Much work has been done to promote sex and gender-based analyses in health research and to think critically about the influence of sex and gender on health behaviours and outcomes. However, despite this increased attention on sex and gender, there remain obstacles to effectively applying and measuring these concepts in health research. Some health researchers continue to ignore the concepts of sex and gender or incorrectly conflate their meanings. We report on a primer that was developed by the authors to help researchers understand and use the concepts of sex and gender in their work. We provide detailed definitions of sex and gender, discuss a sex and gender-based analysis (SGBA), and suggest three approaches for incorporating sex and gender in health research at various stages of the research process. We discuss our knowledge translation process and share some of the challenges we faced in disseminating our primer with key stakeholders. In conclusion, we stress the need for continued attention to sex and gender in health research. Sex and gender in health researchIn the context of doing more sensitive, precise and relevant health research, there is an increasing emphasis on attending to issues of sex and gender. Much work has been done to promote sex and gender-based analyses in health research and to think critically about the influence of sex and gender on health behaviours and outcomes [1][2][3][4][5][6][7][8][9][10]. This work is viewed as key to understanding and addressing health inequities that exist throughout the world. Several journals have published special issues in recent years, emphasizing the scientific, methodological, and ethical rationales for including sex and gender in health research [2,4,10,11]. Despite this increased attention on sex and gender, there remain obstacles to effectively applying these concepts in health research. Some health researchers continue to ignore the concepts of sex and gender or use the terms synonymously and thus incorrectly [9,12]. Certain disciplines are more familiar with these concepts than others; while gender has been a prominent concept in the social sciences for decades, and has therefore influenced social science health research, it has only relatively recently begun to enter the lexicon of biomedical and clinical health researchers. Thus, gender, which fundamentally refers to social and cultural influences, is often conflated or confused with sex, referring to the biological category of influences [9]. This conflation leads to confusion about the contributions of sex and gender to health, incomplete analysis and reporting in health research, and potential missed opportunities for developing appropriate medical interventions and policy responses [9].To address these errors and omissions, researchers have begun to tackle the operational challenges of incorporating sex and gender in health research, providing method-

BackgroundThere has been a recent swell in activity by health research funding organizations and science journal editors to increase uptake of sex and gender considerations in study design, conduct and reporting in order to ensure that research results apply to everyone. However, examination of the implementation research literature reveals that attention to sex and gender has not yet infiltrated research methods in this field.DiscussionThe rationale for routinely considering sex and gender in implementation research is multifold. Sex and gender are important in decision-making, communication, stakeholder engagement and preferences for the uptake of interventions. Gender roles, gender identity, gender relations, and institutionalized gender influence the way in which an implementation strategy works, for whom, under what circumstances and why. There is emerging evidence that programme theories may operate differently within and across sexes, genders and other intersectional characteristics under various circumstances. Furthermore, without proper study, implementation strategies may inadvertently exploit or ignore, rather than transform thinking about sex and gender-related factors. Techniques are described for measuring and analyzing sex and gender in implementation research using both quantitative and qualitative methods.SummaryThe present paper describes the application of methods for integrating sex and gender in implementation research. Consistently asking critical questions about sex and gender will likely lead to the discovery of positive outcomes, as well as unintended consequences. The result has potential to strengthen both the practice and science of implementation, improve health outcomes and reduce gender inequities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12874-016-0247-7) contains supplementary material, which is available to authorized users.

Objectives Female smoking is predicted to double between 2005 and 2025. There have been numerous calls for action on women's tobacco use over the past two decades. In the present work, evidence about female tobacco use, progress, challenges and ways forward for developing gendered tobacco control is reviewed. Methods Literature on girls, women and tobacco was reviewed to identify trends and determinants of tobacco use and exposure, the application of gender analysis, tobacco marketing, the impact of tobacco control on girls and women and ways to address these issues particularly in low-income and middle-income countries.