2022. "Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment," IJERPH, MDPI, vol. 19(15), pages 1-15, August.
    6. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Matthew Taing & Daniel P. O’Connor & Lorraine R. Re, 2021. "Organizational Factors Moderating Changes in Tobacco Use Dependence Care Delivery Following a Comprehensive Tobacco-Free Workplace Intervention in Non-Profit Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(19), pages 1-16, October.
    7. Cassidy R. LoParco & Tzuan A. Chen & Isabel Martinez Leal & Maggie Britton & Brian J. Carter & Virmarie Correa-Fernández & Bryce Kyburz & Teresa Williams & Kathleen Casey & Anastasia Rogova & Hsien-Ch, 2022. "Organization-Level Factors Associated with Changes in the Delivery of the Five A’s for Smoking Cessation following the Implementation of a Comprehensive Tobacco-Free Workplace Program within Substance," IJERPH, MDPI, vol. 19(19), pages 1-13, September.
    8. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Haleem A. Brown & Daniel P. O’Connor & Lorraine R. , 2021. "Organizational-Level Moderators Impacting Tobacco-Related Knowledge Change after Tobacco Education Training in Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(14), pages 1-14, July.
    9. Haleem A. Brown & Rachel D. Roberts & Tzuan A. Chen & Michael S. Businelle & Ezemenari M. Obasi & Darla E. Kendzor & Lorraine R. Reitzel, 2022. "Perceived Disease Risk of Smoking, Barriers to Quitting, and Cessation Intervention Preferences by Sex Amongst Homeless Adult Concurrent Tobacco Product Users and Conventional Cigarette-Only Users," IJERPH, MDPI, vol. 19(6), pages 1-14, March.
    10. Matthew Taing & Vijay Nitturi & Tzuan A. Chen & Bryce Kyburz & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Teresa Williams & Kathleen Casey & Daniel P. O’Connor & Litty Kos, 2021. "Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers," IJERPH, MDPI, vol. 19(1), pages 1-17, December.

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