Currently, too many people around the world are spending more money on tobacco than food. A growing number of these individuals are women. In fact, tobacco use is among the greatest health threats facing women around the globe today. Worldwide, about 12 percent of women smoke compared to about 47 percent of men, but tobacco-control advocates project that, without strong government and private-sector intervention, smoking prevalence among women will nearly triple over the next generation, with the number of women smokers rising from the current 187 million to more than 530 million. Eighty percent of these female smokers will live in the developing world, and half will die prematurely from tobacco-related causes.
In developing countries, only 2 to 10 percent of women smoke, compared with 25 to 30 percent in developed countries. Cultural stigmas help maintain this gap. But, while smoking may be socially unacceptable in some countries, bringing shame upon a woman's family, tobacco use in other forms among women in developing countries is extremely high. In Central and South Asia, only 3 percent of women presumably smoke manufactured cigarettes, but 50 to 60 percent chew tobacco in many parts of India. In Nepal and some areas of rural India, women also smoke bidis (0.2 grams of wrapped tobacco) and chutta (a kind of cheroot).
Tobacco and Gender
Women have fought for many years for equality with men, and tobacco has cleverly been situated as an “equality engine.” Sadly, women have partially succeeded in their quest for parity, but it has come with a deadly price: They continue to be discriminated against in the workplace, but their mortality rates for tobacco-related pathologies are practically equal to those of men.
The tobacco industry targets women, and, worried about their waistlines and workplace potential, the “fairer sex” is lighting up at alarming rates. Unfortunately, smoking cessation is not yet specially directed to women.
Research shows that there are biological differences in addiction patterns between men and women. An investigation by Sakire Pogun of Izmir, Turkey on sex differences in the cerebral effects of nicotine was conducted using male and female rats. The rats were placed into a vat of water in which there was a hidden platform. In the beginning, all of the rats had to swim for a long time before locating the platform. Then the platform was removed and replaced by another one. The female rats found the new platform much more quickly than the male rats. After injecting nicotine into male rats in the same study, however, they behaved similarly to female rats and located the new platform with ease.
Taking Steps to Address the Gender Issue
In an effort to better understand and reverse the relationship between women and tobacco, the 1st International Symposium on Women and Tobacco (ISOWAT) was held in Toledo, Spain, October 5-8, 2005.
Sending representatives from governmental, non-governmental and inter-governmental organizations and other forms of civil society, about 45 countries from five continents participated, including an important number from Latin America, where governmental support for tobacco control is almost nonexistent. Only a few people do the majority of tobacco-control work in most Latin American nations, volunteering their time, taking on extra professional responsibilities and sacrificing their home lives to make a difference. The Chilean tobacco-control team, for example, consists of only a handful of people trying to do the work of 100, most of them for no salaried compensation.
Nonetheless, progress is being made. Argentina, Brazil, Mexico and Uruguay have created tobacco-control movements; their work in tobacco cessation is noteworthy, and transferable to the rest of the continent. Argentina has focused on legislation; it has yet to ratify the Framework Convention on Tobacco Control (FCTC), however, because so many of its regions that produce tobacco (and have been smartly manipulated by the tobacco industry) are opposed to the ratification. Brazil has already ratified the FCTC and is the leader in the region when it comes to tobacco control with very advanced tobacco-control legislation. Mexico is spearheading an interesting smoking-cessation program, while Uruguay is preparing to enact legislation that prohibits smoking in all public places and all workplaces, public and private, in 2006.
Chile is doing its best to catch up to its continental neighbors. Although it has ratified the FCTC, the nation has the world’s highest prevalence (a 44 percent incidence) of cigarette smoking and tobacco use among young girls, according to The Global Youth Tobacco Survey. That said, the country’s next president will probably be a female medical doctor with a master’s in public health, so the situation may soon improve.
ISOWAT has also fostered hope, sparking discussion and emphasizing the need for cooperation in understanding and addressing the tobacco-control issue from a gender perspective. To facilitate collaboration among those dedicated to female tobacco control in Ibero-America, an e-mail conversation list, email@example.com, was developed. The symposium also resulted in the creation of the Toledo Declaration, an unprecedented decree that calls on national governments to:
- Ratify the FCTC, especially countries that are significant tobacco producers
- Involve women and civil society in the development of policies, legislation and programs to ensure implementation of the FCTC
- Act in good faith to protect their people and the environment by recognizing the inherent contradiction between the goals of the tobacco industry and the aims of tobacco control
- Recognize that tobacco use and exposure to second-hand smoke violate fundamental human rights, including the right to life, health and well-being
- Use tobacco control as a key strategy for achieving the United Nations Millennium Development Goals
- Facilitate the development of leadership and other capacities within countries without strong tobacco-control initiatives
- Understand critical gender-specific issues in relation to tobacco and to implement, where appropriate, gender-specific interventions to reduce tobacco use
- Ban immediately tobacco advertising, promotion and sponsorship, and if they are parties to the FCTC, develop a protocol addressing global aspects of tobacco promotion.
The Toledo Declaration also summons parties to the FCTC to develop a women’s protocol to ensure that all aspects of the treaty, including data collection, monitoring, surveillance and research, incorporate measures to take account of gender.
And so it begins. One step at a time. One person at a time. But as dedicated tobacco-control advocates join together, the movement, and the motion, mount. And women the world over will soon benefit.
Written with assistance from: Mira Aghi (India), Adriana Blanco (Uruguay) and Carmen Gloria Lafuente (Chile), with thanks to members of the ISOWAT Organizer Equipment in Spain formed by Cleopatra R’Kaina; Pilar Espejo; Javier Ayesta; Cristina de Castro; Ricardo Abengózar; Blanca Benito; Lázara Lisset Gelabert; Mireia Jan; P. Lourdes Márquez; Miriam Rodríguez; Miriam Otero; M. Ángeles Planchuelo; Justa Redondo; and Elena Uría.
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