The stigma of smoking among women: A systematic review

Jean-Charles David, David Fonte, Anne-Laure Sutter-Dallay, Marc Auriacombe, Fuschia Serre, Nicole Rascle, Deborah Loyal
Social Science & Medicine. 2024-01-01; 340: 116491
DOI: 10.1016/j.socscimed.2023.116491

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David JC(1), Fonte D(2), Sutter-Dallay AL(3), Auriacombe M(4), Serre F(5),
Rascle N(6), Loyal D(2).

Author information:
(1)Université Paris Cité, CRPMS, Paris, France. Electronic address:
(2)Université Paris Cité, CRPMS, Paris, France.
(3)Inserm U1219 Bordeaux Population Health, Bordeaux, France; Hôpital Charles
Perrens, Bordeaux, France.
(4)Hôpital Charles Perrens, Bordeaux, France; CNRS UMR 6033, SANPSY, Bordeaux,
(5)CNRS UMR 6033, SANPSY, Bordeaux, France.
(6)Inserm U1219 Bordeaux Population Health, Bordeaux, France.

BACKGROUND: Smoking stigma has been well documented, but little is known
regarding its specific features and effects on women. Notably, women face unique
social, cultural, and economic challenges that may interact with smoking stigma
and impact health outcomes. This review investigates the extent to which smoking
women encounter and internalise stigma, while examining the various coping
mechanisms they employ to manage these negative experiences.
METHODS: In November 2022, major databases were systematically searched with no
time restrictions. After applying inclusion and exclusion criteria, 23 studies
(three quantitative and 20 qualitative) met our criteria. We conducted a quality
assessment and summarised the findings pertaining to public stigma, self-stigma,
and coping strategies.
RESULTS: The stigma about smoking emerges from a variety of sources, such as
family, healthcare providers, or internet forums. Women smokers are universally
aware of the negative image they have in society. Yet, their experiences and
management of the stigma of smoking are shaped by other variables such as
cultural background, social class, or motherhood status. Smoking stigma produces
ambivalent effects, such as concealment, reduced usage of support services, and
to a lesser extent, smoking cessation motivation.
CONCLUSIONS: These results indicate that smoking stigma is an important social
justice and public health issue and that further research is needed to better
prevent its effects on women’s well-being and health behaviours.

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