Are you a quitter? Go girl!

Tobacco-Free SC
9 min readMay 13, 2015

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PR Pioneer Edward Bernays developed marketing campaigns to remove the stigma of women’s smoking.

Tobacco and women, they go back. One of Big Tobacco’s most successful marketing efforts targeted women in the 1920's when Freud’s nephew, PR pioneer Edward Bernays, was hired to move society beyond the negative stigma of the smoking woman.

Bernays labeled cigarettes ‘torches of freedom’, sneeked two women with some Lucky Strike cigarettes into New York’s Fifth Avenue Easter Parade, and tipped off the press.

The strategy worked.

Today, lung cancer, caused largely by smoking, is the leading cause of cancer death amongst women far outpacing breast cancer.

Heart disease, for which smoking is a significant risk factor, is a leading cause of death in women.

And, smoking while pregnant and during motherhood is responsible for higher rates of premature birth, low birth-weight, SIDS, childhood asthma, obesity, heart disease, cancer and … more smokers.

The impact of women’s tobacco-use is deep, vast.

As with men, the impact on a woman’s health includes significantly increased risk of heart disease, multiple types of cancer, COPD, Type II Diabetes, age related dementia, and more.

Smoking also poses particular risks to a woman’s fertility, pregnancy, and the health of her children. These risks can impact a child throughout their life, even if the child never smokes. A woman’s smoking can change DNA in herself and future generations she may never meet (source).

This impact is emotionally, socially, and fiscally expensive. The Campaign for Tobacco-Free Kids reports that the healthcare costs for smoking- related illness in women in South Carolina is $693 million per year.

Much of this is paid for by publicly funded healthcare, such as Medicaid and Medicare.

But the full cost reaches beyond this. Women’s role as mothers means smoking’s damage is magnified throughout a family and into future generations.

Smoking and Fertility

Women who smoke are 60% more likely to be infertile than women who don’t smoke, and 42% more likely to experience delays in conception of over a year, says Judith Reichman, MD. (She references 12 relevant studies that included over 10,000 women who smoke and over 19,000 nonsmokers.) Treatments for infertility (IVF) are less effective for women who smoke. Chemicals in cigarettes also speed up the loss-rate of eggs resulting in earlier menopause.

Smoking, Pregnancy, & Motherhood — the numbers

Most women are aware that smoking during pregnancy can damage an unborn child, but many find it difficult to quit even in the face of that protective instinct.

A little more than 18% of women in South Carolina smoke. Fewer than half (45%) of U.S. women who smoke quit when they become pregnant, according to the CDC. Although much of the damage is done in the first trimester, mothers do keep trying to quit throughout their pregnancy. Only about 13% of U.S. women report smoking during the last 3 months of their pregnancy. However, after pregnancy, 52% of women who had quit during pregnancy relapse and begin smoking again.

What does that mean?

Pregnant women who smoke are twice as likely to experience complications.

According to the CDC, smoking during pregnancy increases risk:

  • that the amniotic sack will rupture or separate from the uterine wall.
  • of placenta previa, where the placenta covers the opening of the cervix.
  • of ectopic pregnancy.
  • of miscarriage and premature birth.

These conditions stress the fetus, sometimes to the point of death. They can also cause significant blood loss and risk to the health of the mother. They can create the need for a cesarean section. These and other complications can involve extended stays in infant ICU or hospital incubators.

Smoking during pregnancy increases the risk of birth defects and other conditions.

Smoking during pregnancy reduces the amount of oxygen delivered to the placenta, which reduces the oxygen the developing baby receives.

It delivers nicotine, a poisonous neurotoxin, and other toxic chemicals to the fetus at crucial stages negatively affecting the formation of a child’s nervous system and other organs.

Babies born to mothers who smoke are significantly more likely to be born:

  • with shortened or missing arms or legs, cleft palate and lip, and misshapen heads.
  • with birth defects involving gastrointestinal organs, heart disease, and undescended testicles.
  • with Cerebral Palsey or Down’s Syndrome.
  • to experience developmental delays and problems with hearing or eyesight.

They are more likely to be born with a low birth weight, increasing their risk of illness or death. They are up to three times more likely to die of SIDS (Sudden Infant Death Syndrome). (Source) (Source)(Source)

Smoking during pregnancy increases the likelihood that a child will experience breathing problems at birth and develop respiratory illness later in childhood, regardless of whether a woman stops smoking later. Studies show that it increases the risk that a child, or grandchild, will develop asthma, regardless whether a mother smokes after the child’s birth or not.

Smoking during pregnancy may increase a child’s risk of emotional or behavioral disorders in early childhood and school years, such as ADHD, aggressive behavior towards family members and playmates, destroying things, or breaking rules at school. Researchers believe this is a result of nicotine’s impact on the fetus’ brain.

Smoking during pregnancy appears to affect a child’s intellect. Researchers found an average of 15 IQ points in favor of women who did not smoke during pregnancy, leading them to surmise that smoking affects intellectual development of the baby.

Children of women who smoke experience a 50% higher risk of childhood obesity, according to a recent meta-analysis. Additional research has shown that teens who were exposed to cigarette smoke in the womb are more likely to develop abdominal obesity, a risk factor for cardiovascular disease, a risk factor for cardiovascular disease.

