Report details tobacco industry’s predatory marketing to women and girls and the devastating health consequences

Strong action is needed to help women and girls quit tobacco and prevent young people from ever starting

A new report details the tobacco industry’s long history of developing cigarette brands and predatory marketing campaigns that deliberately target women and girls and how that has led to devastating consequences for women’s health at every stage of their lives.

The report documents the industry’s aggressive, century-long targeting of women and girls, utilizing themes of beauty, fashion, freedom and sophistication – and often playing into sexist tropes – while ignoring or downplaying the serious health risks of tobacco use. The report demonstrates that strong action is needed now to protect women’s health and save lives, and it offers proven solutions to prevent young girls from starting to smoke or vape and help all women quit using tobacco.      

The report – titled A Lifetime of Damage: How Big Tobacco’s Predatory Marketing Harms the Health of Women and Girls – was released by the Campaign for Tobacco-Free Kids, American College of Obstetricians and Gynecologists, Association of Maternal & Child Health Programs, Black Women’s Health Imperative, National Partnership for Women & Families, and National Women’s Law Center.

More than 16 million women and girls in the United States currently smoke, putting them at risk for the serious and deadly diseases caused by smoking. Over 200,000 women die in the U.S. every year due to smoking and exposure to secondhand smoke. In addition, youth e-cigarette use has skyrocketed to what the U.S. Surgeon General and the FDA have called “epidemic” levels, with nearly 1 in 5 high school girls in the U.S. now using e-cigarettes.

As detailed by the Tobacco Control Data Initiative, South Africa has a high cigarette prevalence rate, at 19% of adults (15 years and over) 6.9% of women, over 1.3 million people, smoke. Over 25 000 people die directly from smoking, nearly 7000 of whom are women. Smoking also has an enormous financial cost. Tobacco-related illnesses cost the South African economy R42 billion in 2016. R28 billion of this cost is due to illness-caused productivity losses and the losses in potential earnings from those who died prematurely, while the remaining R14 billion is due to direct healthcare costs. 

THE TOBACCO INDUSTRY’S PREDATORY MARKETING TO WOMEN AND GIRLS

As the report documents, the tobacco industry has long understood the importance of recruiting women and girls as customers and has a century-long history of targeting them.

Extensive market research on the attitudes of women has helped tobacco companies better understand how to target their products and advertise to this important group of potential customers. In the same way that tobacco companies have aggressively targeted Black Americans with campaigns for menthol cigarettes, they have targeted women and girls with specific brands and campaigns that use themes of beauty, sophistication, weight loss, fashion and freedom that continue today.

Launched with marketing directed at women in the 1920s, Marlboro’s debut tagline, “Mild as May,” portrayed smoking as feminine, complete with greaseproof tips to protect lipstick from smudging. A 1920s ad for Lucky Strike cigarettes urged women to “Reach for a Lucky instead of a sweet” – marketing the cigarette as a diet aid led to a more than 300% increase in the brand’s sales in the first year of the advertising campaign.

Cigarette advertising targeted at women reached new levels in the late 1960s when Philip Morris introduced Virginia Slims, the first woman-specific brand to hit the market. With the iconic slogan “You’ve come a long way, baby,” the Virginia Slims marketing campaign cynically appropriated themes and goals of the women’s liberation movement – independence and empowerment – to sell a product that would result in addiction, disease and death for millions of women.

The tobacco industry has specifically targeted Black and Hispanic women with a broad range of marketing efforts, including sponsorship of community and music events, magazine advertising and retail promotions. This marketing was part of the overall tobacco industry strategy to recruit new female customers, underscoring tobacco as an important health equity and racial justice issue.

While the digital age has brought new tobacco products and tactics, the marketing still echoes themes common over the past several decades. Newer products like Juul and blu e-cigarettes and Philip Morris’ IQOS heated cigarette reach young women and girls through social media influencers, special parties and events, and celebrity endorsements.

