An intersectional life-course perspective on Black women’s smoking trajectories

Attempting to address health disparities via a single analytical category (e.g., gender or race) overlooks the complex ways multiple social categories and institutions intersect to create health disparities. Grounded in the intersectional life-course perspective, this study examines how the lived experiences of gender, race, and class, and interlocking systems of oppression shape Black women's smoking trajectories. Black women exhibit a unique smoking trajectory compared to others: the onset of smoking occurs later but they have an increased likelihood of smoking over their life course. Nevertheless, despite this distinctive smoking trajectory and disproportionately higher smoking-related health issues among Black smokers, few qualitative studies investigate their smoking patterns. This qualitative research fills that gap by applying an intersectional life-course perspective and grounded theory. Drawing on 40 in-depth interviews with socioeconomically disadvantaged Black women who were current and former smokers, this study identifies the following smoking trajectories among the study participants: early onset of experimental smoking, intermittent smoking in adolescence, and daily smoking in young adulthood. Additionally, data indicates three life-course pathways through which the transition from intermittent to daily smoking occurs: (a) social norms surrounding smoking; (b) financial (in)dependence; and, (c) gendered, raced, and classed stressors. These pathways intertwine and can co-occur. Findings suggest considering diverse life-course patterns of smoking across the intersections of gender, race, class, and socio-geographical contexts in future research and policies.