Protecting Women from Dangerous Tobacco Products
Sally Cowal
Sr. VP, Global Cancer Control, American Cancer Society
Karen M. Wilson, MD, MPH, FAAP
Chair, American Academy of Pediatrics Tobacco Consortium
The AAP and ACS co-chair the Taskforce on Women and Non-Communicable Diseases.
Big Tobacco spends astronomical amounts of money on the marketing of their deadly products — close to a million dollars per hour, in the United States alone, to be exact. From association of smoking with enhanced virility, to point-of-sale tactics placing products at children eye-level, inches away from candy displays, the tobacco industry continues to aggressively market its products.
Perhaps highest on its marketing target list these days are women and girls, a demographic that currently constitutes 18 percent of all smokers. Already, 165 million women and girls already smoke. However, it’s those who don’t smoke that are now seen as an enormous, untapped market. The industry’s marketing tactics to reach these women and girls are characteristically unscrupulous. Governments, guided by the public health community, need to immediately organize a smart and effective response.
The time to act is now, because the number of young girls smoking across the globe is already growing. There are now at least 10.5 million girls under the age of 20 who smoke. That’s about 30 percent of all the kids who smoke, far outpacing the 18 percent of all smokers who are women. Women’s smoking rates are catching up with men’s: in six countries, women now smoke more than men[1]. More concerning, there are 16 countries in which girls under the age of 20 smoke more than boys of the same age[2]. It’s no wonder: everywhere you look, packs embellished with floral prints or cute animals, watermelon and chocolate-flavored cigarettes, and heart-shaped filters are hitting the shelves. And, more importantly, in many parts of the world, fast economic growth and increasing disposable incomes are making tobacco products increasingly affordable — too easy to buy — in particular for young women and girls.
There is no reason why tobacco products should be easily affordable and therein lies a key solution to counteract the aggressive, targeted marketing campaigns led by the industry. We can — and should — use excise taxes to make tobacco products less affordable. When prices go up, people buy fewer tobacco products. Smokers either stop smoking or reduce the amount that they smoke. Many nonsmoking youths never start to begin with. Regular and significant tobacco tax increases would do a lot to prevent girls from starting to smoke, and to motivate female smokers to quit. Yet, in most countries, despite the mountain of evidence showing the clear value of tobacco taxes, they are not optimally implemented. In fact, a recent study assessing the impact of a range of tobacco control policies on reductions in tobacco use over the last ten years showed that our gains could have been much more significant if tobacco tax increases had been the subject of stronger implementation efforts[3].
If those are the statistics today, can you imagine what they will be in 25 years? If we don’t turn the tide, this increase in female smoking across the globe will lead to grave health and economic outcomes. The situation is already dire: 6.3 million people die from tobacco use each year, mostly from noncommunicable diseases (NCDs) such as cardiovascular disease, chronic respiratory disease, cancer and diabetes. Almost two million of those deaths occur among women.
The Taskforce on Women and NCDs was created to address this issue around the globe, supporting a group of 14 global health organizations from the women’s health and NCD communities to respond to the unique and growing burden of NCDs on women in low- and middle-income countries. In practical terms, this means expanding our technical assistance and informing good policymaking to control the rise in NCDs. Good policy MUST include higher tobacco taxes, and our organizations are taking action.
The cancer community is already taking on tobacco tax increases as a key prevention policy. Cancer causes approximately a quarter of all tobacco-related NCD deaths, and tobacco-related cancers are responsible for 12 percent of all cancer deaths among women. In response, over 30 cancer and like-minded organizations from all continents, including the American Cancer Society, have joined forces to launch the Prevent20 Coalition* to promote the use of tobacco taxes as a cancer prevention strategy and more are joining each day. Last week in Geneva, the NCD community was out in full support of a World Health Assembly cancer resolution that included tobacco taxation. These are a couple examples of the growing efforts to make tobacco tax a priority in the NCD community but we must continue to use our collective voice to keep this critical policy intervention at the forefront of our prevention efforts.
*For more information about the toll of tobacco worldwide, the value of increased tobacco taxation, or the Prevent20 mission, visit www.wecanprevent20.org.
[1] Iceland, Ireland, Sweden, Northern Ireland, Scotland, Wales.
[2] Bulgaria, Czech Republic, Hungary, Slovenia , Australia , Andorra , Denmark , Finland , Iceland , Ireland, Norway , Spain , Sweden , United Kingdom , Canada , and the Virgin Islands.
[3] Gravely, S. et al. (2017) Implementation of key demand-reduction measures of the WHO Framework Convention on Tobacco Control and change in smoking prevalence in 126 countries: an association study. The Lancet Public Health. 2. e166–74. http://dx.doi.org/10.1016/S2468-2667(17)30045-2
