Rising tobacco use among women

100 years ago in 1908, more than 15,000 women marched in New York demanding equal pay and voting rights. This day is commemorated as International Women's Day (8 March). This year the theme is: Shaping progress.

It is not very encouraging to see organizations and individuals working on specific issues are so compartmentalized that it is difficult to bring them together even on cross-cutting issues and opportunities for enhanced advocacy.

For instance on International Women's Day, raising awareness about rising tobacco use among women, especially young girls in developing countries, is so apt.

Tobacco use among women has been on a rise, particularly in developing countries, says the new World Health Organization (WHO)'s report on Global Tobacco Epidemic 2008.

Late in February 2008, researchers have released the results of the first-ever international study of the tobacco use habits of pregnant women. Investigators say the rates of smoking, use of smokeless tobacco and exposure to secondhand smoke during pregnancy are higher than expected in developing and middle income countries, and pose an emerging threat to the health of women and their children.

Investigators found smokeless tobacco was popular among up to one-third of pregnant women in some parts of India.

The highest levels of secondhand smoke exposure were found in Pakistan, where nearly half of all pregnant women reported that both they and their children were regularly exposed to someone else's smoke.

Women who smoke during pregnancy are more likely to go into labor prematurely and give birth to low weight babies. Experts say smoking in pregnancy can also cause sudden infant death syndrome after the baby is born.

Greater female autonomy and changes in women's roles are associated with smoking uptake. Depression is strongly associated with smoking, and women have about twice the rate of depression than men.

Through comprehensive social research, the tobacco industry understands popular culture and psycho-social aspirations, and it incorporates this knowledge within massive promotional eff orts to seek new markets and sustain existing ones. Prevailing gender norms are a key feature within promotion for both sexes.

Using seductive but false images of vitality, slimness, emancipation, sophistication, and sexual allure, the industry targets women.

Liberation, autonomy, and even female friendship feature in developed countries advertising, and, increasingly, in regions where female roles have begun to change.

The Tobacco Reporter, an industry document, optimistically discussed its prospects in Asia in 1998:

"Rising per capita consumption…and an increasing acceptance of women smoking continue to generate new demand".

Slender, so-called "light", cigarettes packaged in pastel colours convey femininity and slimness in Japan and industrialized countries.

Tobacco causes similar health problems for men and women, including lung cancer, upper aerodigestive cancer, several other cancers, heart disease, stroke, chronic bronchitis and emphysema. Tobacco poses additional specific threats for men and women. Men risk declines

in fertility and sexual potency, and female smokers risk increased cardiovascular disease, in particular while using oral contraceptives, and higher rates of infertility, premature labour, low birth-weight infants, cervical cancer, early menopause, and bone fractures. Smoking during pregnancy adversely aff ects foetal development.

Female non-smokers are more likely to be exposed to environmental tobacco smoke, with its elevated risks of lung cancer and heart disease.

Lung cancer death rates in the European Union are nearly three times higher for female compared to male non-smokers, which researchers attribute to exposure to spouse smoking.

A recent meta-analysis found women develop lung cancer with lower levels of smoking compared to men, and are more at risk of contracting the (more aggressive) small cell lung cancer.

Among non-small cell cancer types, adenocarcinoma is more common among women. Explanations centre on women's greater use of low -tar cigarettes and more "compensatory" smoking (deeper inhalation), and faster smoking in response to workplace bans.

It appears women are most at risk of lung cancer if they begin smoking by age 25, six years later than for men.

It is imperative not only to raise awareness about tobacco hazards, but also to hold tobacco corporations accountable for the misleading and surreptitious tobacco promotion, and strengthening the implementation of existing tobacco control policies.

In India, the Cigarette and Other Tobacco Products Act (2003) and the global tobacco treaty (Framework Convention on Tobacco Control, FCTC) both have strongly endorsed tobacco advertising restrictions, ban to sale to minors, effective warnings on tobacco products and ban on use of misleading terms like `mild', `low tar' or `slim' on tobacco packs. But implementing such effective public health measures is indeed a huge challenge confronting us in present times.

Recently the group of ministers in India which was mandated to review the warning labels on tobacco packs, has actually reduced the size of the pictorial warnings from 50% to 30-40% and opted for less-effective pictorial warnings disapproving the more strong ones earlier approved to be effective in dissuading people especially young people from initiating tobacco use.

Let's hope, the theme of this year's International Women's Day (8 March) – SHAPING PROGRESS – will also mobilize women and men to shape progress on neglected public health measures as well.

Author is the Asian Correspondent and a member of Network for Accountability of Tobacco Transnationals (NATT). and can be reached at bobbyramakant_AT_yahoo.com

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