TOBACCO REDUCTION WOMEN AND TOBACCO By Colette Vidal [Cigarettes] [Reasons Women Smoke] [Smoking and Pregnancy] [Environment Tobacco Smoke (E.T.S)] [Other Women Specific Issues] [Bibliography]   CIGARETTES Widespread use of tobacco among Canadian women is relatively recent. It is only in the last sixty years that cigarettes - the main tobacco product used by women - have become popular. In the 1920's, it was considered "bad" or " immoral" for a woman to smoke. However, as attitudes changed, advertising caught up quickly and linked cigarettes to women's emancipation. Moreover, the development of an increasing variety of cigarettes (low tar, "light", filter, mild, slim) contributed to getting many more young girls to smoke. Linking cigarette smoking to health, slimness, attractiveness also helped sales of cigarettes to women in the 1970's when the male cigarette market began sagging. It is clear that tobacco companies are trying hard to maintain profits by focusing their advertising campaigns on the most vulnerable groups: the poor, youth, the oppressed. In many cases, women belong to all of these groups. Certainly, many Native women do and accordingly, they tend to smoke twice as much as non-Native women. Worse still, teenage girls have higher smoking rates than boys and this applies to Natives and non-Natives alike. Finally, while the smoking rates for men have I declined drastically since 1966, women's rates have been reduced only slightly, suggesting that women are not responding as well as men to non-smoking and health campaign messages. If this trend is not reversed, women, and especially young women, will smoke more than any other group.   REASONS WOMEN SMOKE Both men and women who become addicted to nicotine start smoking in their teens4 or earlier. Most teenagers pick up the cigarette habit because of peer pressure I wanting to be part of the crowd, and to "be grown-up". Equally important is the influence of role models including parents and siblings who smoke. According to statistics1, living with a smoker increases the chances of being one. When children are raised in a smoking environment, they become accustomed to the smoke, the smoking behaviour, and see it as normal. Research shows that mothers who smoke have the most influence on their young daughters. Apart from the general reasons outlined above, girls also pick up smoking because they are sensitive to tobacco companies advertising which depicts smoking as sexy, mature and liberated as well as a means of staying slim at an age when all of these factors are important. The fight put up by the industry against the cigarette advertising ban in Canada is testimony to the effectiveness of advertising in keeping profits high. With the recent lifting of that ban, children and teenagers will again be bombarded by ads extolling the attractiveness of smoking. The use of cigarette brand names to sponsor sports and cultural events is also part of the same strategy which links fun, health and entertainment to smoking and targets the most profitable long-term market, youth. In fact, the very packaging of cigarettes is geared to specific groups and includes such "gimmicks" as scratch and sniff1 strips, and promotional materials such as free lighters, cosmetic mirrors, cigarette pouches, etc.all of which are designed to appeal to young women and even to children. Whereas the influence of role models, parents and peers seems to be the main factor,in causing children and teenagers to start smoking, persistence of the habit is linked to other elements. Women as a group, and especially Native women, tend to be disadvantaged. Smoking is cross-culturally more prevalent among the poor, the least educated and the unemployed. It is, in a sense, the easiest form of relaxation for those who can hardly afford or have access to anything else. Cigarettes become a way of coping with stress, unhappiness, loneliness, low self-esteem, and boredom. In addition, when one is addicted to nicotine and lives in a household or a community where most people are smoking, it seems futile or impossible to quit. Given the socio-economic conditions prevailing in many Native communities, the high smoking rates found among Native people and Native women in particular, tie in with the findings that the least control one has over one's life, the more one smokes.   SMOKING & PREGNANCY Given that the highest rates3 of smoking are found in the 20 to 44 age group for both males and females and that in addition, Native teenage girls have higher rates than boys, this means that a very large number of childbearing Native women smoke putting themselves and their children (born or unborn) at risk. The potential consequences of smoking are particularly serious during pregnancy. When a pregnant woman smokes, carbon monoxide and nicotine are passed on to the baby affecting its heartbeat and decreasing its supply of oxygen. Maternal smoking during pregnancy increases the risk 8 of miscarriage, premature delivery, birth defects and stillbirths. Babies of smoking mothers tend to be of lower than average birthweight and are 2.5 to 4 times more likely to die of Sudden Infant Death Syndrome (S.I.D.S.). This latter risk increases with the number of cigarettes smoked by the mother and the number of smokers in the home. Babies breastfed by a smoking mother absorb4-8 nicotine and this can cause irritability, poor sleeping habits and crying and vomiting after nursing. In addition, because tobacco smoke impairs lung function, infants exposed to it are more subject to coughs, bronchitis and even pneumonia.   