clash of discourses feminism and tobacco...

WOMEN’S HEALTH JOURNAL 1/2010 • Latin American and Caribbean Women’s Health Network 13

O P I N I O NCLASH OF DISCOURSES

Feminism andTobacco Controlby Lezak Shallat

Lezak Shallat is a U.S. journalist based in Chile. She is the formereditor of LACWHN’s Women’s Health Journal (the English versionof the Revista Mujer Salud) and has led a number of projects ontobacco control from a gender-based perspective in collaborationwith the Fundación EPES (Santiago, Chile), the American CancerSociety and the Framework Convention Alliance.

14 WOMEN’S HEALTH JOURNAL 1/2010 • Latin American and Caribbean Women’s Health Network

“Gender and Tobacco” was thetheme of World No Tobacco Day,celebrated on May 31, 2010. ThisWorld Health Organization campaignprovided us with an excellentoccasion to reflect on an underlyingissue: the lack of an alliancebetween the women’s health andtobacco control movements toaddress high smoking rates amongwomen in one of the heaviestsmoking populations in theAmericas: Chile.

This year, the campaign placedspecial emphasis on the marketingof cigarettes to women, a subjectamply addressed by both thetobacco control and women’s healthmovements from a gender perspec-tive. For the feminist movement, therejection of sexist advertising –women portrayed as sex objectswith enforced standards of beauty(young, slender and sexy) – is aneverending battle.

From the tobacco control movement,there is ongoing denunciation of theways that cigarettes are promotedas a symbol of women’s liberation,autonomy and gender equality.These perspectives are an exampleof the interrelated concerns of thetwo movements.

At first glance, one might not expectto find contradictions between thesetwo movements on the issue ofsafeguarding women’s healththrough advocacy for better tobaccocontrol. On the contrary, one wouldexpect to find a collaborative effort,shoulder to shoulder, to confronttobacco use. In addition to health,the two movements share verybroad common objectives, such asthe creation of more healthysocieties where justice, equality anddemocratic participation prevail. Itmay be hard for feminists to discernthis fundamental element among thetobacco control movement’s goals,

but behind the barrage of NOSMOKING notices, it is there.

Helping women shake tobaccoabuse is part of the broader struggleto free women from the injustices oftheir daily lives, of the exhaustingdouble and triple workloads thatdrive them to seek a moment’srelaxation with a smoke. And thestruggle against the tobaccoindustry’s abuse of its corporatepower is part of the broader chal-lenge to the dominant model ofglobalization where all our demandscome into play.

But something happens betweenfeminists and anti-tobacco groupsthat is keeping these shared aimshidden from view. How many timeshave we attended meetings on HIV/AIDS or access to legal abortiononly to be reminded that, in Chile atleast, clouds of tobacco smoke takemany more lives than AIDS andmaternal deaths combined? Accord-ing to a study published in 2009 (seethe sidebar on p. 18), six out of theten main causes of death for Chileanwomen are associated with smoking.At the global level, tobacco is thekey factor in preventable deaths.

Cigarettes pose a blind spot forfeminists. The typical explanation isthat “we all smoke.” While this isobviously not the case, it does havean element of truth. Many Chileanwomen smoke, and the greatestconcentration of women smokers isamong university students andhealth professionals. As a result,many movement leaders arereluctant to promote tobacco controlbecause they do not see themselvesas legitimate agents of change whoare practicing what they preach. Asone seasoned clean air activist putit, “No one comes to hear mypresentations. Smokers aren’tinterested because they smoke.Non-smokers aren’t interestedbecause they don’t smoke.”

As a general rule, tobacco is absentfrom the Latin American feministhealth agenda on rights and politicalparticipation. And, for its part, the


regional tobacco control movementdoes not include many feministgroups among its active members ormany organizations devoted mainlyto women’s health. This chasmbecame apparent in a surveyconducted in Chile by the EPESFoundation and which was subse-quently repeated by other organiza-tions in Argentina and Brazil. Thereis a great deal of mutual ignoranceregarding the priorities, interests,instruments, strategic mechanismsand campaigns of each respectivemovement. As a consequence, thereis a lack of engagement thatweakens both. For example, thesurvey indicated that feminist healthleaders are unaware of the Frame-work Convention on Tobacco Control(FCTC), despite the fact that it is aninternational public health instrumentthat establishes precedents thatcould serve to strengthen regionalregulatory frameworks in issues atthe center of the feminist agenda,such as eradication of violence and

the protection of reproductive rights.Tobacco control activists (even thosewith a special interest in women), onthe other hand, tend to be unawareof mechanisms for gender equalityoperating in health and other areas(i.e., women’s political participation,education, anti-discrimination) thatare in place, both in their owncountries and internationally.

Language: Yes but No

There is one point in particular uponwhich the dialogue between the twomovements flounders. It is located atthe intersection of the discoursesand vocabularies that express basicconcepts of each movement. It is alinguistic terrain that constitutes anideological barrier that impedes jointaction towards common goals.

