Tobacco Advertisements Targeted on Women
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Cent Eur J Public Health 2011; 19 (2): 73–78 TOBACCO ADVERTISEMENTS TARGETED ON WOMEN: CREATING AN AWARENESS AMONG WOMEN Dorota Kaleta1, Bukola Usidame1, Kinga Polańska2 1Department of Preventive Medicine, Medical University, Łódź, Poland 2Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Łódź, Poland SUMMARY It has been always believed that men smoke more than women, but the trend of smoking in women is increasing nowadays. In some countries there are even more female smokers than male smokers. This is a major health risk because women are present and future mothers, and increasing number of smoking women will enlarge the number of exposed children. Relatively few women are aware of gender-specific health risks, including cervical cancer, osteoporosis, poor pregnancy outcome and early menopause. Tobacco related diseases are on the rise in women, considering the fact that more women now die of lung cancer than breast cancer. Tobacco companies have invented various ways to target women through tobacco advertising despite the various bans. This inevitably leads to the increase in female smoking rates. There are various recommendations from the World Health Organization which include the need for governments to pay particular attention to protect women from the tobacco companies’ at- tempts to lure them into lifetimes of nicotine dependence and to take up counter advertisements against the tobacco companies. Key words: tobacco advertisements, women, smoking, World Health Organization Address for correspondence: D. Kaleta, Department of Preventive Medicine, Medical University, Żeligowskiego 7/9, 90-752 Łódź, Poland. E-mail: [email protected] INTRODUCTION in Poland, in 2007, indicated that 23% of women smoked daily, 3% were occasional smokers, 10% were former smokers and 64% The global prevalence of tobacco use is substantially higher never smoked (5). Additionally, data from 2000 indicated that in men (47%) than in women (12%), reflecting the traditionally tobacco-smoking has caused 69,000 deaths in Poland of which low prevalence of female smoking in many developing countries. 12,000 (17.4%) were in women and 6,000 (50%) of them were However, the tobacco industry has targeted women in promotional premature deaths (at age 35–69 years) (5–6). In the early 1980s, strategies, calculating that the large population of women who the frequency of smoking increased particularly among women, do not use tobacco represent a vast untapped market for tobacco to about 30% for daily smokers, driven, among other things, by (1). According to the World Health Organization (WHO), women the introduction of cigarette vouchers and the rationing of tobacco comprise about 20% of the world's more than 1 billion smokers. products. In 1982, the percentage of smokers was the highest in the The female population in developing countries will rise from country’s history and one of the highest in Europe. That percentage the present 2.5 to 3.5 billion by 2025, so even if the prevalence reached 70% among young and middle-aged men, and 50% in remains low, the absolute numbers of women smokers will in- similar-aged women (5). Between 1990 and 1998, the percentage crease. This makes women a target group for the tobacco industry of girls smoking cigarettes increased among 13-year-olds from (2). About 250 million women in the world are daily smokers 3% to 10% and among 15-year-olds from 16% to 28%. It seems (about 22% of women in developed countries and 9% of women that the phenomenon was at least partially related to the mass in developing countries). In addition, many women in south Asia advertising of cigarettes aimed primarily at adolescent girls and chew tobacco. Cigarette smoking among women is declining in young women (5). In the 1990s, social acceptance of smoking many developed countries, notably Australia, Canada, the UK noticeably lessened. Comparative international studies conducted and the USA, but this trend is not found in all of those countries. in Poland and EU countries showed that in the late 1990s the In several southern, central and eastern European countries ciga- social climate against smoking in Poland was the strongest in Eu- rette smoking is either still increasing among women or has not rope. The change in attitude towards smoking was stimulated by shown any decline (3). Additionally in some Nordic and western population-based public awareness campaigns, smoking cessation European countries there is little or no difference between male programmes, effective enforcement of comprehensive tobacco and female smoking rates or as it is in Sweden the percentages control legislation and the launch of a government programme of daily smokers (among age group 16–84 years) is even higher aimed at reducing smoking and its health consequence. The among women than men (16% vs. 12% in 2007) (4). number