Stress is a trigger for smoking? No shit, Sherlock.

National Public Radio had a recent story on the power of smoking - and how women have a harder time quitting.

What is interesting about this is not that it identifies "acute emotion" as what can lead to smoking. "Acute Emotion" is what my social worker partner would say is a trigger. Yeah. That's kind of been done, Researcher.

What is interesting is the road the research begins to walk down - using a gender lens. While they toss it up to hormones (which do affect us in interesting ways but is a completely separate conversation), I would also offer up that dealing with a sexist world can be a trigger. And a homophobic world. And a racist world. And a transphobic world. And a world (and most definitely the US) that doesn't know how to talk about class.

Researcher says relapse starts with a single lapse — for example, smoking a cigarette during a period of not smoking, thinking that the return to smoking is temporary ("I just need one cigarette for this moment"). Researcher says people tend to have lapses when they're emotionally upset. He also says this seems to occur more frequently with women. Which is where I would say that those institutions that impact our lives comes into play (heterosexism, sexism, racism, classism, etc.).

We know smoking is bad for our health. The connection between hypertension and racism that African-Americans experience has been well documented. And sexism has been documented as it relates to Posttraumatic Stress Disorder. But we have not walked far enough down this road. We have not made the connections between how these subconscious and overt institutional narratives dovetail to affect our mental health and physical health. As well as access to care.

We have not adequately quantified how these narratives interplay and affect us - like women of color, for example. If Judge Sonia Sotomayor picked up a cigarette for a bit of self-medication, I couldn't hate on that. Really - after seeing the ignorance this judge is facing from what will be her future colleagues from the legislative branch, I was hard pressed not to pick up a cigarette myself. I'm glad she had crazy back up.

But I do think that the research world and public health world need to start looking way more critically at how these institutional narratives impact our health - including homophobia and transphobia. Especially in this prescient moment of health care reform. It won't do any good to reform it if none of us qualify (because I smoke to deal with the fucked-up world we live in) or are cared for appropriately (because my doc thinks queers don't deserve care).