The sidebar on this page provides asummary of some of the reserva-tions of feminists with respect to thetobacco control discourse.

Cigarettes as a Symbol ofAutonomy and Equality

• A right “won” in the 1950s.

• Symbol of equality with men.

• Difficult to retreat from a“victory” in the quest for theright to greater autonomy.

Ideological Reservations

• “Nobody tells me what to do withmy body.”

• Tobacco control is a newfundamentalism.

• “What takes place in privateamong consenting adults is noone else’s business.”

• Tobacco lies outside the nexusin which the relations of powerare expressed.

Social Context

• Smoking as a symbol of rebellion,subversion of authority.

• Women’s rights activistsas fighters, challenging conven-tional norms.

Tobacco, Mental Healthand Gender

• Tobacco is associated withpleasure, socializing.

• Smoking is a coping mechanism,a response to anxiety, stress, etc.

• Why deprive women of thissource of comfort and pleasure?

Activists Who Smoke

• Perception of inconsistency inworking on tobacco control issues.

• An obstacle to addressing theissue of tobacco more fully.

Messages Not Well Received

• Exclusive focus on women in theirreproductive role (i.e., tobacco isharmful to baby’s health).

• Control, prohibitions, bans.

• Terror campaigns, scare tactics.

• Guilt-inducing.

• Failure to address women’sspecific concerns.

Summary of the results of the survey “A dialogue for understanding and action,” Fundación EPES, 2007. For more information, visitthe Website: http://www.epes.cl/htm/nofuman.html.


From the feminist discourse, thesepoints rest on fundamental postu-lates of feminism, including: the rightto exercise control over one’s body;the right to autonomy; the inviolabil-ity of private conduct betweenconsenting adults when these do notcause harm; the critique of healthpolicies focusing exclusively onwomen’s health from their reproduc-tive functions and/or role as guard-ians of family health; and the critiqueof biomedical health models thatignore the psycho-social contexts ofwomen’s lives and health. Theserest upon the underlying recognitionand rejection of patriarchy as ahierarchical system that exercises

power (sexual, economic, social andcultural), authority and control.

The Issue of Control

It is here that we find one of theknots of contention. For the tobaccocontrol movement, the use of theword “control” encompasses anentire strategy to focus its discourseon the product – tobacco, tobaccoindustries, marketing, sale and use –and not on the people (smokers)who use tobacco. The tobaccocontrol movement does not see itselfchiefly as a movement “against”tobacco, but as a movement in favorof clean air and smoke-free areas,supporting the health of non-smokers. It is a “pro-control”movement seeking to control anindustry, a product, a system ofcommercialization, an addiction, aharmful activity that is often fatal.Within the movement, there is notalk of “anti-tobacco” measuresor policies. This abbreviatedterminology is reserved for headlinesand journalists.

Among feminists, on the other hand,the word “control” causes discom-fort. It is located at the opposite endof the spectrum from autonomy, theright to do with one’s body whateverone wants. Freedom and self-determination arise from theabsence of controls imposed byothers. The discourses clash. But ifwe look behind the words, we findmany considerations – informedconsent, self-care and empathy forothers – that make it possible tosteer these two apparently conflictingapproaches towards a shared aim.

The same applies to the concept of“autonomy.” It is an aspiration ofmodern women, recognized as suchby the feminist movement andpromoted as the right to decide foroneself about work, education,reproductive life and more.For this very reason, the tobaccoindustry has manipulated thenotion of autonomy as a concept tosell cigarettes.

“Women and Tobacco: A NewIssue on the Feminist Agenda” isthe title of a study by the RedeFeminista de Saúde, DireitosSexuais e Direitos Reproductivos(Feminist Network for Health,Sexual Rights and ReproductiveRights) in Brazil in 2009, in alliancewith the NGO Coletivo FemininoPlural (Plural Feminine Collective)and the support of the Alianza parael Control de Tabaco (ACT,Alliance for the Control of To-bacco), with technical guidance ofthe Núcleo Interdisciplinar deEstudos sobre Mulher e Gênero(Interdisciplinary Studies Group onWomen and Gender) at theFederal University of Rio Grandedo Sul.

The main goal of the project,based on the results of a participa-tory diagnostic assessment carriedout throughout Brazil by theregional offices and focal points ofRedeSaúde, was to incorporate itsmembers and the Brazilianwomen’s movement into tobaccocontrol advocacy, by focusing onthe effects of tobacco addiction onwomen’s health.

The following specific goals havebeen set: the need to identifyexperiences in the use of tobaccoin the daily lives of members; toidentify the effects that it has hadon their organization; and at thesame time, to carry out actions toraise social awareness and fosterpublic policies to move towardstobacco control in Brazil inaccordance with the challenges setforth in the Framework Conventionon Tobacco Control of the WorldHealth Organization.

