Tobacco smoking has serious negative effects on the body. A wide variety of diseases and medical phenomena affect the sexes differently, and the same holds true for the effects of tobacco. Since the proliferation of tobacco, many cultures have viewed smoking as a masculine vice, and as such the majority of research into the specific differences between men and women with regard to the effects of tobacco have only been studied in-depth in recent years.
Countries and regions
Egypt
Syria
Gaza In 2010 the Hamas-led Islamist government of Gaza imposed a ban on women smoking the popular nargilas in public. A spokesman for the Interior Ministry explained that "It is inappropriate for a woman to sit cross-legged and smoke in public. It harms the image of our people."Gaza ban on women smoking pipes, Reuters, 19 July 2010, The Independent. The ban was soon lifted later that year and women returned to smoking in popular venues like the cafe of Gaza's Crazy Water Park."Edict lifted for female smokers" Jason Koutsoukis, July 29, 2010, The Sunday Morning Herald. The park was burned down by masked men in September 2010, after being closed by the Hamas.Gunmen torch Gaza beach club shuttered by Hamas, AFP 19-09-2010 The Committee for the Propagation of Virtue and the Prevention of Vice (Gaza Strip) has arrested women for smoking in public.Jonathan Spyer, Analysis: The Islamic republic of Gaza, Jerusalem Post 29-09-2009
Japan
In Edo period or earlier than it, tobacco had come to Japan. were the main smokers among Japanese women by the early 19th century.
North Korea
United States
General health effects
According to the Centers for Disease Control and Prevention, cigarette smoking is the leading cause of preventable death in the United States and produces substantial health-related economic costs to society."Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs – United States, 1995—1999", MMWR: Morbidity and Mortality Weekly Report 51, no. 14 (April 12, 2002): 300-3 During the time between 1995 and 1999, smoking resulted in approximately 440,000 premature deaths per year and about $157 billion in "health-related economic losses". Smoking has been known to increase to the risks of, and has been linked to, a plethora of adverse health effects. For instance, "Cigarette smoking accounts for about one-third of all cancers, including 90 percent of lung cancer cases. [Smoking also] causes lung diseases such as chronic bronchitis and emphysema, [and can] increase the risk of heart disease, including stroke, heart attack, vascular disease, and aneurysm."Institute on Drug Abuse, "Cigarettes and Other Tobacco Products", June 2009, According to the Surgeon General's Report of 2004, titled "The Health Consequences of Smoking", other consequences of smoking include increased risk of cataracts, lowered levels of antioxidants, especially vitamin C, heightened inflammation, and periodontitis.U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004
Unique gender differences and health effects for women
In the United States, although general rates of smoking are declining – "24.1% in 1998 to 20.6% in 2008",Cigarette Smoking Among Adults and Trends in Smoking Cessation – United States, 2008 and there are higher rates among men – the gendered health consequences illustrate that women are at a greater disadvantage. "In 2008, smoking prevalence was higher among men (23%) than women (18.3%)"; however that gender gap appears to be narrowing. Prior to recent increasing smoking rates, women usually experienced different effects of smoking compared to men. For instance, a decrease in lifetime expectancy is greater for female smokers compared to male smokers. On average, while an adult male loses 13.2 years due to smoking, an adult female smoker loses 14.5 years of life."Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs – United States, 1995—1999". This decreased life expectancy for male smokers mirrors the gender differences in life expectancy overall. However, when it comes to smokers in particular, males tend to smoke more heavily than women do.National Center on Addiction and Substance Abuse at Columbia University. Women under the Influence. Baltimore: Johns Hopkins University Press, 2006. Yet still women continue to show more deleterious results.
