Presentation by Hildrun Sundseth (European Institute of Women's Health) on the occasion of the EESC hearing on Manufacture, presentation and sale of tobacco and related products (Brussels, 19 Feb 2013).
On of the phenomena of the last 50 years is that smoking is increasing in women, most worrying is that smoking in young girls is increasing, in some countries Girls now out smoke Boys, with devastating consequences for their future health
In the US lung cancer in women has grown to epidemic proportions. We could have seen it coming in Europe, but Tobacco control was mainly on the male smoker and not women.
Smoking in young girls and women has dramatically increased since the 1990’s in 14 out of 26 EU countries girls outsmoke boys now.
Speculation that hormones such as estrogen may directly or indirectly affect cancer growth Complex interaction between genetic, hormonal, behavioural and environmental factors Lung cancer in women is little understood, was considered a man’s disease, but now overtakes death from breast cancer in Ireland, Poland and UK We see a similar picture in CVD, used to be considered a male domain, but now women die of CVD too and it appears smoking women have a higher risk of CVD than smoking men.
Lung cancer is deadly. Women tend to get lung cancer at an earlier age than men and the disease is striking more younger women who have NEVER SMOKED Danger of passive smoking for women Study published in the journal Annals of Oncology on 13 Feb 2013 raises alarm Within the next decade lung cancer is predicted to be the main cause of cancer deaths in European women, overtaking that breast cancer . Since 2009, the lung cancer death rate among women has increased 7 percent. An estimated 82,640 women will die from lung cancer this year compared to 88,886 from breast cancer - a very small gap. Professor Carlo La Vecchia (MD), head of the Department of Epidemiology at the Mario Negri Institute, said:
Shows that in Lung cancer death is almost inevitable. We are lacking reliable screening programmes.
Active maternal smoking means passive smoking to the fetus
Smoking patterns are different in women and men
Focus on how females see themselves, social pressures they face, their aspirations and image
Pack & Product Design for Women
Women's health and tobacco control
Women’s Health and tobacco ControlHildrun SundsethBoard MemberEuropean Institute of Women’s Health
About the EIWH• The European Institute of Women’s Health is a health NGO launched in 1996.• The EIWH aims to ensure a gender-sensitive approach to health policy, prevention, treatment, care and research in order to reduce health inequalities and improve quality.• Organisation: • Extensive multi-national, multi-disciplinary network of patient groups, health NGOs, researchers, gender experts, politicians, and medical professionals • Expert Advisory Board
Why Women’s Health?“The health of women has a directbearing on the health of the future generation, their families, and communities, and ultimately, the health of societies.”NIH Office of Research on Women’s Health, 2010 http://orwh.od.nih.gov/ORWH_Strategic-Plan_Vol_1_508.pdf
Smoking-Related Diseases in Women• Major risk factor for many chronic diseases• CVD including heart attack and stroke,• Cancers of the lung, larynx, oral cavity, and esophagus, colon, etc• Breast, cervical and ovarian cancer• Chronic bronchitis, asthma, emyphsema• COPD• Diabetes, Osteoporosis, etc
Reproductive Health• Infertility/Subfertility• Complications in pregnancy• Early Menopause• Cervical and Ovarian Cancer• Breast Cancer
Smoking Kills Women• Smoking is the single most important preventable cause of death in women• Killing half of the regular smokers• 12% of all female death between 35-69 years• Death rates reflect the trend of women taking up smoking 20 to 30 years ago• Full impact on women’s health still to come
Change in smoking rates 15 year old boys and girls1993/94 to 2009/10
Women Are Vulnerable• Faster addicted to nicotine and flavours• Women more susceptible to stress than men• Influence of hormones during menstrual cycle?• Afraid to gain weight if they stop smoking• Some evidence that women experience more severe withdrawal symptoms• Nicotine replacement less effective in women• Women more vulnerable to passive smoking, higher risk of lung cancer and CVD than in men
Lung Cancer IncidenceEU-27 women—2008 estimates
Smoking during Pregnancy• 11%-30% of pregnant women smoke or are exposed to tobacco smoke• Smoking & second hand smoke has a devastating effect on their children• Miscarriage, premature birth,• Birth defects• Sudden infant death, respiratory infections, wheezing, asthma, middle ear infection in their children• Smoking parents - role model for future smokers
FCTC - Women and Smoking• Recognises that Tobacco control has been gender-blind and ignored the social and cultural context• Calls for Tobacco Control strategies that are sensitive to gender and include women in policy making• Counteract Tobacco companies marketing that targets young girls and women
Socio-economic aspects of Smoking• Smoking women often disadvantaged • Poor education, low income, single mothers, lack of self- esteem• Anti-smoking initiatives need to take a gender- based approach• Special focus on poorer, socially disadvantaged, vulnerable groups• Effective tobacco control measure to target women are needed– Plain packaging
Tobacco IndustryTargets young girls and women• Women are an increasing new market• Sophistication, style, luxury• Romance and sex• Sociability, enjoyment, success• Emancipation, independence• Freshness and health• Slim and glamorous
Creating a Female Market• Pack design to communicate brand image and glamour• Sophisticated marketing• Sponsorship of sports and arts• Point of sale promotional material• Distribution of free products • Germany at political party conferences• Brand stretching• Paid placement of cigarette brands in films, television• Points of sale near schools, supermarkets• Smoking in films
Appealing to Women• Brands come in a variety of flavours that appeal to girls and women • Mint/menthol, Fruit, Vanillia, Chocolate flavours• Makes starting smoking more palatable to young girls• SNUS traditionally used by older men, but • now new forms of SNUS, attractively packaged, cranberry and rhubarb flavour
Recommendations• Make tobacco control gender-sensitive & gender- specific• Policy needs to be backed by support measures that address the socio-cultural environment• Help young girls to resist pressures to start smoking and women to quit through social media• Create social, economic and political climate that promotes non-smoking as the norm• Reduce countries economic dependence on the production, manufacture and sale of tobacco.• Legislate plain packaging - Australian example