Tobacco control for women: We have not come a long way!

Dr Richa Sharma, CNS Correspondent, India
Sometime ago, I saw on the internet the words ‘strong woman’ written against a background of a woman smoking a cigarette. It left a strong impression on my mind and I wondered how a cigarette with some smoke, alongside a woman, can convey ideas of individuality and independence of females. Well, this is how the tobacco industry has been getting to the women for a very long time.

All around us, we have seen a surge in smoking patterns among men, women and even children. According to our Health Ministry, the latest data on cigarette consumption shows that cigarette use has reduced to 93.2 billion sticks in 2014-15 (10 billion less than in 2012-13) along with production reducing to 105.3 billion sticks as compared to 117 billion (2012-13). However, the tobacco atlas reports that 23.3% of males and 3.2% of females are still smoking cigarettes everyday in India. Another alarming report in Times of India (January 2014)  stated that India has become home to second highest number of female smokers ( 12.1 million) second to the United States. Even though the prevalence of smoking remains high among men as compared to women, researchers have warned that the tide may gradually turn in the reverse direction.

In a webinar hosted by CNS, noted tobacco control expert of the International Union against Tuberculosis and Lung Disease (The Union),  Dr Mira Aghi, shared her views on the very relevant question of why is there a need to have gender specific tobacco control policies? Women are theoretically half the global population; they too use and die due to tobacco. The tobacco industry targets women and the annual death toll among women, attributed to tobacco use, will be 2.5 million by 2030. Smoking increases the risk of cardiovascular diseases, results in higher rates of infertility, premature labour, low birth weight infants, cervical cancer, early menopause and bone fractures. It adversely affects foetal development during pregnancy, leading to sudden infant death syndrome and smoking females tend to produce less breast milk. Women tend to  have a stronger addiction, suffer from stronger withdrawal symptoms and nicotine replacement therapy isles effective among them as compared to males added Dr Aghi.

Why do women smoke? Are the reasons not similar to those of men? Well some of them are. For instance most of the people  (men and women) smoke to look cool, or under peer pressure, or to relieve the stresses of daily life, or to satisfy their curiosity of smoking. However, there have been studies mentioning certain differences in the smoking patterns among various genders. Women are known to smoke to combat negative feelings, to alleviate the stress that accompanies managing personal and professional work, as a treat for themselves, a break from the busy schedules and also to lose weight. Women also find it much harder to quit smoking than men do. These special traits are exploited by the tobacco industry in targeting women and young girls to increase its ever growing consumer base.

Before Word War 1, smoking was treated as a male reserve where the females were either shown as serving them cigarettes or used in fashionable ways to attract men. However, with an advent in female emancipation, they sensed the cultural shift and started marketing cigarettes to the women as ‘torches of freedom’ and as an expression of their liberation. The tobacco industry has been trying to lure women and children in smoking by advertising tobacco in the most creative ways by incorporating popular culture and psychosocial aspirations in its huge promotional efforts. Women have been targeted with glamorous, strong and independent themed advertising for years now. Various product design concepts associated with being slim, modern, sophisticated have been utilised in making the campaign appealing to the women. Virginia slims were introduced in 1968 and the slogan said ‘You’ve come a long way, Baby!’ and paved the way for introduction of similar ‘women only’ cigarettes that are long, extra slim and falsely branded as light and low tar to appear safer. Dr Mira Aghi also highlighted that the tobacco industry has been very carefully adapting the marketing strategies with changing times. However the world public health bodies have not paid much attention to this aspect. Tobacco control policies are fractured and do not take into account the special needs and issues unique to the women.

One of the major action point is to include gender and diversity based analyses in the design and evaluation of tobacco control measures. It is also imperative to develop guidelines for gender impact assessment to evaluate the effectiveness of tobacco control measures so that a much clearer picture can be obtained about the current status of tobacco use and cessation among the women, suggests Dr Aghi. We can only hope that the world leadership wakes up to this threat before the damage becomes irreversible.

Dr Richa Sharma, Citizen News Service - CNS
March 8, 2016