Women and tobacco: a fatal attraction

563 Editorials Bull World Health Organ 2010;88:563 | doi:10.2471/BLT.10.080747 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) re- port Women and health: today’s evidence, tomorrow’s agenda also points to evidence that tobacco advertising increasingly tar- gets 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 empha- sis 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 target- ed by the tobacco industry, various images and themes have been used to encourage women smoking, by promoting its social acceptability and to highlight the sup- posed 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 suc- cess, health and freshness, emancipation and, last but not least, being slim. Almost the same marketing tech- niques 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 wom- en 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 pro- motional 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 espe- cially to women and girls. The cigarette pack and specially for- mulated cigarettes (“light”, “slim”, “super- slim”) are prime methods of targeting the female market. For example, around 100 special women’s brands have been intro- duced 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 to- bacco industry. It is essential that health authorities are sensitive to gender when formulating and implementing tobacco control policies. The solution of the prob- lem of women’s tobacco use is the same as for men: the strict implementation of the WHO Framework Convention on To- bacco 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 pre- amble 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 con- tribution that nongovernmental organi- zations, including women’s groups, make to national and international tobacco control efforts. These concerns are later reflected in the guiding principles (Ar- ticle 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 ad- vertising, 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 de- veloping 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]. Women and tobacco: a fatal attraction Margaretha Haglunda a National Institute of Public Health, Forskarens väg 3, Stockholm, SE103-52, Sweden. Correspondence to Margaretha Haglund (e-mail: margaretha.haglund@fhi.se).