ENVIR0NMENT TOBACCO SMOKE (E.T.S) Environmental tobacco smoke or what is more often called sidestream smoke (S.S.) affects non-smokers who live in a home or work in a place where other people are smoking. Sidestream smoke contains1 higher concentrations of toxic compounds than mainstream smoke (M.S.) (that which is inhaled by the smoker). "Passive" smokers, many of whom are children, are in this way continuously exposed to nicotine, nitrosamins and a variety of other carcinogens. The level of these chemicals in the air will vary according to the number of smokers in the house, the intensity of smoking and the type of ventilation system used. In Native communities, where houses are often crowded and many people smoke, children breathe inordinate amounts of these poisonous gases. Research has shown that children of smoking parents are twice as likely to suffer from respiratory diseases such as asthma, bronchitis and pneumonia. They also are much more likely to become8-9 smokers themselves and run a greater risk of developing1 lung cancer later in life. With respect to lung cancer, studies have demonstrated that E.T.S. is responsible for a sizeable number of such cancers in non-smokers. Non-smoking spouses of smokers are about at a 34%1 increased risk compared to those married to non-smokers.   OTHER WOMEN SPECIFIC ISSUES Apart from the common hazards of smoking for both men and women, women face some gender specific problems. Cigarette smoking increases the risk of cardiovascular disease which includes heart attacks, strokes and hardening of the arteries. With the combination of smoking and oral contraceptives (the pill), this risk is 10-20 times higher than for non-smokers. Many types of cancer have been linked to smoking, with lung cancer being the most common. Women are now more likely to die of lung cancer than of breast cancer and Native women in the N.W.T. are particularly at risk because of the high rate of smoking in that part of the country. Other types of cancer on the increase among female smokers include kidney, bladder, pancreatic cancer and cancer of the cervix. Women who smoke tend4-9 to have more menstrual disorders, more difficulties to conceive and experience an earlier menopause. They are also at higher risk for osteoporosis (bone loss) and gum disease. Apart from the above risks, women experience gender specific problems when it comes to quitting. They often worry about their self-image and the weight gain that smoking cessation may bring. They also have difficulties quitting because of high levels of stress. Moreover, many of them, especially younger women, have been sold on the idea that low-tar "light" cigarettes are "safe" and may be less motivated to stop. Finally, isolation and the lack of social support often experienced by women increases the dependency on cigarettes and makes quitting appear too difficult or impossible. Yet, because women are key to improving the chances for healthy Native families and communities since they are the ones who bear and raise children, it is urgent that they be given the necessary knowledge and support to fight tobacco misuse. Women must be empowered to take care of their own health so they can in turn pass that gift onto their children. This is the direction prevention and cessation programs must take to ensure a brighter future.   Bibliography 1. Canadian Cancer Society, When a Woman Smokes, Booklet, 1993. 2. * Greaves, Lorraine, Taking Control - An Action Handbook on Woman and Tobacco, Break Free, Health & Welfare Canada, 1989. 3. * Greaves, Lorraine, Background Paper on Women and Tobacco (1987) and U12date (1990), Health & Welfare Canada, Minister of Supply & Services, 1990. 4. * Les Editions Communiqu'Elles, Women and Smoking:What's New?, Health & Welfare Canada, 1990. 5. Les Editions Communiqu'Elles, Women and Smoking, What's New?, Health & Welfare Canada, 1990. 6. Mitchell, E.A. et al., "Smoking and the Sudden Infant Death Syndrome" Pediatrics, Vol.. 91, No.5, May 1993:893-896. 7. National Research Council, Environmental Tobacco Smoke - Measuring Exposures and Assessing Health Effects, National Academy Press, Washington, D.C. 1986. 8. Pauktuutit Inuit Women's Association of Canada Inuit and Tobacco - Breathing Easy, A report under the National Inuit Tobacco Use Reduction Campaign, Ottawa, 1995. 9. * Union of Ontario Indians, NASAWIN, Health & Welfare Canada, Ontario 1992. 9. Women's Health Clinic, Catching our Breath - A journal about Change for Women who Smoke, Winnipeg, Manitoba, 1990. 10. Women's Health Clinic, Catching our Breath - A Journal about Change for Women who Smoke, Winnipeg, Manitoba, 1990. copyright © 1997 NIICHRO 05/01/98