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Female Smoking Behaviors and Female Smoking Related Social Stigma: Qualitative Research Using Focus Group Discussion
J Korean Soc Res Nicotine Tob 2024; 15(1): 8-18
Published online March 30, 2024
© 2024 The Korean Society for Research on Nicotine and Tobacco.

Eon Sook Lee1, HyeonSuk Kim2*, Young-Su Ju3, Minsu Ock4

1Department of Family Medicine, Ilsan-Paik Hospital, College of Medicine, Inje University, Goyang, 2School of Nursing, Shinhan University, Uijeongbu, 3National Medical Center, Seoul, 4Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
Correspondence to: *源쁽닕
떊븳븰援 媛꾪샇븰
Received March 12, 2024; Revised March 28, 2024; Accepted March 28, 2024.
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, dis-tribution, and reproduction in any medium, provided the original work is properly cited.
Background: Women who smoke are thought to exhibit different smoking and cessation behaviors compared with men; however, research on this topic is limited. In this study, we assessed the characteristics, concealment of smoking and the related social pressure as experienced by women smokers.
Methods: A focus group discussion was conducted with women aged 20-39 years, who were divided into three groups: current smokers (N=8), former smokers (N=8), and non-smokers (N=6). A semi-structured survey was conducted using open-ended questions to allow the participants to freely express their opinions. Data were analyzed using a consensual qualitative research methodology.
Results: In total, 4 overarching and distinct domains, 13 subdomains, and 55 key elements emerged. The four domains were the motivation to start smoking; smoking behaviors; stigma related to women smokers and concealment of smoking status; and the experience and awareness of quitting smoking. Results showed that most women started smoking due to pressure from friends, and their extent of smoking was small. Women smokers reported experiencing social pressure related to their smoking behaviors.
Conclusion: It is necessary to establish a smoking cessation policy that reflects the characteristics of women smokers by understanding their smoking and cessation behavior and the social pressure they experience.
Keywords : Female; Smoking; Smoking cessation; Social pressure; Qualitative research
  1. US Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress: a Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2014.
  2. Hackshaw A, Morris JK, Boniface S, Tang JL, Milenkovic D. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. Bmj. 2018; 360: j5855.
    Pubmed KoreaMed CrossRef
  3. Smith PH, Bessette AJ, Weinberger AH, Sheffer CE, McKee SA. Sex/gender differences in smoking cessation: A review. Preventive medicine. 2016; 92: 135-40.
    Pubmed KoreaMed CrossRef
  4. Cepeda-Benito A, Reynoso JT, Erath S. Meta-analysis of the efficacy of nicotine replacement therapy for smoking cessation: differences between men and women. J Consult Clin Psychol. 2004; 72(4): 712-22.
    Pubmed CrossRef
  5. The Social Survey of Statistics Korea. Statistics Korea, Daejeon, Korea 2024.
  6. Jung-Choi KH, Khang YH, Cho HJ. Hidden female smokers in Asia: a comparison of self-reported with cotinine-verified smoking prevalence rates in representative national data from an Asian population. Tob Control. 2012; 21(6): 536-42.
    Pubmed CrossRef
  7. Park MB, Kim CB, Nam EW, Hong KS. Does South Korea have hidden female smokers: discrepancies in smoking rates between self-reports and urinary cotinine level. BMC women’s health. 2014; 14: 156.
    Pubmed KoreaMed CrossRef
  8. Suh K. Updates in the Smoking and Smoking Cessation of Korean Women. korean journal of psychology. 2007; 12(4): 695-713.
  9. Kim SS, Fang H, Difranza J, Ziedonis DM, Ma GX. Gender Differences in the Fagerstrom Test for Nicotine Dependence in Korean Americans. Journal of smoking cessation. 2012; 7(1): 1-6.
    Pubmed KoreaMed CrossRef
  10. Study for the Improvement of Survey methods on Female Smoking [Internet]. Korea Disease Control and Prevention Agency. 2016.
  11. Krueger RA, Casey MA. Focus Groups: A Practical Guide for Applied Research, 4th ed. Thousand Oaks (CA): SAGE Publications, Inc. 2009.
  12. Hill CE, Thompson BJ, Williams EN. A guide to conducting consensual qualitative research. The Counseling Psychologist. 1997; 25: 517-72.
    KoreaMed CrossRef
  13. Hwang SJ, Ou SW, Kim SN, Hwang HS, Cho BL, Huh BY. Smoking patterns and factors associated with smoking in Korean adult women. Korean J Fam Med. 2000; 21(3): 344-56.
  14. Kim YS, Jo HS. Smoking Behavior and Related Factors of Female Smokers from Public Health Center in Incheon. Journal of Korean Society for Health Education and Promotion. 2008; 25(3): 125-38.
  15. Reyes-Guzman CM, Pfeiffer RM, Lubin J, Freedman ND, Cleary SD, Levine PH, et al. Determinants of Light and Intermittent Smoking in the United States: Results from Three Pooled National Health Surveys. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2017; 26(2): 228-39.
    Pubmed KoreaMed CrossRef
  16. Schane RE, Ling PM, Glantz SA. Health effects of light and intermittent smoking: a review. Circulation. 2010; 121(13): 1518-22.
    Pubmed KoreaMed CrossRef
  17. Kim ES, Cho HJ, Cho YJ, Kim H. Smoking Cessation Service for smoking high-risk women and out of school adolescents. Ministry of Health & Welfare. 2016.
  18. Jeong JH, Jeon EJ, Han JY, Kim YS, Won YS, Seo M. A Phenomenological Study on Smoking Experience among Female College Students. Korean J Health Educ Promot. 2010; 27(3): 1-12.
  19. World Economic Forum, The Global Gender Gap Report 2018. 2018.
  20. Triandafilidis Z, Ussher JM, Perz J, Huppatz K. An Intersectional Analysis of Women’s Experiences of Smoking-Related Stigma. Qual Health Res. 2017; 27(10): 1445-60.
    Pubmed CrossRef
  21. Hagen EH, Garfield MJ, Sullivan RJ. The low prevalence of female smoking in the developing world: gender inequality or maternal adaptations for fetal protection? Evolution, medicine, and public health. 2016; 2016(1): 195-211.
    Pubmed KoreaMed CrossRef
  22. Hitchman SC, Fong GT. Gender empowerment and female-to-male smoking prevalence ratios. Bulletin of the World Health Organization. 2011; 89(3): 195-202.
    Pubmed KoreaMed CrossRef
  23. Crotti R, Geiger T, Ratcheva V and S. Zahidi. 쏮easuring the Global Gender Gap in The Global Gender Gap Report 2020. World Economic Forum. 2020.
  24. World Health Organization. WHO framework convention on tobacco control. Elaboration of guidelines for implementation of Article 12 of the convention. Progress report of the working group. 2008.
  25. Castaldelli-Maia JM, Ventriglio A, Bhugra D. Tobacco smoking: From 쁤lamour’ to 쁲tigma’. A comprehensive review. Psychiatry Clin Neurosci. 2016; 70(1): 24-33.
    Pubmed CrossRef
  26. Zwar N, Richmond R, Peters M, Litt J, Bell J, Caldwell B, Fretter I. Supporting smoking cessation: a guide for health professionals. The Royal Australian College of General Practitioners. 2011.
  27. United States Public Health Service Office of the Surgeon G, National Center for Chronic Disease P, Health Promotion Office on S, Health. Publications and Reports of the Surgeon General. Smoking Cessation: A Report of the Surgeon General. Washington (DC): US Department of Health and Human Services; 2020.