Secondhand smoke policy
Sex, Gender, and Secondhand Smoke Policies: Implications for Disadvantaged Women

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Context

Although implementation of secondhand smoke policies is increasing, little research has examined the unintended consequences of these policies for disadvantaged women.

Evidence acquisition

Macro-, meso-, and micro-level issues connected to secondhand smoke and women are considered to illustrate the range of ways in which sex, gender, and disadvantage affect women's exposure to secondhand smoke. A review of current literature, primarily published between 2000 and 2008, on sex- and gender-based issues related to secondhand smoke exposure and the effects of secondhand smoke policies for various subpopulations of women, including low-income girls and women, nonwhite minority women, and pregnant women, was conducted in 2008. These materials were critically analyzed using a sex and gender analysis, allowing for the drawing of inferences and reflections on the unintended effects of secondhand smoke policies on disadvantaged women.

Evidence synthesis

Smoke-free policies do not always have equal or even desired effects on low-income girls and women. Low-income women are more likely to be exposed to secondhand smoke, may have limited capacity to manage their exposure to secondhand smoke both at home and in the workplace, and may experience heightened stigmatization as a result of secondhand smoke policies.

Conclusions

Various sex- and gender-related factors, such as gendered roles, unequal power differences between men and women, child-caring roles, and unequal earning power, affect exposure and responses to secondhand smoke, women's capacity to control exposure, and their responses to protective policies. In sum, a much more nuanced gender- and diversity-sensitive framework is needed to develop research and tobacco control policies that address these issues.

Section snippets

Background

Exposure to secondhand smoke (SHS) increases the risk of lung cancer and ischemic heart disease among nonsmokers, and children exposed to SHS are at increased risk of bronchitis, asthma attacks, pneumonia, middle ear disease, sudden infant death syndrome, and a reduction in lung function.1 Nonsmoking women who are exposed to SHS have a greater chance than men of developing respiratory diseases (particularly lung cancer).2, 3, 4 A recent report indicates that SHS also increases the incidence of

Methods

A review of current literature, primarily published between 2000 and 2008, on sex- and gender-related issues linked to SHS exposure and the effects of SHS policies for various subpopulations of women, including low-income girls and women, nonwhite minority women, and pregnant women, was conducted. The literature reviewed was primarily from developed countries, including the U.S., Canada, Australia, and the UK. These materials were critically analyzed using a sex and gender analysis, allowing

Patterns of Exposure and Opportunities for Protection

Developing programs and policies that protect all women effectively from exposure to SHS requires an examination of macro-, meso-, and micro-level contexts, where smoke-free policies are enacted, experienced, and resisted. The macro level refers to broad social structural influences, including societal values; the meso level refers to social organizations such as work and religious and educational settings; and the micro level refers to the individual or interpersonal context.13 At the macro

Discussion and Conclusion

To date, policies and initiatives aimed at reducing SHS and exposure to SHS have not consistently been designed with sex and gender issues in mind. Nor have their effects, both intended and unintended, been consistently examined or evaluated according to these dimensions. This article has addressed these issues for low-income women, framed in three contextual levels (macro-, meso-, and micro-), where examination of various dynamics and processes reveal varied unintended results. Evidence that

References (47)

  • L.R. Rivero et al.

    Towards the world-wide ban of indoor cigarette smoking in public places

    International J Hyg Environ Health

    (2006)
  • The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General

    (2006)
  • T. Hirayama

    Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan

    Br Med J

    (1981)
  • C.-H. Lee et al.

    Lifetime environmental exposure to tobacco smoke and primary lung cancer of non-smoking Taiwanese women

    Int J Epidemiol

    (2000)
  • California identifies secondhand smoke as a “toxic air contaminant”

    (2006)
  • A. Ludbrook et al.

    International review of the health and economic impact of regulation of smoking in public places

    (2005)
  • L. Greaves et al.

    Special effects: tobacco policies and low socioeconomic status girls and women

    J Epidemiol Community Health

    (2006)
  • M.J. Ashley et al.

    Reducing children's exposure to environmental tobacco smoke in homes: issues and strategies

    Tob Control

    (1998)
  • Exploring concepts of gender and health

    (2003)
  • Health Canada's gender-based analysis policy

    (2000)
  • J. Johnson et al.

    Better science with sex and gender: a primer for health research

    (2007)
  • D. Spitzer

    Engendering health disparities

    Can J Public Health

    (2005)
  • M. Pitt-Catsouphes et al.

    Connecting social work perspectives to work-family research and practice

  • Cited by (0)

    View full text