2007 johns hopkins bloomberg school of public health women and tobacco natasha jategaonkar, msc...
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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
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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
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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.
Tobacco Patterns Are Changing
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†
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Text source: The Tobacco Atlas 2nd Edition. (2006); Image source: Lung Health Image Library. (2007). Permission granted for educational use.
Tobacco Patterns Are Changing
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
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Stages of the Tobacco Epidemic
Source: adapted by CTLT from Lopez, A.D., et al. (1994).
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Image sources: (bottom) Lung Health Image Library. (2007); (top) © ILO/Deloche, P.(2000). Permission granted for educational use.
How Tobacco Affects Women’s Lives
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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
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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
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Source: Greaves, L., et al. (2006).
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
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Source: Greaves, L., et al. (2006).
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
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Source: Greaves, L., et al. (2006).
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
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Source: Greaves, L., et al. (2006).
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
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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
Source: Greaves, L., et al. (2006).
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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†
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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
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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
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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†
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Image sources (left to right): Ruby Lane. (2007); Tobacco Documents Online. (1994). Permission granted for educational use.
Women, Tobacco, and Sales and Marketing
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Image sources: (left) Tobacco Documents Online. (1996); (right) Trinkets & Trash. (2007). Permission granted for educational use.
Women, Tobacco, and Sales and Marketing
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Image sources (left to right): Rediff.com. (2004); Campaign for Tobacco Free Kids. (1999). Permission granted for educational use.
Women, Tobacco, and Sales and Marketing
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Images source: Campaign for Tobacco Free Kids. (2004). Permission granted for educational use.
Women, Tobacco, and Sales and Marketing
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Image source: Wen, et al. (2005).
Women, Tobacco, and Sales and Marketing
Women’s bodies are often exploited to sell tobacco products
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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
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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).
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Source: Greaves, L., et al. (2006).
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
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Source: Greaves, L., et al. (2006).
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
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Source: Greaves, L., et al. (2006).
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
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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