WOMEN’S HEALTH AND TOBACCO CONTROL

Hildrun Sundseth Board Member European Institute of Women’s Health

About the EIWH • The European Institute of Women’s Health is a health

NGO launched in 1996. • The EIWH aims to ensure a gender-sensitive approach to

health policy, prevention, treatment, care and research in order to reduce health inequalities and improve quality.

• Organisation:

• Extensive multi-national, multi-disciplinary network of patient groups, health NGOs, researchers, gender experts, politicians, and medical professionals

• Expert Advisory Board

Why Women’s Health?

“The health of women has a direct bearing on the health of the future

generation, their families, and communities, and ultimately, the

health of societies.”

NIH Office of Research on Women’s Health, 2010

http://orwh.od.nih.gov/ORWH_Strategic-Plan_Vol_1_508.pdf

Smoking in Women

Smoking-Related Diseases in Women

• Major risk factor for many chronic diseases • CVD including heart attack and stroke, • Cancers of the lung, larynx, oral cavity, and esophagus, colon, etc

• Breast, cervical and ovarian cancer • Chronic bronchitis, asthma, emyphsema • COPD • Diabetes, Osteoporosis, etc

Reproductive Health

• Infertility/Subfertility • Complications in pregnancy • Early Menopause • Cervical and Ovarian Cancer • Breast Cancer

Smoking Kills Women

• Smoking is the single most important preventable cause of death in women

• Killing half of the regular smokers • 12% of all female death between 35-69 years

• Death rates reflect the trend of women taking up smoking 20 to 30 years ago

• Full impact on women’s health still to come

60 European Cardiovascular Disease Statistics

Figure 4.2c Change in smoking rates among 15 year olds, by sex, 1993/94 to 2009/10, Europe

! Boys

! Girls

Norway

Germany

Belgium (Flemish)

United Kingdom - Wales

United Kingdom - Scotland

Finland

Denmark

Belgium (French)

Spain

Poland

France

Sweden

Austria

Switzerland

Russian Federation

Latvia

Hungary

Estonia

Slovakia

Czech Republic

Italy

-25 -20 -15 -10 -5 0 5 10 15 20 25

Change in smoking rates 15 year old boys and girls

1993/94 to 2009/10

Women Are Vulnerable • Faster addicted to nicotine and flavours • Women more susceptible to stress than men •  Influence of hormones during menstrual cycle? • Afraid to gain weight if they stop smoking • Some evidence that women experience more severe withdrawal symptoms

• Nicotine replacement less effective in women • Women more vulnerable to passive smoking, higher risk of lung cancer and CVD than in men

Lung Cancer Incidence EU-27 women—2008 estimates

0 50 100 150 Sweden Cyprus

Portugal Finland

Malta Austria Ireland

Germany United Kingdom

Denmark Italy

France Netherlands Luxembourg

EU-27 Bulgaria Slovakia Slovenia

Spain Greece

Czech Republic Romania

Latvia Lithuania Belgium Estonia Poland

Hungary

Rate per 100,000 population

Males

Females

0 20 40 60 Sweden Cyprus

Portugal Finland

Malta Austria Ireland

Germany United Kingdom

Denmark Italy

France Netherlands Luxembourg

EU-27 Bulgaria Slovakia Slovenia

Spain Greece

Czech Republic Romania

Latvia Lithuania Belgium Estonia Poland

Hungary

Rate per 100,000 population

Females

Females

Lung Cancer Incident & Mortality

Smoking during Pregnancy

• 11%-30% of pregnant women smoke or are exposed to tobacco smoke

• Smoking & second hand smoke has a devastating effect on their children

• Miscarriage, premature birth, • Birth defects • Sudden infant death, respiratory infections, wheezing,

asthma, middle ear infection in their children • Smoking parents - role model for future smokers

FCTC - Women and Smoking • Recognises that Tobacco control has been gender-blind and ignored the social and cultural context

• Calls for Tobacco Control strategies that are sensitive to gender and include women in policy making

• Counteract Tobacco companies marketing that targets young girls and women

Socio-economic aspects of Smoking

• Smoking women often disadvantaged • Poor education, low income, single mothers, lack of

self- esteem • Anti-smoking initiatives need to take a gender-based approach

• Special focus on poorer, socially disadvantaged, vulnerable groups

• Effective tobacco control measure to target women are needed– Plain packaging

Tobacco Industry Targets young girls and women

• Women are an increasing new market • Sophistication, style, luxury • Romance and sex • Sociability, enjoyment, success • Emancipation, independence • Freshness and health • Slim and glamorous

Creating a Female Market • Sophisticated marketing • Pack design to communicate brand image and glamour • Sponsorship of sports and arts • Point of sale promotional material • Distribution of free products

•  Germany at political party conferences • Brand stretching • Paid placement of cigarette brands in films, television • Points of sale near schools, supermarkets • Smoking in films

Female-Oriented Brands

Female-Oriented Brands Female-Oriented Brands

Female-Oriented Brands

Appealing to Women • Brands come in a variety of flavours that appeal to girls and women • Mint/menthol, Fruit, Vanillia, Chocolate flavours

• Makes starting smoking more palatable to young girls

• SNUS traditionally used by older men, but

•  now new forms of SNUS, attractively packaged, cranberry and rhubarb flavour

Recommendations • Make tobacco control gender-sensitive & gender-

specific • Policy needs to be backed by support measures that

address the socio-cultural environment • Help young girls to resist pressures to start smoking and

women to quit through social media • Create social, economic and political climate that

promotes non-smoking as the norm • Reduce countries' economic dependence on the

production, manufacture and sale of tobacco (Tax) • Legislate plain packaging - Australian example

Pattern of smoking epidemic