16.8 Do women smoke for different reasons than men?

This is currently an area of some debate, with research producing conflicting results. The issue is complex and evaluations need to take account of a number of variables such as socioeconomic status and educational level, as well as the more difficult to measure societal conditioning of gender roles and expectations.

Overseas research has suggested that women smoke more in situations of difficulty and negative emotion, while men smoke more for stimulation and in pleasurable settings,(5) and some Australian research has also suggested gender differences in smoking behaviour.(12) Although following quitting, women are no more likely than men to 'slip-up' (start smoking again but return to quitting) or 'relapse' (start smoking again), they tend to do so in different circumstances. Women are more likely to start smoking again while feeling sadness or depression. Men, on the other hand, are more likely to slip up or relapse when they are at work or when drinking alcohol. This study suggests that smoking may play a different role in male and female smokers' lives, men being more likely to smoke while dealing with external pressures, and women in response to the emotional consequences of such pressures.

Following an analysis of Australian attitudinal data collected during the 1980s, Clarke et al have argued that current male and female attitudes to smoking and smoking behaviour, including the few areas of divergence (the issue of weight gain, the contexts in which either sex is more likely to slip up or relapse following cessation, and perceived support from others during a quit attempt), are more accurately predicted by smoking status and the 'situation' each individual operates within, than by gender.(90) (Attitudes to quitting are discussed in more detail in Section 16.10 below).

Irrespective of the basis of the motivation, the issue of weight gain is an issue of greater importance to women who smoke than male smokers. Females are more likely to take up smoking as a means of weight control, and to continue smoking rather than risk putting on weight.(9) A quarter of female smokers mention weight gain as a disadvantage of quitting, twice the proportion of men concerned by the possibility, (although interestingly, only 14% of both male and female quitters reported weight gain as a disadvantage once they had stopped smoking(91)). Australian research has shown that women are far more likely to overestimate their bodyweight, and that even women with a weight appropriate to their height are more likely to believe that they are overweight. Although there are more overweight men than women in Australia, women have a greater tendency to diet -- an obsession which has spawned an entire weight reduction industry.(92) The fact that some women might be more concerned about their appearance than their health is a sad commentary on society.

There is some evidence that women are affected by nicotine in different ways than men, and that pharmacologically-based aids to cessation are not equally effective for both sexes. These are areas requiring further research.(93)


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