In 1960, about 10% of all cigarette advertisements appeared in popular women's magazines, and by 1985, cigarette advertisements increased by 34%.
Evidence suggests a pattern of international tobacco advertising that associates smoking with success, similar to that seen in the United States. This development emphasizes the enormous potential of advertising to change social norms. As western-styled marketing has increased, campaigns commonly have focused on women. For example, in 1989, the brand Yves Saint Laurent introduced a new elegant package designed to appeal to women in Malaysia and other Asian countries. National tobacco monopolies and companies, such as those in Indonesia and Japan, began to copy this promotional targeting of women.
One of the most popular media for reaching women—particularly in places where tobacco advertising is banned on television - is women's magazines. Magazines can lend an air of social acceptability or stylish image to smoking. This may be particularly important in countries where smoking rates are low among women and where tobacco companies are attempting to associate smoking with Western values. A study of 111 women's magazines in 17 European countries in 1996-1997 found that 55% of the magazines that responded accepted cigarette advertisements, and only 4 had a policy of voluntarily refusing it. Only 31% of the magazines had published an article of one page or more on smoking and health in the previous 12 months. Magazines that accepted tobacco advertisements seem less likely to give coverage to smoking and health issues.
Events and activities popular among young people are often sponsored by tobacco companies. Free tickets to films and to pop and rock concerts have been given in exchange for empty cigarette packets in Hong Kong and Taiwan. Popular U.S. female stars have allowed their names to be associated with cigarettes in other countries.
Many countries have banned tobacco advertising and promotion. In 1998, the European Union adopted a directive to ban most tobacco advertising and sponsorship by July 30, 2006. Other countries have banned direct advertising, and still others have instituted partial restraints. Such bans are often circumvented by tobacco companies through various promotional venues such as the creation of retail stores named after cigarette brands or corporate sponsorship of sporting and other events. Moreover, national bans on tobacco advertisements may be rendered ineffective by tobacco promotion on satellite television, by cable broadcasting, or via the Internet.
Health Consequence of Tobacco Use Among Women
Women who stop smoking greatly reduce their risk of dying prematurely. The relative benefits of smoking ending are greater when women stop smoking at younger ages, but smoking ending is beneficial at all ages.
Women who stop smoking greatly reduce their risk of dying prematurely, and quitting smoking is useful at all ages. Although some clinical intervention studies suggest that women may have more difficulty quitting smoking than men, national survey data show that women are quitting at rates similar to or even higher than those for men. Prevention and cessation interventions are generally of similar effectiveness for women and men and, to date, few sex differences in factors related to smoking initiation and successful quitting have been identified.
Exposure to environmental tobacco smoke is a cause of lung cancer and coronary heart disease among women who are lifetime nonsmokers. Infants born to women exposed to environmental tobacco smoke during pregnancy have a small decrement in birth weight and a slightly increased risk of intrauterine growth retardation compared to infants of no exposed women.
A dozen diseases are waiting for women-smokers.
Cigarette smoking is the major cause of lung cancer among women. About 90% of all lung cancer deaths among U.S. women smokers are attributable to smoking.
In 1950, lung cancer accounted for only 3% of all cancer deaths among women; however, by 2000, it accounted for an estimated 25% of cancer deaths.
Since 1950, lung cancer mortality rates for U.S. women have increased an estimated 600%. In 1987, lung cancer surpassed breast cancer to become the leading cause of cancer death among U.S. women. In 2000, about 27,000 more women died of lung cancer (67,600) than breast cancer (40,800).
Smoking is a major cause of cancer of the oropharynx and bladder among women. Evidence is also strong that women who smoke have increased risk for cancer of the pancreas and kidney. For cancer of the larynx and esophagus, evidence that smoking increases the risk among women is more limited but consistent with large increases in risk.
Women who smoke may have a higher risk for liver cancer and colorectal cancer than women who do not smoke.
Smoking is consistently associated with an increased risk for cervical cancer. The extent to which this association is independent of human papillomavirus (tumor caused by virus) infection is uncertain.
Several studies suggest that exposure to environmental tobacco smoke is associated with an increased risk for breast cancer; however, this association remains uncertain.
More research is needed.
Smoking is a major cause of coronary heart disease among women. Risk increases with the number of cigarettes smoked and the duration of smoking. Women who smoke have an increase risk for ischemic stroke (blood clot in one of the arteries supplying the brain) and subarachnoid hemorrhage (bleeding in the area surrounding the brain).
Women who smoke have an increased risk for peripheral vascular atherosclerosis. Smoking cessation reduces the excess risk of coronary heart disease, no matter at what age women stop smoking. The risk is substantially reduced within 1 or 2 years after they stop smoking.
The increased risk for stroke associated with smoking begins to reverse after women stop smoking. About 10 to 15 years after stopping, the risk for stroke approaches that of a women who never smoked.
Chronic Obstructive Pulmonary Disease (COPD) and Lung Function
Cigarette smoking is the primary cause of COPD in women, and the risk increases with the amount and duration of cigarette use. Mortality rates for COPD have increased among women for the past 20 to 30 years. About, 90% of mortality from COPD among U.S. women is attributed to smoking.
Exposure to maternal smoking is associated with reduced lung function among infants, and exposure to environmental tobacco smoke during childhood and adolescence may be associated with impaired lung function among girls.
Smoking by girls can reduce their rate of lung growth and the level of maximum lung function. Women who smoke may experience a premature decline of lung function.
Some studies suggest that cigarette smoking may alter menstrual function by increasing the risks for painful menstruation, secondary amenorrhea (abnormal absence of menstrual), and menstrual irregularity
Women smokers have natural menopause at a younger age than do nonsmokers, and they may experience more severe menopausal symptoms.
Women who smoke have increased risk for conception delay and for both primary and secondary infertility.
Women who smoke during pregnancy risk pregnancy complications, premature birth, low-birth-weight infants, stillbirth, and infant mortality.
Women who smoke may have a modest increase in risks for ectopic pregnancy (fallopian tube or peritoneal cavity pregnancy) and spontaneous abortion.
Studies show a link between smoking and the risk of sudden infant death syndrome (SIDS) among the offspring of women who smoke during pregnancy.
Bone Density and Fracture Risk
Postmenopausal women who smoke have lower bone density than women who never smoked.
Women who smoke have an increased risk for hip fracture than women who never smoked.
Women who smoke may have a modestly elevated risk for rheumatoid arthritis. Women smokers have an increased risk for cataract, and may have an increased risk for age-related macular degeneration.