The researchers responsible forthe study were: Jussara Reis Prá,Coordinator of the Inter-disciplinaryStudies Group on Women andGender, UFRGS; Telia Negrão andMaria Luisa Pereira de Oliveira,Adjunct Executive Secretary ofRedeSaúde, project coordinators;and Neusa Heinzelmann,Health Consultant for the projectand a member of the ColetivoFeminino Plural.

For more information:http://www.redesaude.org.br

Brazil: Participatory Researchon Women & Tobacco


Activists and Smokers

The women’s health movement inChile approaches tobacco controlfrom a specific context and historicagenda. Forged, to a certain degree,in the battle against the militarydictatorship, the women’s movementhas achieved many political victoriesand social advances. Its agendafocuses on three major goals:eliminate violence against women;promote reproductive and sexualrights and health (and especiallyaccess to legal, safe abortion); andpromote gender equality andwomen’s political participation. It is amovement that raises its voice,takes to the streets, challengesauthority and conducts a sophisti-cated monitoring from civil society ofgovernmental action on commit-ments to advance women’s rightsand health. It wears a mantle ofmystique: the combative, progres-sive woman, questioning, transgres-sive, battle-hardened, gesticulating

with a cigarette like Che Guevara. Itis a challenge to incorporate thiswoman into campaigns forsmoking prevention, smoke-freeareas and other tobacco controladvocacy issues.

Building Bridges

Although there are many gaps inresearch, we do not lack informationon the impact of tobacco on wom-en’s health. What we are lacking isfor women’s health advocates tomake the issue their own. Withouttheir participation, neither govern-ments nor citizen and social move-ments can stop the tobacco epi-demic. In Chile, EPES Foundationhas promoted dialogue with wom-en’s health and rights leaders byholding a national meeting toaddress obstacles and synergiesand by conducting several projectsthat look at tobacco use from agender perspective. The results arepromising but not immediate. The

historic and current agendas ofwomen’s organizations are notnegotiable or easy to shift, especiallywhen there are no resources tosupport incorporation of new issues,campaigns or activities. And politicalcircumstances also take a toll: theimpetus EPES triggered with anational meeting of women’s healthadvocates nearly collapsed com-pletely when, weeks later, themovement faced a major politicalsetback to provision of emergencycontraceptives that demandedthe movement’s full attention formany months.

Nevertheless, the cause movesforward. In Argentina, the FundaciónInteramericana del Corazón (Inter-American Heart Foundation) hasmade an alliance with the Fundaciónde Estudio e Investigación de laMujer (FEIM, Foundation for Studyand Research on Women) andCanadian tobacco control advocatesto foster a gender perspective in

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The consequences of this phe-nomenon are dramatic if we recallthat six of the ten principal causesof death for Chilean women areassociated with tobacco use. Themortality of the Chilean populationattributable to tobacco hasincreased steadily from 1985 to2005. In contrast to Europe,Canada and the United States,tobacco use has remained high forthe last 20 years in Chile.

• Mujer y Tabaco, FundaciónEPES: http://www.epes.cl/htm/nofuman.html

• “World No Tobacco Day” inFacebook: www.facebook.com

• Campaña No Tabaco blog:http://notabaco.blogspot.com

• INWAT Latinamericano y delCaribe: http://inwatlack.blogspot.com/ (and also on Facebook)

Chile: Highest Smoking Ratesfor Women in Latin America

Chile has one of the highest ratesof tobacco use among women inLatin America and the world.Various studies have demon-strated the striking increase in theprevalence of women’s use oftobacco over the past 30 years,which has gone from 25% from themid-to-late 1980s to around 40%today. The prospects for reducingthese high rates of smoking arenot promising, particularly consid-ering that the population ofadolescent women in Chile alsopresents one of the highest levelsof tobacco use in the world.

tobacco policy. And in Brazil, ACTBrhas funded feminist groups to look atgender and tobacco. One product ofthis research is the new study“Women and Tobacco Use: A NewIssue on the Feminist Agenda”(November 2009) of the RedeFeminista de Saúde, DireitosSexuais e Direitos Reprodutivos.

At the regional level, the Interna-tional Network of Women againstTobacco has a Latin America/Caribbean branch for informationand exchange among tobaccocontrol advocates interested inwomen’s issues from a genderperspective. The going is slow, butwe are beginning to see a conver-gence of issues and activists. To theextent that the women’s healthmovement and the tobacco controlmovement in Latin America canovercome their misconceptionsabout one another and harmonizetheir discourses, women’s healthwill benefit.◆

Source: Klaus Puschel, et al., “Factores predictores de inicio y cesación detabaquismo en una cohorte de mujeres chilenas con 5.5 años de seguimiento,”Revista Médica de Chile, vol. 137, no. 8, August 2009.

For more information visitwww.epes.cl or write to:[email protected]

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