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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
Change in smoking rates
 15 year old boys and girls




1993/94 to 2009/10
Pattern of smoking epidemic
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
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
• Pack design to communicate brand image and glamour
• Sophisticated marketing
• 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.
•   Legislate plain packaging - Australian example

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Women's health and tobacco control

  • 1. Women’s Health and tobacco Control Hildrun Sundseth Board Member European Institute of Women’s Health
  • 2. 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
  • 3. 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
  • 5. 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
  • 6. Reproductive Health • Infertility/Subfertility • Complications in pregnancy • Early Menopause • Cervical and Ovarian Cancer • Breast Cancer
  • 7. 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
  • 8. Change in smoking rates 15 year old boys and girls 1993/94 to 2009/10
  • 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
  • 11. Lung Cancer Incidence EU-27 women—2008 estimates
  • 12. Lung Cancer Incident & Mortality
  • 13. 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
  • 14. 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
  • 15. 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
  • 16. 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
  • 17. Creating a Female Market • Pack design to communicate brand image and glamour • Sophisticated marketing • 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
  • 21. 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
  • 22.
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  • 27. 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. • Legislate plain packaging - Australian example

Notes de l'éditeur

  1. On of the phenomena of the last 50 years is that smoking is increasing in women, most worrying is that smoking in young girls is increasing, in some countries Girls now out smoke Boys, with devastating consequences for their future health
  2. In the US lung cancer in women has grown to epidemic proportions. We could have seen it coming in Europe, but Tobacco control was mainly on the male smoker and not women.
  3. Smoking in young girls and women has dramatically increased since the 1990’s in 14 out of 26 EU countries girls outsmoke boys now.
  4. Speculation that hormones such as estrogen may directly or indirectly affect cancer growth Complex interaction between genetic, hormonal, behavioural and environmental factors Lung cancer in women is little understood, was considered a man’s disease, but now overtakes death from breast cancer in Ireland, Poland and UK We see a similar picture in CVD, used to be considered a male domain, but now women die of CVD too and it appears smoking women have a higher risk of CVD than smoking men.
  5. Lung cancer is deadly. Women tend to get lung cancer at an earlier age than men and the disease is striking more younger women who have NEVER SMOKED Danger of passive smoking for women Study published in the journal Annals of Oncology on 13 Feb 2013 raises alarm Within the next decade lung cancer is predicted to be the main cause of cancer deaths in European women, overtaking that breast cancer . Since 2009, the lung cancer death rate among women has increased 7 percent. An estimated 82,640 women will die from lung cancer this year compared to 88,886 from breast cancer - a very small gap.   

 Professor Carlo La Vecchia (MD), head of the Department of Epidemiology at the Mario Negri Institute, said:
  6. Shows that in Lung cancer death is almost inevitable. We are lacking reliable screening programmes.
  7. Active maternal smoking means passive smoking to the fetus
  8. Smoking patterns are different in women and men
  9. Focus on how females see themselves, social pressures they face, their aspirations and image
  10. Pack & Product Design for Women