Press Release
Tobacco use among women on the rise

(28 July 2008)

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

 

© 2007 Coalition for Tobacco Control in Pakistan, All Rights Reserved