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Monday, May 31, 2010

Women losing the battle against tobacco use

By Ben Ukwuoma

AS the world marks this year’s World No Tobacco Day, the evidence of tobacco use among young females is increasing in many countries and regions. This has reopened the call for governments to ban all tobacco advertising, promotion and sponsorship and to eliminate tobacco smoking in all public and work places as provided in the World Health Organisation Framework Convention on Tobacco Control. PETRESE is not only pretty, she is intelligent, too. She is also from a family that is comfortable. That gave her an early expose to many good and bad things in life. One of the bad things she herself admits to nowadays is smoking.

At 24, she has double Master’s degrees. She drinks strong alcohol like fish drinks water. And she lights another stick of cigarette before she snuffs off an earlier one. Since the last two odd years, she intermittently coughs and no medication has been able to cure it. Just last week, a comprehensive medical check on her lungs revealed large dark spots. Her physician last week broke the news of an affliction of cancer of the lungs to her heart-broken parents. Petrese is on the fast lane to early death.

But she is not alone. There are many, old and young, men and women, illiterate and elites who are hooked on excessive use of tobacco. Medically, it has been confirmed that of the over five million people who die each year from tobacco use, approximately 1.5 million are women.

Unless urgent action is taken, experts say that tobacco use could kill more than eight million people by 2030, of whom 2.5 million would be women.

Approximately, three-quarters of these female deaths would occur in the low-income and middle-income countries that are least able to absorb such losses. Every one of these premature deaths would have been avoidable.In some countries, the bigger threat to women is from exposure to the smoke of others, particularly men. Isidore S. Obot of the Department of General and Applied Psychology, University of Jos, Plateau State, carried out a study on the incidence of cigarette smoking, cigar/pipe tobacco and snuff use in the Nigerian population. In a sample of 1,271 adult heads of household (1,137 males, 134 females), the overall prevalence of regular smoking was 22.6 per cent. The proportions of regular cigar/pipe tobacco and snuff users were 17.9 per cent and 9.6 per cent. Among cigarette smokers, 60.6 per cent smoked at least half a pack a day, 11.2 per cent at least one pack a day. Males smoked more than females. The poor, uneducated respondents smoked more than the relatively rich and educated. Smoking was more rampant in the third decade of life than in other age groups. Smokers had a higher incidence of health problems and both nonsmokers and heavy smokers were less aware of the risk of smoking than light smokers. In the light of the above, it is suggested that health education should be a major component of tobacco and health policy in Nigeria. The harmful health effects of smoking cigarettes presented below only begin to convey the longterm side effects of smoking. Quitting makes sense for many reasons but simply put: Smoking is bad for health.Worldwide, of the approximately 430,000 adult deaths caused every year by second-hand smoke, about 64 per cent occur in women.

On World No Tobacco Day 2010 today, focus is on the harm which tobacco marketing and smoke do to women. At the same time, it seeks to make men more aware of their responsibility to avoid smoking around the women with whom they live and work.

Women, and men, must be protected from tobacco industry marketing and smoke, as stated in the preamble to the WHO Framework Convention on Tobacco Control. In effect since 2005, this international treaty acknowledges "the increase in smoking and other forms of tobacco consumption by women and young girls worldwide" and explicitly recognises "the need for gender-specific tobacco control strategies".

Unfortunately, less than nine per cent of the world's population is covered by comprehensive advertising bans. Only 5.4 per cent is covered by comprehensive national smoke-free laws.The rising epidemic of tobacco use among women has forced the WHO to issue an alert, calling countries to protect women and girls against the sickness and suffering caused by tobacco use. In half of the 151 countries recently surveyed for trends in tobacco use among young people, approximately as many girls used tobacco as boys. More girls used tobacco than boys in some of the countries, including Bulgaria, Chile, Colombia, Cook Islands, Croatia, Czech Republic, Mexico, New Zealand, Nigeria and Uruguay.WHO Director-General, Dr. Margaret Chan says: "Tobacco use is neither liberating nor glamorous. It is addictive and deadly."

