2007 johns hopkins bloomberg school of public health women and tobacco natasha jategaonkar, msc...

2007 Johns Hopkins Bloomberg School of Public Health

Women and TobaccoWomen and Tobacco

Natasha Jategaonkar, MScBritish Columbia Centre of Excellence for Women’s HealthFramework Convention Alliance

2 2007 Johns Hopkins Bloomberg School of Public Health

Learning Objectives

Discuss the reasons why women and tobacco are a specific area of inquiry Specific concerns How tobacco use affects women’s bodies and lives

Demonstrate statistics and figures on tobacco use among women

Explain ways in which tobacco production and marketing have an influence on women’s lives, even among women who don’t smoke


Text source: The Tobacco Atlas 2nd Edition. (2006); Image source: Lung Health Image Library. (2007). Permission granted for educational use.

Tobacco Patterns Are Changing

Men 48% of the world’s men

smoke (35% in developed countries; 50% in developing countries)

Men’s smoking rates have peaked and are now in a slow decline

Tobacco continues to kill four million men per year


Text source: *The Tobacco Atlas 2nd Edition. (2006); †Greaves, L., et al. (2006); Image source: Lung Health Image Library. (2007). Permission granted for educational use.


Women 12% of the world’s women

smoke (22% in developed countries; 9% in developing countries)*

By 2025, it is predicted that 20% of the world’s women will smoke†


Text source: The Tobacco Atlas 2nd Edition. (2006); Image source: Lung Health Image Library. (2007). Permission granted for educational use.


Youth Globally, boys are

more likely than girls to smoke

However, in half of the countries surveyed in the Global Youth Tobacco Survey, there was no gender difference in youth smoking

Worldwide, tobacco use among girls is increasing


Stages of the Tobacco Epidemic

Source: adapted by CTLT from Lopez, A.D., et al. (1994).


Image sources: (bottom) Lung Health Image Library. (2007); (top) © ILO/Deloche, P.(2000). Permission granted for educational use.

How Tobacco Affects Women’s Lives


Images source: Lung Health Image Library. (2007). Permission granted for educational use.

Forms of Tobacco Other than Cigarettes

Bidis: small, thin, hand-rolled cigarettes

Water-pipe: tobacco burns and then the smoke passes through water before it is inhaled (hookah, shisha, or narghile)

Snus: a form of oral smokeless tobacco


Source: Greaves, L., et al. (2006).

Women, Tobacco, and Health

1964: U.S. Surgeon General’s report showed “definite” link between tobacco use and cancer for men, and a “probable” link between tobacco use and cancer for women

Smoking has negative effects on nearly every system of a woman’s body

“Light” and “low tar” cigarettes are designed for and marketed to women, but health risks remain the same



Women and Cardiovascular Disease

Cigarette smoking dramatically increases the risk of heart disease and stroke

Heart disease is a major cause of death for women in the developed world and, increasingly, in the developing world

Women who smoke and simultaneously take oral contraceptives further increase their risk of heart disease

Bidis also increase risk of heart disease



Women and Cancer

Lung cancer is the most common cancer caused by smoking

In several developed countries, lung cancer is surpassing breast cancer as the leading cause of cancer death for women

Smoking increases women’s risk of cancer of mouth, throat, larynx, esophagus, stomach, pancreas, bladder, kidney, cervix, and uterus

New evidence links smoking to breast cancer

Bidis increase risk of cancer of the lung, mouth, stomach and esophagus



Women and Lung Health

Girls who smoke cigarettes have poor lung growth

Women who smoke cigarettes have an earlier decline in lung function

Cigarette smoking causes emphysema and chronic bronchitis, increases risk of acute lower respiratory illnesses, and worsens asthma

Cigarette smoke adds to other lung burdens, such as coal residue, and wood smoke

Bidis also increases risk of chronic bronchitis



Women and Reproductive Health

Smoking increases the risk of painful and irregular menstruation

Smoking during pregnancy increases the risk of ectopic pregnancy, miscarriage, stillbirth, and Sudden Infant Death Syndrome (SIDS)

Water-pipe smoke can lead to complications of pregnancy

Smokeless tobacco use during pregnancy reduces fetal birth weight and doubles the risk of stillbirth


Women and Addiction, Mental Health, and Other Issues

Addiction and mental health Nicotine is an addictive agent In some countries, smoking is more common among

women with mental health conditions

Other health issues Cigarette smoking can lower bone density, contribute to

cataracts, and cause periodontitis Working in tobacco fields may cause green tobacco

sickness



Text source: *Greaves, L., et al. (2006); †California Environmental Protection Agency: Air Resources Board. (2005).

