Women-Specific Smoking Cessation Interventions: A Systematic Review
Author(s): Alexa Gruber, Alexa Braverman, Wayne deRuiter, Terri Rodak, Laurie Zawertailo, Nadia Minian, Scott Veldhuizen, Leslie Buckley, Marta Maslej, Lorraine Greaves, Jonathan Rose, Matt Ratto, Peter Selby, Osnat Melamed
Objective: Smoking causes greater health risks among women relative to men. Helping women quit is a priority for the two million Canadian women who smoke today. Women’s smoking and cessation behaviours are influenced by various sex- and gender-related factors. However, most smoking cessation (SC) programs follow a gender-neutral approach. This partly explains lower success rates among women compared to men. We aimed to systematically review the literature on women-specific SC interventions and adaptations to meet women’s unique needs.
Methods: Studies describing women-specific SC interventions, published between June 2009 and June 2023, were selected from Medline (Ovid), EMBASE (Ovid), APA PsycInfo (Ovid), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (Ovid) databases. Information was extracted on study characteristics, intervention effects on cessation outcomes, strategies to address gender and intersecting identities, and promotion of gender equality.
Results: We identified 26 women-specific SC studies. Twelve studies (46%) had superior effects on smoking behaviours relative to the comparison group, fourteen (54%) found no significant difference, and none had inferior effects. Studies addressed women-specific barriers to quitting: weight gain, lack of social support, stress, adverse mental health states, and cultural stigma. Some studies were tailored to ethnic minority groups (i.e., African American and Korean American women), or to women with co-existing medical comorbidities (i.e., women with HIV, depression, and postmenopausal status).
Conclusions: This systematic review highlighted women-specific strategies to address gender-related barriers to quitting. Findings may be used to guide the development of specialized women’s SC programs to improve quit outcomes and support women’s health.