“Nobody can take away my cigarettes—not even if I get hurt”—Lithuanian cigarette poster

America’s women’s and girls’ organizations and our public health community hereby join in an urgent appeal to the United States Congress to recognize America’s particular obligation to help protect the world’s women and girls from their growing addiction to lethal tobacco. Among the greatest health threats facing women around the globe today is tobacco use, and American tobacco companies are aggressively marketing to increase the number of women and girls who smoke, especially in developing countries. Worldwide, 47% of men smoke compared to 12% of women. But the low rates among women are changing fast. Without strong government and private sector intervention, smoking prevalence among women could triple over the next generation, the number of women smokers rising from the current 187 million to over 530 million. Some 80% of these smokers will live in the developing world, and half of them will die prematurely from tobacco-related causes.

The tobacco industry is aggressively targeting women and girls in developing countries with seductive advertising that blatantly exploits ideas of independence, power, emancipation, and slimness. The industry claims that cigarette advertising merely encourages brand switching. But, the launching of Virginia Slims in Hong Kong — at a time when less than 2% of Hong Kong women under the age of 40 smoked — exemplifies industry attempts to create a market.

Poster features “Madonna” selling cigarettes in Philippines—a devoutly catholic country

The tobacco companies sponsor tours by female pop stars to developing regions and produce yearly calendars in the Philippines – a deeply religious country – featuring the Madonna amidst cigarette packs. In Taiwan, for the Lunar New Year, the industry recently produced the Yves St. Laurent luxurious gift pack containing two cartons of cigarettes plus some crystal, and the Virginia Slim Lights gift packs with stylish lighters for female smokers. Fashion conscious Indian girls and women – traditionally nonsmokers – are special targets of such marketing.

In the developing markets in Eastern Europe, Asia, the Middle East, Africa and Latin America, direct and indirect advertising is widespread. Tobacco sponsorship of sports, prominent ads for bistros, boutiques, travel companies and TV films, all bearing industry logos are commonplace.

Several comprehensive studies show that tobacco advertising revenue discourages the media from reporting the risks of smoking. This is of special concern in developing countries, where awareness of the hazards of smoking is low, sometimes nonexistent. Governments, the public health community, and women in developing countries lack the financial resources and the experience in dealing with the tactics of the U.S. tobacco industry. There is often little known about and less emphasis on the special risks of tobacco faced by women. Tobacco control programs in many countries are absent or inadequate, and those that exist are often directed to men. Woman-specific campaigns are rare and principally concentrate on the effects of a woman’s smoking on a fetus or child. Few programs have encouraged women to quit smoking for their own sake.

The political influence of American and local tobacco companies against tobacco control and education is even greater in these emerging countries than in the United States.

Young Central European female smokers target of CECHE’s A Family Year TV Series

Recommendations For U.S. Government Action

As the world’s leading exporter of tobacco products, the United States has a moral responsibility as well as a special opportunity to reduce the global burden of premature disease and death worldwide by supporting programs and policies that prevent a rise in smoking among women and girls, especially in developing countries.

The United States consistently has provided leadership and funding to address the world’s most pressing public health needs, including HIV/AIDS, hunger, maternal and child health, and immunization. In contrast, the United States Government actually has promoted smoking overseas for decades.

United States companies spend billions of dollars on aggressive tobacco marketing campaigns overseas that directly link smoking with American values, freedom, and liberation. In many markets, American companies reach youthful audiences through television and radio advertising, free samples, and other methods that are illegal in the United States. Through exports and overseas operations, United States tobacco companies sell more cigarettes overseas than they do in the United States.

Smoking in films made in the United States is pervasive and is perhaps one major cause of increased smoking among women and girls around the world. According to one study, more than half of the top-grossing United States films released between 1991 and 1996 exhibited smoking. In these films, 80 percent of the male lead characters and 27 percent of the female characters smoked. The motion picture industry is painting a distorted picture that smoking is a truly American activity.

Fortunately, as Carol Bellamy, the Executive Director of UNICEF has stated, "There is no cause of premature death more preventable than the use of tobacco. That is why UNICEF condemns the calculated shift of the tobacco market from its shrinking consumer base in the industrialized countries to the vast, predominantly young populations of the developing world." The Executive Director said "the tobacco industry’s actions are a prescription for a global health catastrophe, especially for children and women, who are the prime targets for tobacco advertising and promotion."

Another outstanding woman leader has spoken out. The World Health Organization’s Director-General and former Prime Minister of Norway, Gro Harlem Brundtland, saying that "children are the most vulnerable" to tobacco, has called on the World Health Assembly to launch a new global strategy and to halt what she called "the relentless increase in global tobacco consumption." In light of the role American tobacco companies have played in spreading tobacco use globally and the large financial benefits they and we continue to enjoy from tobacco exports - tens of millions of ordinary Americans own U.S. tobacco company stock through their pensions, mutual funds and directly – it is appropriate that Americans act. We call upon the Congress of the United States to enact legislation that will:

End U.S. Government Support for Tobacco Abroad. The United States should actively seek to halt the global transfer of the problem to developing countries and prevent the imminent epidemic of tobacco deaths by refraining from attempts to weaken any foreign tobacco regulation, unless the regulation discriminates against U.S. products in an arbitrary and unjustifiable manner and is not a reasonable means of protecting public health.

Adequately Fund Global Tobacco Control Efforts. A private, nonprofit organization should be established to assist public health organizations in other countries through public education programs, technical assistance to health professionals, mass media campaigns, grants and other general assistance. Significant funding should be provided for a nonprofit organization as well as for global tobacco control efforts by U.S. federal agencies and multilateral organizations such as WHO, UNICEF and the World Bank.

Establish a Code of Conduct for Labeling and Advertising Overseas. U.S. tobacco companies should be required to print health warning labels on tobacco products sold overseas that are as stringent as those required in the United States. U.S. tobacco companies should also be prohibited from selling, advertising or marketing tobacco products to children in other countries, with the same standards applied to their overseas conduct as at home.

Stop International Tobacco Smuggling. The Bureau of Alcohol, Tobacco and Firearms, which currently regulates alcohol smuggling, should be given authority to deter tobacco smuggling through, among other things, a system of export permits and increased record keeping.

The next century will bring the full burden of the tobacco epidemic to young girls and women in Asia, Africa, Latin America and other developing regions. As women’s disposable income increases and cigarettes become even more affordable, the tobacco companies will strengthen their grip on the most vulnerable populations – young girls and women who look to the West for the latest in lifestyle. We must ensure continuing congressional leadership and action on tobacco control, or else we risk leaving the rest of the world as orphans, for settlements in the states will not address our international obligations. American leadership and support are urgently needed to launch a global effort and win the war against tobacco.


Questions? Comments? Concerns? E-mail CECHE at CECHE@igc.org

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