Martinez Leal Isabel, Taing Matthew, Correa-Fernández Virmarie, Obasi Ezemenari M, Kyburz Bryce, Le Kathy, Koshy Litty, Chen Tzuan A, Williams Teresa, Casey Kathleen, O'Connor Daniel P, Reitzel Lorraine R
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.
Int J Environ Res Public Health. 2021 May 27;18(11):5764. doi: 10.3390/ijerph18115764.
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.
社会边缘化身份与独特的生物心理社会因素相互交织，使得患有物质使用障碍（SUDs）的女性面临诸多不利因素，她们吸烟和遭受污名化的风险更高。在此，基于我们在四个参与治疗/女性服务中心（N = 6个个体诊所）为患有SUDs的女性提供护理的工作，我们：（1）描述吸烟对患有SUDs的女性的作用；（2）探讨参与者对在她们接受SUD治疗期间实施的全面无烟工作场所（TFW）计划“让德克萨斯无烟”（TTTF）的体验。最终，收集到的信息旨在为针对女性的烟草干预措施的制定提供参考。数据收集在TTTF实施前后进行，包括开展客户（7个）和临床医生（5个）焦点小组。通过主题分析，我们确定了四个主要主题：“吸烟的社会背景”、“寻找支持和更好应对方法的挑战”、“解决潜在问题：构建内在和外在支持环境”以及“维持支持：TFW计划体验”。女性报告称：吸烟是应对压力的“机制”并促进社交；污名化阻碍戒烟；无污名化的咨询戒烟支持提供了替代应对策略；并且，对临床医生而言，TTTF提供的戒烟机会很有价值。临床医生报告称组织支持与否以及与烟草相关的误解是治疗烟草成瘾的主要促进因素/障碍。针对患有SUDs的女性的有效戒烟干预措施应基于她们的性别经历、需求和建议并进行量身定制。参与者建议用健康的减压策略取代吸烟；采用非评判性、支持性戒烟干预措施的重要性；以及TFW计划和尼古丁替代疗法对帮助戒烟的支持。
