Abstract:

Background: Tobacco habit use among women in India is a complex issue influenced by socio-cultural and market factors. Despite efforts there is a rising trend in tobacco use among Indian women thus gender lens need to be focussed to reverse the tobacco epidemic in India. This study aimed to explore knowledge, attitude and practices related tobacco harm reduction and cessation among women tobacco users in Chennai. Methods: We conducted 21 semi-structured interviews personally and over the telephone with women tobacco users between October 2020 and February 2021. The interview content was analysed into pre-determined themes and new themes were identified using thematic analysis.Results: Eight major themes were identified in the study. Themes expressed the influences and triggers for uptake of tobacco use and self-ascriptions of habitual use as non-addictive and self-reliant measures to quit , tobacco use as stress relieving tool. Themes also revealed minimal awareness of reduced risk alternatives such as nicotine replacement therapies, COVID-19 impact on smoking, self-reliant measures undertaken to quit smoking and search for alternatives to smoking due to health scares.Conclusion: This study a first of its kind contributes unique insights about the role familial and peer influences play in initiation of tobacco as revealed by lived experiences of women tobacco users in this study. The findings also show that tobacco use especially smoking in work environment is perceived to confer benefits of social acceptance and belonging to a group among peers which show that it is beyond individual control. Gender specific interventions are warranted to address tobacco use among Indian women based on these dynamics.

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