ISLAMABAD, Pakistan
— More and more girls and women in
Pakistan are turning to tobacco use,
this being a clear sign of the
closing gender gap as smoking among
girls is constantly increasing as a
result of changing social norms and
the tobacco industry’s targeting of
young women.
There are an estimated 25 million
smokers in Pakistan, with the male
to female ratio being 4:1. This
means that 36% of the adult males
and 9% of the adult females in
Pakistan are tobacco users. However,
the Global Youth Tobacco Survey
conducted by the World Health
Organization (WHO) has found that
the boy to girl tobacco use ratio
has shrunk to 2:1. This evidence of
the closing gender gap in terms of
tobacco use is true for both rural
as well as urban women.
Lately, the WHO has drawn attention
to the need for a gendered response
to tobacco use and is calling for
specific programmes and policies to
curb smoking, in all its forms,
among young girls and women.
“Both the history of the tobacco
epidemic and the shape of its
current progression across low- and
middle-income countries have a
gender perspective. Despite the
influence of gender, there has been
little development or examination of
programmes and policies to address
differences between and among women
and men throughout the four stages
of the tobacco epidemic,” the WHO
states in a press release.
The rationale for formulating
women-specific programmes is clear.
“The tobacco industry itself has
exploited gendered imagery and
issues across cultures for decades.
It is crucial to prepare more
effectively for different patterns
of tobacco use in the 21st century
among girls, boys, women and men by
constructing gendered responses,”
the WHO states.
The water-pipe, commonly known as
‘sheesha’ or ‘hukka’ is becoming
increasingly popular among young
women in urban areas, while it is
already an acceptable norm in rural
areas. There is a need to raise
awareness that the water pipe is
also a dangerous form of tobacco
use. One of the myths related to
‘sheesha’ smoking is that it is less
dangerous than cigarette smoking
because the nicotine content is
lower and the tobacco toxins get
filtered out by the water in the
pipe. The reality is that even after
it has passed through water, the
smoke produced by a ‘sheesha’
contains high levels of toxins,
including carbon monoxide, heavy
metals and carcinogens. A ‘sheesha’
session lasts for 20-80 minutes,
during which the smoker may take
anywhere between 50 to 200 puffs.
The ‘sheesha’ smoker may, therefore,
inhale as much smoke during one
session as a cigarette smoker would
while consuming 100 or more
cigarettes.
Young people believe that the fruit
flavours added to tobacco make
‘sheesha’ a health choice. On the
contrary, flavoured tobacco is
smoked over coal, and the fumes from
these fuels add new toxins to the
already dangerous smoke, which
contains large quantities of
chemicals that cause heart disease,
cancer and addiction.
A survey done on youngsters of
school-going age in Karachi recently
showed that almost 70% had tried
‘sheesha’ in the past six months,
and this included children as young
as seven. Many of the commercially
available packets used for ‘sheesha’
smoking have misleading labels such
as 0.5 per cent nicotine and zero
tar. Moreover, the sharing of
‘sheesha’ poses an additional risk
of tuberculosis and hepatitis
transmission.
In addition, other forms of tobacco
use such as ‘paan’ (betel leaf with
tobacco and areca nut), ‘naswar’
(snuff), chewing tobacco and
‘ghutka’ (a combination of
ingredients including betel-nut and
tobacco) are a growing problem, and
are particularly prevalent amongst
women.
Equally alarming is the exposure of
women to second hand smoke in public
transportation, in the workplace and
at home. Data shows that 55% of
households have at least one smoker.
Smoking is particularly injurious
for pregnant women. Cigarette
smoking reduces oxygen delivery to
the foetus and causes hypoxia, thus
adversely affecting the developing
foetus. The effects manifest in the
form of lower birth weight,
increased rates of spontaneous
abortion, stillbirth and early
postpartum death. Moreover,
breast-fed babies are at risk of
harmful effects of nicotine if the
parents are smokers.
Research shows that 30 per cent of
females dying of bladder cancer are
smokers. Non-smoking women married
to smokers are more than twice as
likely as spouses of non-smokers to
develop lung cancer.
The cessation of smoking offers a
lot of hope. After three months of
quitting, former smokers report it
is easier to breathe. After one
year, the risk of heart disease is
reduced by half. After five years,
the risk of cancer is reduced by
half. After 12 years, the risk of
dying from lung cancer is 70 per
cent lower; and after 15 years, the
chances of dying are equal to that
of a non-smoker.
Pakistan is committed under the
Framework Convention on Tobacco
Control (FCTC), which it ratified in
2004, to undertake gender-specific
policy measures that address tobacco
use among women. In 2002, Pakistan
passed tobacco control legislation
that includes measures to ban both
underage sales and smoking in indoor
public places and workplaces. At
present, there is a lack of
enforcement of this legislation.
The WHO believes that the Lady
Health Workers who provide primary
health care to women in their homes,
along with the staff of basic health
units, can play a crucial role in
targeted tobacco control
interventions with women. “The
involvement of women in tobacco
control will support changing social
norms towards tobacco use in
community settings and in public
places. Their involvement will also
fasten the implementation of the
Prohibition of Smoking and
Protection of Non-Smokers Health
Ordinance 2002,” the WHO believes.
By
Shahina Maqbool
Daily
The News