Women and Secondhand Smoke

SHS causes heart disease and lung cancer in adults

Female nonsmokers are more likely than male nonsmokers to develop lung cancer*

According to a 2006 study by the State of California Air Resources Board, exposure to SHS increases risk of breast cancer among nonsmoking pre-menopausal women†


Women, Tobacco, and Poverty

Women are more likely than men to be living in poverty Spending on tobacco products reduces available family

income for food, education, and health care

Tobacco agriculture Unequal power relationships between tobacco

companies and tobacco farmers Labour of women and children goes unrecognized and

unpaid

In developed countries, smoking increasingly concentrated among poor and disadvantaged communities

Tobacco has a differential impact on women’s lives


Text source: *Tobacco and the Environment Fact Sheet No. 22. Action on Smoking and Health. (2004); †The Tobacco Atlas (2006).; Image source: © ILO/Deloche, P.(2000). Permission granted for educational use.

Women, Tobacco, and the Environment

Tobacco plants require huge amounts of fertilizer and pesticides—up to sixteen applications during a three-month growing period*

Chronic exposure to pesticides can cause health problems for the women, men, and children who work in tobacco fields†

Women exposed to pesticides can give birth to babies with birth defects


Text source: *Tobacco and the Environment Fact Sheet No. 22. Action on Smoking and Health. (2004); †Greaves, L. et al. (2006).

Women, Tobacco, and the Environment

Chemical runoff from tobacco fields and tobacco manufacturing pollutes local waterways*

Raw tobacco is cured via wood-firing and globally causes losses of 200,000 hectares of forest per year*

Women are often traditionally responsible for collecting water and firewood for the family and must walk further and work longer to fulfil household labour responsibilities†


Image sources (left to right): Ruby Lane. (2007); Tobacco Documents Online. (1994). Permission granted for educational use.

Women, Tobacco, and Sales and Marketing


Image sources: (left) Tobacco Documents Online. (1996); (right) Trinkets & Trash. (2007). Permission granted for educational use.



Image sources (left to right): Rediff.com. (2004); Campaign for Tobacco Free Kids. (1999). Permission granted for educational use.



Images source: Campaign for Tobacco Free Kids. (2004). Permission granted for educational use.



Image source: Wen, et al. (2005).


Women’s bodies are often exploited to sell tobacco products


Source: World Health Organization. (2005).

Women and the FCTC

Article 8: protection from exposure to tobacco smoke

Article 11: packaging and labeling of tobacco products

Article 12: education, communication, training, and public awareness

Article 13: advertising, sponsorship, and promotion


Women and the FCTC

Article 14: Tobacco dependence and cessation

Article 17: Provision of support for economically viable alternative activities

Articles 20-22: Scientific and technical cooperation and communication of information

Source: World Health Organization. (2005).



Policy Recommendations

Sign, ratify, and implement the Framework Convention on Tobacco Control (FCTC)

Design empowering messages and advertisements for improving women’s health

Promote comprehensive tobacco policies that address not only health, but also social and economic policies



Research Recommendations

Establish or expand existing surveillance data in order to monitor women’s and men’s tobacco use rates

Conduct further research on the health effects for both women and men of tobacco products other than cigarettes

Build capacity and engage women and girls in conducting tobacco research



Program Recommendations

Implement tobacco prevention and cessation programs that are gender-specific and age-specific

Provide information on occupational safety for women and girls involved in tobacco cultivation and production

Develop women-centered programs that address tobacco use during pregnancy and postpartum

Engage women in designing and delivering programs


Summary

Tobacco affects women’s lives in a myriad of ways Smoking has negative effects on nearly every system of

a woman’s body Women’s bodies are often exploited in tobacco

marketing Tobacco farming and processing exploits the labor of

women and girls

We must curb women’s tobacco use while also creating opportunities for education and empowerment