Smoking cessation in Sweden - gender, pathways, and identity

Sammanfattning: Research on smoking has to a great deal been conducted within a public health or a medical context, or focused on policy making. Fewer studies have taken their point of departure in a social sciences context, and still fewer have analysed why individuals start and cease to smoke, and how and why smoking patterns on an aggregate level change over time and vary between different population groups.The aim of this dissertation is to analyse changes in the Swedish tobacco consumption with special emphasis at elucidating the decrease in smoking during the past half-century from different angels. Thus, the first paper explore if and how changes in smoking patterns can be understood and explained with reference to Sweden’s development as a welfare state, and in relation to socio-demographic and socio-economic circumstances. The second paper focuses on the long-term pathways to smoking cessation, by discerning several distinct trajectories from smoker to non-smoker. The third paper analyses gender differences with regard to reasons to smoke, experiences of smoking, and central elements in the cessation process. Finally, in the fourth paper, the issue of to what extent smoking cessation can be described as a process of identity change is explored.  Smoking initiation and cessation vary by socio-demographic and socio-economic factors, and the rapid decrease in smoking has resulted in a rather vulnerable group of smokers in these aspects. The results also indicate that the cessation process is complex, with personal and structural factors interacting in the long-term process, leading to multiple pathways to a smoke-free life. Moreover, they point to gender differences in reasons to smoke and to quit, and in strategies to quit smoking. In addition, identity change seems to be important in remaining smoke-free. The stated inequality in gender and class points in the direction that structural changes and social policies might be of need to decrease smoking even further.