Gender Differences and Tobacco
Gender Difference: A Meaningful Distinction
Both sex and gender are relevant for tobacco control. While sex refers to the biological differences between women and men, gender refers to the array of socially constructed roles and relationships, personality traits, attitudes, behaviors, values, relative power and influence that society ascribes to the two sexes on a differential basis. Men and women are affected differently by tobacco use and tobacco messaging, and smoking rates alone differ between men and women.
Get facts about smoking rates from the Centers for Disease Control and Prevention.
Find more information about how smoking affects Special Populations.
Gender & Tobacco
Gender differences are apparent in the way men and women are affected by tobacco and influenced by tobacco messaging. Some studies have indicated the following results:
- Girls and women are more likely to fear weight gain than boys, and to initiate and continue smoking for weight control.
- Women gain more weight after quitting than men.
- Women and girls tend to smoke as a “buffer” against negative feelings, while men smoke more from habit or to enhance positive sensations.
- Low-income mothers in Western countries used smoking as a “time out” from the demands of caring for young children.
- Some females in the Philippines expressed emotional dependence on tobacco in the midst of life difficulties, while young urban Vietnamese women said they might start smoking if they become “very unhappy”.
- Female addiction may be reinforced more by the sensory and social context of smoking, rather than by nicotine, suggesting that patches may not be so effective an aid.
- Women quit less easily than men due to their different responses to nicotine as well as a lack of social support, fear of weight gain, depression and hormones.
- Relapse rates in women are higher, and it may take a number of attempts before the achieve success.
Read the Surgeon General’s Report on Women and Smoking. Note: large file - will take a few seconds to load.
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The Impact on Health
When it comes to health, tobacco poses specific threats for men and women. Men risk declines in fertility and sexual potency, and female smokers risk increased cardiovascular disease, in particular while using oral contraceptives, and higher rates of infertility, premature labor, low birth weight infants, cervical cancer, early menopause, and bone fractures.
Smoking during pregnancy adversely affects fetal development. Female non-smokers are more likely to be exposed to environmental tobacco smoke, which elevates the risks of lung cancer and heart disease.
Diseases that are more prevalent or manifest differently in women include cardiovascular disease,
substance abuse and addiction, and lung diseases such as cancer and asthma.
Read the American Medical Association report Women's Health: Sex- and Gender-Based Differences in Health and Disease.
Gender Differences with Lung Cancer & Smoking
Other research indicates differences in the risk between men and women when it comes to lung cancer.
A study by the Journal of the National Cancer Institute confirms findings that the occurrence rates for major lung cancer types are consistently higher for women than for men at every level of exposure to cigarette smoke – a difference likely due to the higher susceptibility to tobacco carcinogens in women.
Read about the Differences in Lung Cancer Risk Between Men and Women: Examination of the Evidence from the Journal of the National Cancer Institute.
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Exploiting Gender Differences to Promote Tobacco
Through comprehensive social research, the tobacco industry understands popular culture and psycho-social aspirations, and it incorporates this knowledge into its massive promotional efforts as it seeks new markets and sustains existing ones. Prevailing gender norms are a key feature within promotion for both sexes. When users realize how they are targeted, it is a significant step toward reducing vulnerability.
- Smoking is portrayed as a manly habit linked to happiness, fitness, wealth, power and sexual success, while in reality it brings premature death and sexual problems.
- The tobacco industry deliberately targets women with new products and glamorous, sexy, and independent themed advertising.
- Tobacco is promoted to women as a buffer for negative feelings, a time-out from stress, and as way to control weight.
- The greatest growth of tobacco advertising aimed at women followed the introduction of Virginia Slims in 1968 with its slogan “You’ve Come a Long Way, Baby!” Since then, there have been an increasing number of cigarette brands and advertising campaigns targeted toward women, including women-targeted brands and promotions.
Learn more about Gender, Health and Tobacco.
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Researchers have found a significant difference in quitting success between men and women, as well as between men (when compared to other men) and between women (when compared to other women). Past attempts at quitting smoking, adherence to bupropion medication, body mass index, stress, depression, and education are all factors that have an impact on a person’s chances of quitting smoking successfully. Some factors make more of a difference for a woman’s chance of success while other factors matter more to men.
Read about Gender Differences in Smoking and Cessation Behaviors Among Adults After Implementation of Local Comprehensive Tobacco Control.
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New Opportunities for Clinicians
- If it is true that women have less success in quitting, more complex approaches may be needed to achieve better outcomes. Intensive counseling would address the circumstances that create obstacles to cessation.
- Awareness and advocacy are also needed. Investigative journalism offers scope for mass exposure about gender and tobacco. Community and school-based discussion of the health impacts of gender expectations for both males and females would foster greater self-awareness and, thus, resistance to gender-based advertising and harmful social norms.
- Revising cessation treatments for women and tailoring therapy to increase behavioral support and less reliance of nicotine replacement.
- Increased attention should be devoted to reduction in preventable risk factors for chronic disease such as tobacco, alcohol, and other drug use, which in women are increasing rather than decreasing.
- Increased attention on the part of both physicians and patients to modifiable risk factors for cardiovascular disease remains important given its predominant contribution to morbidity and mortality in older women.
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