of people who gave up smoking went into millions and Table 1 presents data of daily cigarette smoking for selected a clear fall in smoking incidence among smokers of both sexes European countries. The results of a national survey conducted was observed (5). Among men, the fall in percentage of daily 73 smokers occurred in all age groups (from around 60% in 1982 Table 1. Comparison of daily cigarette smoking in selected to 40% in 2000–2004), reaching among all men approximately European countries (data sources: WHO Report on the Global 1% annual rate of decline. Among women the highest decline in Tobacco Epidemic, 2009) incidence of daily smoking occurred in the youngest age group % of daily tobacco smokers (20–29 years: from 50% to 25%). Subsequent surveys in 2002 Country (year) women men and 2006, conducted after the enforcement of a complete ban on advertising, promotion and sponsorship of tobacco products, show Austria (2004) 35.5 40.2 that smoking prevalence among girls leveled off and subsequently Czech Republic (2008) 19.3 26.1 began to fall (6–7). Germany (2005) 18.8 27.9 On the other hand, smoking trends in Ukraine has been ob- Greece (2002) 39.0 47.4 served to be increasing in recent years despite the fact that the Hungary (2003) 27.7 38.6 public and the authorities have become more aware of the harm related to tobacco and the need for tobacco control measures. In Poland (2007) 23.0 34.0 2005, the Law of Ukraine on Measures to Prevent and Reduce the Slovakia (2003) 14.3 32.8 Use of Tobacco Products and their Harmful Impact on the Health Sweden (2007) 16.0 12.0 of the Population was adopted (called “The tobacco control law”). Ukraine (2005) 16.7 62.3 In 2006, Ukraine ratified the WHO Framework Convention on Tobacco Control (WHO FCTC), which is a binding international agreement (8–9). The cross-sectional surveys conducted in all regions of the country found a considerable increase in smoking new young employees for tobacco business (job fairs, etc.) and prevalence between 2001 and 2005 (9). In Ukraine an average of charitable events for handicapped people (11–12). additional 1.5–2% of adult women (aged 15+ years) and 3–4% According to the data from the Czech Smoking Prevalence of adult men were taking up smoking each year. In a survey done Survey (2008) in the Czech Republic, daily tobacco smoking was in 2001 (18+) with a sample size of about 2000 people, 31% of declared by 22.6% of the population (age group 15+ years) and by them were smokers and 10% where female smokers. 19% of women (4). Additionally, it is important to notice that there Another survey done in 2005 (including children from age has been a decrease of about 36% in cigarette consumption from 15–17 years) indicated that 41% of the population was current 1993 until now. In Austria, in 2004, 47% of the adult population smokers and 20% was female current smokers. The smoking was current smokers, and the same percentage corresponded to prevalence in women aged >18 years increased from 4.9% of the female adult current smokers. Very high percentages of female population (18.8% of total smokers) in the year 2000 to 6.4% in current smokers were also indicated in Greece and Hungary (40% the year 2006 (23.3 of total smokers) (9–10). The upward trend and 31% respectively) (4). In Germany, those percentages were in smoking prevalence has been linked to the simultaneous fall lower (27% for total population and 22% for women) (4). About in the real prices of cigarettes. The characteristics of the tobacco 8 out of every 75 deaths in Germany are attributed to smoking epidemic among Ukrainian women suggest that it may be related related diseases for women between the age of 35–69. For women to the processes of emancipation and social improvement. Women over the age of 70, eighteen out of every 369 deaths are attributed are more likely to smoke if they are young, live in large cities to smoking related diseases (10, 13). Ban on tobacco smoking in and have a university education. The epidemic is, however, now Germany is placed in just a few measures including advertising spreading more widely: women in older age groups and those to certain audiences and smoking on buses (8). living in smaller settlements are showing increasing trends Contrary to the belief that almost everyone is aware of the towards becoming smokers, although a university education health risks associated with tobacco, one British survey found that remains associated with the highest risk of smoking uptake. The nearly 99% of women did not know of the link between smoking epidemiological study conducted by the Institute of Cardiology and cervical cancer. Another survey found that 60% of Chinese of Academy of Medical Sciences of Ukraine revealed that within adults did not know that smoking can cause lung cancer while the last 25 years, the smoking rate among women increased 3-fold 96% were unaware it can cause heart disease (14, 15, 16).