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Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
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E-mail: tobaccoinfo@cdc.gov
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2001 Surgeon General's Report—Women and Smoking
What Is Needed to Reduce Smoking Among Women
Disclaimer
Highlights
- Increase awareness of the devastating impact of smoking on women’s
health. Smoking is the leading known cause of preventable death and
disease among women—In 1997, smoking accounted for about
165,000 deaths among U.S. women. In 1987, lung cancer became the leading
cause of cancer death among women, and by 2000, about 27,000 more women
in the United States died of lung cancer (about 68,000) than of breast
cancer (about 41,000).
- Expose and counter the tobacco industry’s deliberate targeting
of women and decry its efforts to link smoking, which is so harmful
to women’s health, with women’s rights and progress in society—In 1999
tobacco companies spent more than $8.24 billion,— or more than
$22.6 million a day—to advertise and promote cigarettes. To sell its
products, the tobacco industry exploits themes of success and independence,
particularly in its advertising in women’s magazines.
- Encourage a more vocal constituency on issues related to women
and smoking—Taking a lesson from the success of advocacy to reduce
breast cancer, we must make concerted efforts to call public attention
to the toll of lung cancer and other smoking-related diseases on women’s
health. Women affected by tobacco-related diseases and their families
and friends can partner with women’s and girls’ organizations, women’s
magazines, female celebrities, and others—not only in an effort to
raise awareness of tobacco-related disease as a women’s issue, but also
to call for policies and programs that deglamorize and discourage tobacco
use.
- Recognize that nonsmoking is by far the norm among
women—Publicize that most women are nonsmokers. Nearly four-fifths of U.S.
women are nonsmokers, and in some subgroup populations, smoking is relatively
rare (e.g., only 11.2 % of women who have completed college are current
smokers, and only 5.4 % of black high school seniors girls are daily
smokers). It important to recognize that among adult women those who
are most empowered, as measured by educational attainment, are the least
likely to be smokers. Moreover, most women who smoke want to quit.
- Conduct further studies of the relationship between smoking and
certain outcomes of importance to women’s health—Additional
research is needed to explore these issues:
- The link between exposure to environmental tobacco smoke and
the risk of breast cancer.
- Cigarette brand variations in toxicity and whether any of these
possible variations may be related to changes in lung cancer histology
during the past decade.
- Changes in tobacco products and whether increased exposure to
tobacco-specific nitrosamines may be related to the increased incidence
rates of adenocarcinoma (malignant glandular tumor) of the lung.
- Health effects of smoking among women in the developing world.
- Encourage the reporting of gender-specific results from studies
of influences on smoking behavior, smoking prevention and cessation
interventions, and the health effects of tobacco use, including use
of new tobacco products—Research is needed to better understand
and to reduce current disparities in smoking prevalence among women
of different groups as defined by socioeconomic status, race, ethnicity,
and sexual orientation. Women with only 9 to 11 years of education are
about three times as likely to be smokers as are women with a college
education. American Indian or Alaska Native women are much more likely
to smoke than are Hispanic women and Asian or Pacific Islander women.
Among teenage girls, white girls are much more likely to smoke than
are African American girls.
- Determine why, during most of the 1990s, smoking prevalence
declined so little among women and increased so markedly among teenage
girls — This lack of progress is a major concern and threatens
to prolong the epidemic of smoking-related diseases among women.
More research is needed to determine the influences that encourage
many women and girls to smoke even in the face that all that is
known of the dire health consequence of smoking. If, for example,
smoking in movies by female celebrities promotes smoking, then discouraging
such practices as well as engaging well-known actresses to be spokespersons
on the issue of women and smoking should be a high priority.
- Develop a research and evaluation agenda related to women and
smoking—Research agendas should focus on these issues:
- Determining whether gender-tailored interventions increase
the effectiveness of various smoking prevention and cessation
methods.
- Documenting whether there are gender differences in the
effectiveness of pharmacologic treatments for tobacco cessation.
- Determining which tobacco prevention and cessation interventions
are most effective for specific subgroups of girls and women.
- Designing interventions to reduce disparities in smoking
prevalence across all subgroups of girls and women.
- Support efforts, at both individual and societal levels,
to reduce smoking and exposure to environmental tobacco smoke among
women. Tobacco-use treatments are among the most cost-effective
of preventive health interventions at the individual level, and
they should be part of all women’s health care programs. Health
insurance plans should cover such services. Societal strategies
to reduce tobacco use and exposure to environmental tobacco smoke
include counteradvertising, increasing tobacco taxes, enacting laws
to reduce minors’ access to tobacco products, and banning smoking
in work sites and in public places.
- Enact comprehensive statewide tobacco control programs proven
to be effective in reducing and preventing tobacco use—Results
from states such as Arizona, California, Florida, Maine, Massachusetts,
and Oregon show that science-based tobacco control programs have
successfully reduced smoking rates among women and girls. California
established a comprehensive statewide tobacco control program more
than 10 years ago, and is now starting to observe the benefits of
its sustained efforts. Between 1988 and 1997, the incidence rate
of lung cancer among women declined by 4.8% in California but increased
by 13.2% in other regions of the United States.
- Increase efforts to stop the emerging epidemic of smoking
among women in developing countries—Strongly encourage
and support multinational policies that discourage the spread of
smoking and tobacco-related diseases among women in countries where
smoking prevalence has traditionally been low. It is urgent that
what is already known about effective means of tobacco control at
the societal level be disseminated throughout the world.
- Support the World Health Organization’s Framework Convention
for Tobacco Control (FCTC)—The FCTC is an international legal
instrument designed to curb the global spread of tobacco use through
specific protocols–currently being negotiated–that relate to
tobacco pricing, smuggling, advertising, sponsorship, and other
activities.
Disclaimer: Data and findings provided on this page reflect the content of
this particular Surgeon General's Report. More recent information may exist
elsewhere on the Smoking & Tobacco Use Web site (for example, in fact sheets,
frequently asked questions, or other materials that are reviewed on a regular
basis and updated accordingly).
Page last updated March 27, 2001