THE DEVASTATING CONSEQUENCES FOR THE HEALTH OF WOMEN AND GIRLS

The report details the devastating consequences of tobacco use that occur at every stage of a woman’s life. Tobacco use can lead to nicotine addiction for young girls, impact a woman’s ability to become pregnant and cause serious pregnancy complications. Smoking is also a primary cause of deadly and debilitating chronic diseases and causes serious health harms later in life:

• Harm to adolescent health, including nicotine addiction: Nicotine exposure and tobacco use at a young age can have lasting consequences for young girls. 90% of adult smokers begin smoking while in their teens, or earlier. In addition, youth e-cigarette use has skyrocketed in the U.S., with 3.6 million middle and high school students currently using e-cigarettes. Nicotine is a highly addictive drug that can have lasting and damaging effects on adolescent brain development, particularly impacting the parts of the brain responsible for attention, learning, mood and impulse control. Adolescent girls who smoke also have reduced rates of lung growth and are at risk of early cardiovascular damage.
• Harm to reproductive health: Smoking and exposure to tobacco smoke are harmful to reproductive health, and smoking can also affect pregnancy and a baby’s health after birth. Tobacco use during pregnancy remains a major preventable cause of disease and death of the fetus, infant and mother. Smoking can make it harder to become pregnant and women who smoke have a higher risk of never becoming pregnant. Smoking increases the risk for pregnancy complications, including miscarriage, ectopic pregnancy, premature delivery, stillbirth, low birthweight and infant mortality. Smoking during pregnancy and exposure to secondhand smoke also increase the risk of sudden infant death syndrome (SIDS).
• Chronic and deadly diseases during adulthood: Smoking puts women at increased risk for heart disease, lung cancer, stroke, emphysema, diabetes and many other serious chronic illnesses. Over 60,000 women die every year of smoking-caused cardiovascular diseases, and more women die from lung cancer than any other cancer. The risks to women from smoking have risen sharply over the last 50 years and are now equal to those for men for lung cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular diseases. For the first time ever, women who smoke are as likely as men to die from many of the diseases caused by smoking.
• Additional health harms as women age: Smoking is also a risk factor for many health conditions that predominantly affect older individuals. These include Alzheimer’s disease, which is the fifth leading cause of death for adults aged 65 and older; age-related macular degeneration (AMD), the leading cause of blindness for people 65 and older in the U.S.; and bone loss and osteoporosis.

The report concludes with recommended policy solutions to help women and girls quit smoking and prevent young people from starting to use tobacco products. These actions, which can create better health outcomes for decades to come, include:

• Expanding the availability and promotion of smoking cessation treatments and ensuring women receive advice to quit from their healthcare providers.
• Eliminating all flavoured tobacco products, including menthol cigarettes and flavoured e-cigarettes. Flavours mask the harshness and increase the appeal of tobacco products, making it easier for new users – particularly youth – to try these products and ultimately become addicted. Menthol also makes cigarettes more addictive and harder to quit. The FDA recently took a major step forward by announcing that it will initiate rulemaking to prohibit menthol cigarettes and flavoured cigars.
• Implementing other proven policy solutions, including cigarette tax increases, well-funded tobacco prevention and cessation programs, and comprehensive smoke-free workplace laws.

South Africa has pending tobacco control legislation in the new Control of Tobacco Products and Electronic Delivery Systems Bill, including measures to create smoke-free public spaces, says Dr. Sharon Nyatsanza, Project and Communications Manager for the National Council Against Smoking. “When passed, the bill will better protect all citizens, including women and children, from the pervasive influence of tobacco companies. We call on the government of South Africa to take swift action and pass the Control of Tobacco Products and Electronic Delivery Systems Draft Bill into law.” 

(ENDS)

REPORT: https://www.tobaccofreekids.org/assets/content/press_office/2021/womens-report.pdf

AVAILABLE FOR INTERVIEW:

Sharon Nyatsanza (Phd), Project & Communications Manager, NCAS
Dr Catherine Egbe, Specialist Scientist: Alcohol, Tobacco and other Drug Research Unit, South African Medical Research Council
Professor Pamela Naidoo, CEO, The Heart and Stroke Foundation of South Africa
Lorraine Govender, National Advocacy Co-Ordinator, CANSA