This year’s campaign theme, “gender and tobacco” with an emphasis on “marketing to women”, focuses on the harmful effects of tobacco marketing towards women and girls.It also highlights the need for governments to ban all tobacco advertising, promotion and sponsorship and to eliminate tobacco smoke in all public and work places as provided in the WHO Framework Convention on Tobacco Control.Women are a major target for the tobacco industry in its effort to recruit new users to replace those who will quit or die prematurely from tobacco-related diseases.

"We know that tobacco advertising increasingly targets girls," said WHO Assistant Director-General for Non-communicable Diseases and Mental Health, Dr. Ala Alwan. "This campaign calls attention to the tobacco industry's attempts to market its deadly products by associating tobacco use with beauty and liberation."

Often the threat to women is less from their being enticed to smoke or chew tobacco than from their being exposed to the smoke of others, particularly men.

"By enforcing the WHO Framework Convention, governments can reduce the toll of fatal and crippling heart attacks, strokes, cancers and respiratory diseases that have become increasingly prevalent among women," says Dr. Douglas Bettcher, Director of WHO's Tobacco Free Initiative.

WHO calls on governments and the public to demand a ban on all forms of tobacco advertising, promotion and sponsorship; to support implementation and strong enforcement of legislation to provide 100 per cent protection from tobacco smoke in all public and work places; and to take global action to advocate for women's freedom from tobacco. The health hazards of smoking are well documented, and prevention of smoking has been described as the single greatest opportunity for preventing non-communicable disease in the world today.Cigarette smoking during pregnancy is said to increase the risk of low birth weight, prematurity, spontaneous abortion, reduction in breast milk and perinatal mortality in humans, which has been referred to as the fetal tobacco syndrome. Smoking increases women's risk for cancer of the cervix. There is a possible link between active smoking and premenopausal breast cancer.

The health effects of tobacco are the circumstances, mechanisms, and factors of tobacco consumption on human health. Epidemiological research has been focused primarily on tobacco smoking, which has been studied more extensively than any other form of consumption.

Tobacco use leads most commonly to diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD), emphysema, and cancer (particularly lung cancer, cancers of the larynx and mouth, and pancreatic cancer). It also causes peripheral vascular disease and hypertension, all developed due to the exposure time and the level of dosage of tobacco. Furthermore, the earlier and the higher level of tar content in the tobacco-filled cigarettes cause the greater risk of these diseases.

Cigarettes sold in developing nations are said to have higher tar content, and are less likely to be filtered, potentially increasing vulnerability to tobacco-related disease in these regions.Smoke contains several carcinogenic pyrolytic products that bind to deoxyribonucleic acid (DNA) and cause many genetic mutations. There are over 19 known chemical carcinogens in cigarette smoke. Tobacco also contains nicotine, which is a highly addictive psychoactive chemical.

When tobacco is smoked, nicotine causes physical and psychological dependency. Tobacco use is also a significant factor in miscarriages among pregnant smokers. It contributes to a number of other threats to the health of the foetus such as premature births and low birth weight and increases by 1.4 to three times the chance for Sudden Infant Death Syndrome (SIDS). The result of scientific studies done in neonatal rats seems to indicate that exposure to cigarette smoke in the womb may reduce the foetal brain's ability to recognise hypoxic conditions, thus increasing the chance of accidental asphyxiation.

Incidence of impotence is approximately 85 per cent higher in male smokers compared to non-smokers, and it is a key cause of erectile dysfunction (ED).

Generally, women's reasons for smoking often differ from men's. The tobacco industry cons many women into believing that smoking is a sign of liberation, and many women wrongly view smoking as a good way of keeping slim.Controlling the epidemic of tobacco among women is an important part of any tobacco control strategy. As Mrs. Chan said: "Protecting and promoting the health of women is crucial to health and development – not only for the citizens of today but also for those of future generation. In many countries, vastly more men smoke than women, and many of those countries fail to protect nonsmokers adequately”.

In many countries, women are powerless to protect themselves, and their children, from second-hand smoke.