EDITORIALS

Women and tobacco: a fatal attraction

Margaretha Haglund^*

National Institute of Public Health, Forskarens väg 3, Stockholm, SE103-52, Sweden

Today women comprise about 20% of the world's more than 1 billion smokers. It is also well documented that women are as vulnerable as men to the dangers of tobacco, if not more so. Both men and women who smoke are prone to cancer, heart disease and respiratory disease. Tobacco also causes additional female-specific cancers and compromises pregnancy and reproductive health. The World Health Organization's (WHO) report Women and health: today's evidence, tomorrow's agenda also points to evidence that tobacco advertising increasingly targets girls.¹ The magnitude of the impact of marketing by the industry is indisputable. This year's theme for World No Tobacco Day "Gender and tobacco with an emphasis on marketing to women" was therefore a timely choice.

Decades of history and experience with the tobacco industry's promotion practices clearly show that the industry has taken gender roles and norms into consideration in its market strategies for almost a century. Since the 1920s when American women first began to be targeted by the tobacco industry, various images and themes have been used to encourage women smoking, by promoting its social acceptability and to highlight the supposed desirable attributes of particular brands of cigarettes. Some of the most dominant themes that have been linked with smoking and particular cigarette brands are: glamour, sophistication and style, luxury, class and quality, romance and sex, sociability, enjoyment and success, health and freshness, emancipation and, last but not least, being slim.

Almost the same marketing techniques that have been used to promote smoking among women in developed countries are now being applied to women and girls in developing countries who don't have a history of cigarette smoking. The overall objective of any campaign from the tobacco industry targeting women is to make cigarettes more attractive.

When the "right" image of women smoking is created, the next phase of the industry's marketing strategy aims at expanding and stabilizing the market through the creation of "women only" brands with typical female characteristics.

Some of the promotional activities targeting women include: mass media advertising and sponsorship of cultural and sporting events; point-of-sale promotional material in shops and kiosks; free distribution of tobacco products; brand-stretching (i.e. marketing of other products such as clothing under tobacco brand names); internet promotions; the price and pack designs that appeal especially to women and girls.

The cigarette pack and specially formulated cigarettes ("light", "slim", "super-slim") are prime methods of targeting the female market. For example, around 100 special women's brands have been introduced to the Russian market, where they are promoted with images of glamour and fashion. At the same time, the prevalence of smoking among women in the Russian Federation is increasing rapidly.

It is time for the world to stand up against the fatal attractions of the tobacco industry. It is essential that health authorities are sensitive to gender when formulating and implementing tobacco control policies. The solution of the problem of women's tobacco use is the same as for men: the strict implementation of the WHO Framework Convention on Tobacco Control (FCTC).² In its preamble, the FCTC expresses alarm at the increase in tobacco use among women and girls and the gender-specific risks. The preamble also reinforces the need for women to participate in tobacco control policy-making and implementation at all levels, it calls for gender-specific tobacco control strategies; and emphasizes the special contribution that nongovernmental organizations, including women's groups, make to national and international tobacco control efforts. These concerns are later reflected in the guiding principles (Article 4.2.d) with a legitimate expectation that gender-specific risks should always be addressed when developing tobacco control strategies. The preamble and the guiding principles underpin the FCTC and must be read into all its substantive provisions. Of particular importance is the comprehensive ban on all forms of tobacco advertising, promotion and sponsorship, including cross-border advertising, promotion and sponsorship, standardized plain packaging and the ban of misleading health claims such as "light and low tar". Women and gender experts should be involved and consulted in developing gender-specific information and counter-advertising messages.

References

1. Women and health: today's evidence, tomorrow's agenda. Geneva: World Health Organization; 2009.         

2. Framework Convention on Tobacco Control. Geneva: World Health Organization; 2003. Available from: http://www.who.int/fctc/text_download/en/index.html [accessed 14 June 2010]          .

* Correspondence to Margaretha Haglund (e-mail: margaretha.haglund@fhi.se).