As previously mentioned, smoking is attributable to the majority of lung cancer cases. Over the years lung cancer mortality has dramatically increased among women. "In 1987, lung cancer surpassed breast cancer to become the leading cause of cancer death among U.S. women." Smoking now accounts for 80% of lung cancer deaths among women. Although there has been a more pronounced campaign to raise funds for breast cancer research and a possible cure, more women are dying from lung cancer. Research also continues to question whether women tend to be more susceptible to lung cancer, regardless of similar exposure as their male counterparts. However, making a definitive answer has been difficult, and the issue remains controversial.Freedman, N. D., et al., "Cigarette smoking and subsequent risk of lung cancer in men and women: analysis of a prospective cohort study", Lancet Oncology 9, no.7 (Jul 2008): 649-56 Chronic obstructive pulmonary disease (COPD) is another major issue among women who smoke. The risk of having COPD is increased with amount and duration and smoking accounts for 90 percent of COPD mortalities.U.S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2001
The effects of smoking on cardiovascular health also shows sex differences. Heart diseases continue to be the leading cause of death nationwide, and one of the risk factors is smoking. Unique to women, smoking lowers their estrogen and their high-density lipoproteins that prevent arteries from blockage.Rosenfield, L. E., "Women and Heart Disease" <http://www.med.yale.edu/library/heartbk/19.pdf> For many women the effects of smoking on the heart's health become obvious later on in life. Among current female smokers, "the chance of dying from heart disease or lung cancer exceeds the chance of dying from breast cancer from 40 on (and does so by at least a factor of 5 after age 55)."Woloshin, S., et al., "The risk of death by age, sex, and smoking status in the United States: Putting health risks in context", Journal of the National Cancer Institute, 100, no. 12 (2008): 845-53 The habit becomes particularly crucial when women are also taking birth control because these two in concert increases, even more so, women's chances of having a stroke or a heart attack.Harvard Medical School. "His and hers heart disease", Harvard Health Letter 34, no. 11 (2009): 1
When observing older women, those who smoke in their postmenopausal stages tend to have a lower bone density along with more hip fractures when compared to their non-smoker counterparts.Women and Smoking: A Report of the Surgeon General For the younger cohort of women, during their reproductive stages, smoking affects their reproductive health as well as pregnancy outcomes. Research has revealed that smoking makes it more difficult for women to conceive and it can also result in infertility. Women who smoke while they are pregnant increase their chances of having an early delivery and low-birth weight babies. One of the many serious effects on the fetus itself is sudden infant death syndrome (SIDS). Studies have shown that "infants of mothers who smoke during and after pregnancy are 3 to 4 times more likely to die from sudden infant death syndrome (SIDS) than babies to non-smoking mothers". Smoking during pregnancy could also cause stillbirth, preterm birth, placental abruption. It can also cause Premature menopause.
The future: women, smoking, and globalization
As smoking levels decline in the developed world, they are increasing in the developing world. The major cigarette manufacturers have more than tripled the number of cigarettes exported in the last 35 years.Brandt, Allan M. 2007. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product that Defined America. New York: Basic Books, p. 450. Tobacco companies are using similar strategies to attract women in other countries that they used in the early days of attracting American women. Offering appealing ads that depict cigarettes as modern, empowering, and liberating draws in women smokers who make every effort to be as western as possible.Bulletin of the World Health Organization, 2000, 78 (7) p. 893 The smoking bans occurring in the United States are happening around the globe. In other countries (as in the United States), tobacco manufacturers circumvent advertising restrictions by sponsoring events, retail endorsements, and advertising in alternative markets such as satellite television channels. These methods have proven quite successful for the tobacco industry. Overwhelmingly, in the global market the trends point toward the market becoming increasingly female in the future.Drug and Alcohol Dependence Volume 104, Supplement 1, 1 October 2009, Pages S11–S16
Delving deeper: Women, smoking and globalization
When discussing smoking among women it is crucial to also take into account the fact that smoking, and tobacco use in general, is a global issue that is not confined to the borders of the Western world. The World Health Organization (WHO) notes the stark difference between women in various geographic locations as it states that "[a]bout 22 percent of women in developed countries and 9 percent of women in developing countries smoke tobacco".World Health Organization. "Female Smoking" However, numerically the number of women could be more in developing countries.Mackay, J. and Amanda Amos. "Women and Tobacco", Respirology 8 (2003):123-130
In his article, Fred C. Pampel looks into why these differences may exist and suggests reasons pertaining to gender equality, cigarette diffusion, economic factors and smoking policies.Pampel, F. C. "Global Patterns and Determinants of Sex Differences in Smoking", International Journal of Comparative Sociology 47, no. 6 (2006):466-87. For women in countries where traditional gender roles have changed, it becomes more socially acceptable for women to initiate smoking. However, this evidence should not hinder a deeper look into the smoking among women in developed countries.
Though the rates of smoking among people in developed countries are on a slow decline, smoking rates among middle and low-income countries are increasing. This particularly affects women within developing regions because they are most at risk when male cigarette use is high. About 70% of tobacco users live in developing countries, and about half of the men in these countries are smokers.Doskoch, P. "Many Pregnant Women Use Tobacco in Some Developing Countries" International Family Planning Perspective 34, no. 4 (December 2008): 199-200 Although women are not mainly the ones to smoke, they are still exposed to environmental tobacco smoke (ETS). When among men who smoke, the risks of passive smoking increase for women whether they are at home or at work. Smoking and second-hand smoke not only affects the female body but has detrimental results on the health of their children. This issue is compounded in developing nations that may already have limited medical care for women.