Smoking in Poor Rural Women: A systematic review of the literature

Background:  Despite having many smoking cessation programs available nationwide, smoking rates remain higher, and are declining at a much slower rate among rural women who are poor, suggesting existing interventions are not effective for this population. These higher rates of smoking result in a disproportionately higher burden of cancer, cardiovascular, and other health problems more common in rural residents; thus, efforts to find effective interventions for this group should be continued. The purpose of this systematic review of the literature was to assess the congruency of findings around factors that influence smoking and smoking cessation and the development of smoking cessation interventions for low income rural women.

Methods:  Six databases relevant to the health and social sciences were searched using a combination of select keyword terms. Studies were included in inclusion criteria were met.

Results:  Most studies on this population of smokers are descriptive, and examine economic, environmental, and social factors related to rural smoking patterns. Of the two qualitative studies reviewed, social support received from an individual’s social network was viewed as most beneficial when considering or maintaining smoking cessation. Among the five randomized controlled trials included in the review, however social support was implemented through peripheral resources or resources with little direct connection to women's social networks and did not produce statistically significant results. Few studies have focused on the specific needs and difficulties of smoking cessation among rural women who are poor, and interventions to date have not targeted the complex social network of this population.