Secondhand Smoke Threatens Everyone …

Secondhand smoke contains all of the same toxic chemicals and carcinogens that primary smoke contains, without the benefit of filtering. The U.S. Surgeon General has said that there is no safe level of exposure to secondhand smoke.

Any woman exposed to secondhand smoke, pregnant or not, experiences increased risk of heart disease, cancer, respiratory illness, and age related dementia among other problems.

… including the unborn.

A mother’s exposure to secondhand smoke during pregnancy can make an unborn child more likely to miscarry, be born early, have low birth-weight, SIDS, and learning and behavioral difficulties. (Source)

Research is beginning to show that thirdhand smoke, the toxic residue that cigarette smoke leaves on clothes and surfaces, can affect prenatal lung development. Thirdhand smoke can remain on surfaces for years. A pregnant woman can ingest it by breathing and by touching it. Future research may reveal additional effects.

Secondhand Smoke Exposure Endangers Children

Children exposed to secondhand smoke in their home and cars are at increased risk for a multitude of conditions and illnesses including:

  • SIDS — Children exposed to cigarette smoke pre-natally and after birth are more likely to die from Sudden Infant Death Syndrome (SIDS).
  • Asthma —Children exposed to secondhand smoke are more likely to develop asthma, and develop more severe and frequent asthma attacks.
  • Bronchitis and chronic coughs — Smoking during pregnancy negatively impacts a child’s lung development. Exposure to secondhand smoke after birth further damages airways. More recent research shows that exposure to secondhand smoke impairs a child’s vital cough reflex, making it more likely that they will develop lung infections.
  • Ear infections — Children exposed to secondhand smoke are more likely to experience ear infections. As a household becomes a non-smoking household, the rate of ear infections decreases according to Harvard School of Public Health.
  • Cancer — Children exposed to secondhand smoke are more likely to develop various forms of cancer. Children exposed to secondhand smoke have a higher risk of developing childhood leukemia and of developing lung cancer and breast cancer in adulthood, even if they never smoked.
  • Heart disease — Children exposed to secondhand smoke are at greater risk of developing childhood and adult heart disease. Studies show that children exposed to secondhand smoke are more likely to develop clogged arteries and other cardiovascular disease symptoms as adults. Women exposed to secondhand smoke as children have lower levels of ‘good’ cholesterol that reduces heart disease risk, researchers say.

“For people who are in a home with a smoker, particularly children, the increased risk of cardiovascular or metabolic problems is massive,” Benjamin Bikman, professor of physiology and developmental biology at Brigham Young University.

  • Obesity and Type II Diabetes — Secondhand smoke exposure makes a body insulin resistant. Several studies are beginning to show that secondhand smoke exposure for children and adults means an increased risk of weight gain and Type II diabetes. (Source) (Source).

Smoking kills mothers.

Smoking-related illnesses begin to develop at far younger ages than most people believe.

For many women, these illnesses lead to early death leaving children with one or no parent to raise them.

The children of smokers are more likely to become smokers themselves.

A child exposed to nicotine in the womb or through secondhand smoke is more likely to become addicted to nicotine themselves.

Scientists are learning that there is reason to believe that babies heavily exposed to nicotine in the womb experience some withdrawal symptoms at birth. Other studies are showing that exposure to nicotine in the womb increases the likelihood that a child will grow up to be addicted to nicotine and to other substances (including fatty foods and alcohol, and increasing the long-term effects of cocaine and amphetamines). This is likely due to changes to the amygdala and hypocampus which stimulates appetite.

Research shows that children exposed to secondhand smoke in the home and car develop symptoms of nicotine dependence, even if they don’t smoke. Further research shows that many go on to develop their own addiction to tobacco.

That means that a child, already challenged by their mother’s smoking, is likely to further damage their and their children’s physical and genetic health with tobacco use. This creates a chain of damage that extends through generations.

What to do?

Quit Now: If you use any tobacco product, quit now. 1–800-QUIT-NOW is a great resource. So is www.smokefree.gov website specifically devoted to women.

  • Protect yourself, your unborn child, and your children from exposure to secondhand smoke of any kind, including nicotine containing e-cigarettes. Make your home and car tobacco-free.
  • Support smoke-free and tobacco-free environments, including laws and policies for smoke-free and tobacco-free environments such as schools and workplaces.
  • Support increasing the tax rate for tobacco-products, a strategy that is shown to directly reduce both the adult smoking rate and number of teens who begin smoking.
  • Educate your children. Be sure that they are aware of the multitude of health risks from using tobacco. You can also tell them that tobacco use may impact their ability to get a job, or a date. You tell them, because they are more likely to respond to a parent’s message.

Almost 100 years after Edward Bernays launched his ‘torches of freedom’ campaign, we see its effect in years littered with the unnecessarily illness and premature deaths of countless women and their families.

Time to start repairing the damage. Are you a quitter? You go, girl!

Christie James

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Tobacco-Free SC

The S.C. Tobacco-Free Collaborative is a statewide assembly of organizations committed to eliminating the toll of tobacco use in SC.