Syndemic lives of women who smoke and experience homelessness

Secondary analysis of US qualitative data

Dados Bibliográficos

ID22945405
AutoresKATE FRAZER (0000-0002-6703-266X, Health Sciences Centre, University College Dublin , Belfield Campus, Dublin 4), Maya Vijayaraghavan (0000-0002-3747-984X, Division of General Internal Medicine, University of California , San Francisco, CA 94143)
Ano2025
Volume40
Fascículo6
Data de publicação2025-10-30
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoHealth Promotion International (JOURNAL)
Identificadores do periódicoISSN: 0957-4824 • E-ISSN: 1460-2245
EditoraOxford University Press (OUP) (PUBLISHER)
DOI10.1093/heapro/daaf216
PMID41433202
OpenAlexW7117155778
IdiomaEN
Citações recebidas1
Referências citadas38

Tobacco use remains the leading cause of preventable deaths worldwide. Despite efforts by many countries to reduce the impact of tobacco products and lower smoking rates, smoking prevalence is higher among people experiencing homelessness. The reasons are complex and go beyond individual choices, including limited awareness about quitting, restricted access to services, and previous negative experiences. This study is a secondary data analysis of qualitative interviews with women experiencing homelessness. The original data were collected in 2021 as part of a study aimed at understanding tobacco behaviours, attitudes towards quitting, and factors influencing engagement for a subsequent randomized controlled trial. This secondary qualitative analysis, conducted in 2025, examines how policy and environmental contexts influence smoking behaviours among women experiencing homelessness using a social ecological model (SEM) framework. Data were categorized and mapped using the five specified categories within the SEM: policy and environment, community contexts, organizations and systems, interpersonal connections, and individual power and resource distribution. The participants show remarkable resilience in overcoming early-life and adolescent environmental and contextual hardships. Gaps in health services emphasize the need for aligned policy and service improvements. Using the SEM framework, which emphasizes the policy and environmental contexts, offers a deeper understanding of the context of women’s lives. The evidence from this study supports the implementation of gender- and age-appropriate holistic approaches to healthcare and tobacco interventions tailored to this community.

Context (archaeology) · Interpersonal communication · Mental health · Psychological intervention · Psychological resilience · Qualitative property · Qualitative research · Syndemic · Tobacco control · Employment and Welfare Studies · Homelessness and Social Issues · Smoking Behavior and Cessation