Syndemic lives of women who smoke and experience homelessness: secondary analysis of US qualitative data
This study by Kate Frazer, PhD, and BHHI Faculty Member Maya Vijayaraghavan, MD, MAS, examines how policy, environment, health care access, trauma, and social context shape smoking behaviors among women experiencing homelessness.
Published in Health Promotion International, the study reanalyzes qualitative interviews with 10 women experiencing homelessness in San Francisco. Using a social ecological model, the authors examine how smoking behaviors are shaped by multiple contexts, including health-related policies and environments, community supports, service systems, interpersonal relationships, and the distribution of resources and power.
Most participants wanted to quit smoking, but their ability to do so was shaped by structural barriers, limited access to supportive services, histories of trauma, and the conditions of homelessness. The authors call for gender- and age-appropriate, holistic health care and tobacco interventions that reflect the realities of women’s lives and support their strengths.
The findings show that tobacco use among women experiencing homelessness cannot be addressed through individual behavior change alone. Effective tobacco treatment must account for the environments people live in, the systems they interact with, and the policy and structural barriers that shape health.
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