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Efforts
to
Reduce
Tobacco
Use
Among
Women
and
Girls Fact Sheet
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There
are
numerous
effective
smoking
cessation
methods
available
in
the
United
States.
The
methods
range
from
self-help
materials,
to
intensive
clinical
approaches,
to
broad
community-based
programs.
Minimal
clinical
assistance;
intensive
clinical
assistance;
and
individual,
group,
or
telephone
counseling
have
shown
few
differences
in
effectiveness
between
men
and
women.
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Studies
show
no
major
or
consistent
differences
between
womens
and
mens
motivation
to
quit,
readiness
to
quit,
general
awareness
of
the
harmful
health
effects
of
smoking,
or
the
effectiveness
of
intervention
programs
for
tobacco
use.
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Best
On
national
surveys,
the
probability
of
attempting
to
quit
smoking
and
to
succeed
has
been
equally
high
among
women
and
men
since
late
1970s
or
early
1980s.
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The
majority
of
smokers
who
try
to
stop
using
tobacco
reported
doing
so
on
their
own,
even
though
this
is
the
least
effective
method.
This
pattern
has
changed
somewhat
in
recent
years
with
increased
use
of
pharmacologic
aids.
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The
likelihood
of
having
been
counseled
to
stop
smoking
was
slightly
higher
for
women
(39%)
than
for
men
(35%);
women
report
more
physician
visits
than
men,
which
allows
more
opportunity
for
counseling.
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Intensive
clinical
interventions
involve
individual,
group,
or
telephone
counseling
for
multiple
sessions.
The
most
successful
treatments
are
multi-component
cognitive
behavioral
programs
that
incorporate
strategies
to
prepare
and
motivate
smokers
to
stop
smoking.
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Women
are
somewhat
more
likely
than
men
to
use
intensive
treatment
programs.
Similarly,
women
have
a
stronger
interest
than
men
in
smoking
cessation
groups
that
offer
mutual
support
through
a
buddy
system
and
in
treatment
meetings
over
a
long
period.
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A
number
of
effective
pharmacotherapies
for
nicotine
addiction
have
emerged
in
the
past
decade
nicotine
gum
and
nicotine
patch
(approved
for
over-the-counter
use),
nicotine
nasal
spray,
oral
nicotine
inhaler,
and
Bupropion
(available
by
prescription).
Two
other
pharmacotherapies,
Clonidine
and
the
antidepressant
Nortiptyline,
have
been
recommended
as
second-line
pharmacotherapies,
but
have
not
yet
been
approved
by
the
Food
and
Drug
Administration
for
this
indication
smoking
cessation.
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Pharmacologic
approaches
to
smoking
cessation
raise
a
number
of
issues
specific
to
women.
Nevertheless,
nicotine
replacement
has
been
shown
to
be
more
effective
than
placebo
among
women
smokers
and,
thus,
remains
recommended
for
use.
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More
research
is
needed
to
determine
the
effects
of
nicotine
replacement
therapy
on
pregnant
women
and
their
offspring.
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Studies
have
identified
numerous
gender-related
factors
that
should
be
studied
as
predictors
for
smoking
cessation
as
well
as
factors
for
continued
smoking
or
relapse
after
quitting.
These
factors
include
hormonal
influences,
pregnancy,
fear
of
weight
gain,
lack
of
social
support,
and
depression.
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Women
stop
smoking
more
often
during
pregnancy
both
spontaneously
and
with
assistance
than
at
any
other
time
in
their
lives.
However,
most
women
return
to
smoking
after
pregnancy:
up
to
67%
are
smoking
again
by
12
months
after
delivery.
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Pregnancy-specific
programs
benefit
both
maternal
and
infant
health
and
are
cost-effective.
If
the
national
prevalence
of
smoking
before
or
during
the
first
trimester
of
pregnancy
were
reduced
by
one
percentage
point
annually,
it
would
prevent
1,300
babies
from
being
born
at
low
birth
weight
and
save
$21
million
(in
1995
dollars)
in
direct
medical
costs
in
the
first
year
alone.
Prenatal
smoking
cessation
interventions
can
be
of
economic
benefit
to
healthcare
insurers.
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More
women
than
men
fear
weight
gain
if
they
quit
smoking;
however,
few
studies
have
found
a
relationship
between
weight
gain
concerns
and
smoking
cessation
among
either
women
or
men.
Further,
actual
weight
gain
during
cessation
efforts
does
not
predict
relapse
to
smoking.
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Smoking
cessation
treatment
and
social
support
derived
from
family
and
friends
improve
cessation
rates.
Whether
there
are
gender
differences
in
the
role
of
social
support
on
long-term
smoking
cessation
is
inconclusive.
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Women
of
low
socioeconomic
status
(SES)
have
lower
rates
of
smoking
cessation
than
do
women
of
higher
SES.
Studies
that
analyze
the
effects
of
mass
media
campaigns
suggest
that
smokers
of
low
SES,
especially
women,
are
more
likely
than
smokers
of
high
SES
to
watch
and
obtain
cessation
information
from
television.
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Women
of
low
SES
enrolled
in
intensive
cessation
intervention
programs
(stress
management,
self-esteem
enhancement,
group
support,
and
other
activities
that
improve
quality
of
life)
have
20%25%
successful
cessation
rates.
Unfortunately,
only
a
small
proportion
of
women
of
low
SES
appear
to
take
advantage
of
these
programs.
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In
general,
African-American,
Hispanic,
and
American-Indian
or
Alaska-Native
women
want
to
stop
smoking
at
rates
similar
to
those
of
white
women,
but
there
is
little
research
on
smoking
cessation
among
women
in
racial/ethnic
minority
populations.
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There
is
strong
scientific
evidence
that
shows
increases
in
state
and
federal
excise
taxes
on
tobacco
products
reduce
consumption
and
increase
the
number
of
people
who
stop
using
tobacco.
Price
increases
reduce
consumption
of
tobacco
products
by
adults,
young
adults,
adolescents,
and
children.
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Mass-media
campaigns
implemented
in
combination
with
other
interventions,
such
as
excise
tax
increases
and
community
education
programs
are
effective
in
reducing
tobacco
consumption
and
motivating
tobacco
product
users
to
quit.
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There
are
a
number
of
effective
interventions
to
help
tobacco
users
in
their
efforts
to
quit,
such
as
behavioral
programs
offering
counseling
in
individual
or
group
settings
and
the
use
of
a
number
of
pharmacotherapies,
including
nicotine
replacement.
One
way
to
increase
the
use
of
effective
treatments
is
to
lower
the
cost
for
people
who
wish
to
use
these
treatments.
Scientific
evidence
shows
that
interventions
that
reduce
smokers
costs
(such
as
programs
that
reduce
or
eliminate
the
insureds
copayment)
increase
the
number
of
people
who
stop
using
tobacco
products.
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There
is
no
Medicare
coverage
for
tobacco
use
dependence
except
in
a
few
states
that
will
participate
in
a
demonstration
project
starting
in
April
2001.
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Six
states
provide
Medicaid
coverage
for
counseling,
and
four
states
cover
all
prescription
drugs
and
over-the-counter
nicotine
replacement
products.
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Under
private
insurance,
42%
of
managed
care
organizations
(MCOs)
cover
counseling,
16%
cover
indemnity
counseling,
38%
cover
drugs,
and
25%
cover
indemnity
drugs.
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