Men, women and tobacco in intimate relationships
Reprinted from "Tobacco" issue of Visions Journal, 2007, 3 (4), pp. 22-23
Pregnancy is often a time when couples start to think about changes in tobacco use by one or both partners. Smoking cessation for pregnancy is often temporary, with many women relapsing after childbirth. Although a number of resources to support smoking cessation during pregnancy have been developed, many women still find it difficult to remain smoke-free. We are interested, therefore, in gaining a better understanding of the difficulties women experience in reducing or stopping smoking, in order to develop new approaches to supporting smoking cessation.
In our research, we set out to learn about the everyday routines and habits in couples’ everyday lives that may influence smoking cessation. Twenty-eight women who quit or reduced smoking for pregnancy and their male partners were interviewed following delivery and at three to six months postpartum. Interviews focused on: pre-pregnancy smoking practices; interactions regarding tobacco use before, during and after the woman’s pregnancy; conflicts over smoking; and efforts to minimize environmental tobacco smoke.
What are TRIPs?
When individuals establish relationships as a couple—and one or both individuals smoke—habits and routines that involve tobacco use are developed over time. We examined the interaction patterns that many couples develop around tobacco use and how this influences women’s efforts to reduce or stop smoking. We call these interaction patterns tobacco-related interaction patterns (TRIPs).1
TRIPs become embedded in a couple’s daily life and are often taken for granted. They are reflected in the routines couples establish related to:
where and when smoking usually occurs
who smoking usually occurs with (partners, co-workers, friends, alone)
the way women and men talk about smoking
rituals that involve smoking (e.g., taking turns, lighting each other’s cigarettes, sharing a cigarette)
We identified three types of TRIPs: accommodating, conflictual and disengaged.
Accommodating: Couples who demonstrate accommodating TRIPs share common views about smoking and are empathetic about their partner’s need to smoke. Whether they both smoke or not, the couple tend to view smoking as a “joint issue” and have non-confrontational discussions about tobacco use. Non-smoking partners have a high degree of tolerance for slips and relapse. The following scenario reflects a couple with this TRIP:
Andrew doesn’t smoke, but he accepts that Liz enjoys smoking and that it helps her relax. He doesn’t mind getting the kids ready when they go out. This gives Liz a chance for a quick smoke break. Smoking is her chance to unwind, relieve stress and be social. Liz’s favourite cigarette is the after-dinner cigarette. She usually cooks while Andrew goes for a run. After dinner, Andrew does the dishes and Liz has a few minutes to herself and she often enjoys a smoke.
Conflictual: In conflictual TRIPs, couples consistently describe tensions related to tobacco use, which sometimes include shaming, coercion, monitoring and hostility. For some couples, conflict about tobacco becomes a part of everyday life. Non-smoking partners have a low degree of tolerance for slips and relapse. Women who smoke try to minimize conflict by keeping their smoking away from non-smoking partners. The following scenario reflects a couple with this type of TRIP:
Despite Janet’s gradual reduction, Nick (ex-smoker) is annoyed when he sees her enjoying cigarettes. Janet’s habit of limiting her smoking to their apartment kitchen instead of their balcony bothers Nick. Negative comments, such as “Quit” or “Gross—you should go outside,” are triggered when he enters the kitchen after a run and encounters smoke. When Nick openly criticizes her smoking, Janet thinks, “Be quiet. Leave me alone.” To avoid an argument, she sometimes goes outside to smoke.
Disengaged: In this interaction pattern, couples consistently treat tobacco use as a personal decision and individual activity. Because couples do not question each other’s smoking practices, there is little discussion of tobacco use. Tolerance by partners, whether they smoke or not, is high for women’s slips and relapse. The following scenario reflects a couple with this type of TRIP:
Lorna rarely speaks to Tyler about smoking or cigarettes. Both feel smoking is an individual choice, so there is no reason for them to talk about it. They both smoke as a break from work, with co-workers or when they are hanging out with their own friends. Lorna and Tyler each have their favourite brand and they buy their own cigarettes. They both smoke at home in the evenings, but usually not together.
Tips for women who want to reduce or stop smoking
How do TRIPs influence women’s efforts to reduce or stop smoking?
We discovered that these interaction patterns can influence women’s efforts to reduce or stop smoking in different ways.2
Accommodating TRIPs: Partners accept and support women’s goals and decisions about reducing or stopping smoking. Women openly discuss progress related to reducing or stopping smoking, and feel comfortable asking their partner for support. Sometimes, couples attempt to reduce or stop smoking together.
Conflictual TRIPs: Women find their efforts to reduce smoking closely monitored by their partners and sometimes experience increased pressure to stop smoking. To reduce conflict about smoking, women tend to avoid talking about any difficulties they experience (e.g., with cravings), they hide slips and rarely ask their partners for support. Reductions in tension are noticeable in couple relationships when women stop smoking.
Disengaged TRIPs: When women become pregnant and begin to think about tobacco reduction, they are surprised and sometimes irritated when partners unexpectedly try to monitor and restrict their tobacco use. As women begin to reduce or stop smoking, they often do not receive the support they expect from their partners. Because partners often lack understanding of women’s needs related to smoking, they do not offer either emotional or practical support. This creates tension, especially when partners continue to smoke despite requests by women to reduce or stop their smoking.
Further TRIPs initiatives
A project is underway to evaluate an information booklet describing TRIPs for use with pregnant women who smoke. In addition, we are conducting studies to develop interventions for reducing exposure to second-hand smoke in homes and for helping new fathers stop smoking.
For more information: contact Joan Bottorff at firstname.lastname@example.org
About the authors
Joan is Professor and Dean of the Faculty of Health and Social Development at the University of British Columbia Okanagan.
Joanne is a research coordinator with the Faculty of Health and Social Development at the University of British Columbia, Okanagan
Bottorff, J.L., Kalaw, C., Johnson, J.L. et al. (2005). Unraveling smoking ties: How tobacco use is embedded in couple interactions. Research in Nursing & Health, 28(4), 316-328.
Bottorff, J., Kalaw, C., Johnson J.L. et al. (2006). Couple dynamics during women’s tobacco reduction in pregnancy and postpartum. Nicotine and Tobacco Research, 8(4), 499-509.