Sibylle Fleitmann
European Network for Smoking Prevention
48 rue de Pascale
1040 Brussels - Belgium
Tel:  32 2 230 65 15
Fax:  32 2 230 75 07

The Conference « Women and Tobacco : understanding the past, changing the future » was held in Paris on 23-24 November 1998. The Conference was arranged by ENSP, European Network for Smoking Prevention, in the framework of the Europe Against Cancer program. More than 270 delegates from 25 countries attended. The participants represented governmental authorities as well as non governmental from international to local levels.

The Conference delegates agreed upon the following statement :

Tobacco use of women is one of the most serious issues for Europe as well as for the rest of the world. Three smoking trends are particularly alarming :

1. The percentage of women smokers is still increasing in six EU countries (Portugal, Spain, Italy, Greece, Luxembourg and Austria) mainly due to the rising level of smoking among younger women.
2. In most countries, the uptake of smoking among youngsters is increasing.
3. In most countries, girls are smoking slightly more than boys. In other words, in the youngest age group, women are smoking more than men.

Of particular concern is the fast growing epidemic in the former socialist countries. If this trend continues, it is possible that in the near future more women than men will smoke among the adult population hence intensifying an already major public health problem.

Tobacco is embedded within the social, political and cultural context of women's lives in Europe today. The higher concentration of smoking among lower income and educational groups is of great concern considering their health is already disadvantaged. In addition, tobacco addiction in women has the potential to compromise the emancipation of women.

Between 1975 and 1995 the number of deaths among women attributed to smoking in the European Union increased from 49 000 to 113  000. Across Europe at least double this number of women die every year because of smoking. In addition to the risk of coronary heart disease, cancer and pulmonary diseases, women face the risk of specific gender-related conditions including cervical cancer, osteoporosis, low birth rate and reduced fertility. If women smoke like men they will die like men.  Women do not smoke in the same manner as men for example, women prefer manufactured cigarettes instead of roll-your-own cigarettes. They also prefer filter-tipped, low tar and blond cigarette brands. Almost half of the women smokers in Europe smoke « light » cigarettes compared with one third of men. Consumers are not aware that the marketing of these cigarettes is misleading consumers - low tar cigarettes are still a serious threat to health and are used as a substitute to quitting. The tobacco industry is deliberately targeting women in their advertising campaigns. For example internal tobacco industry documents indicate that light cigarettes have women added value.

To tackle the tobacco epidemic among women the Conference calls National Governments, the European Commission, WHO, NGO's including Women's organisations, health workers, the media and other opinion leaders throughout Europe to recognise tobacco as the major threat to the future health of European women and to take the following actions :

· Implement gender-specific evidence-based strategies from research to prevention and cessation programmes. This will involve increasing
understanding of the social conditions of tobacco use which are specific to women. Measurable national targets should be set such as cutting the percentage of girls that take up smoking and increasing the cessation rates in women who already smoke.

· Prevent the tobacco industry from marketing and labelling tobacco products on the basis of harm reduction claims such as light, mild etc. Cigarettes should be regulated in respect of the consumer interests.

· Ensure a comprehensive ban on tobacco advertising and promotion is adopted throughout Europe. The European Union and Member countries should provide assistance to the six accession countries in implementing the EU Directive and introducing effective tobacco control strategies. WHO should assist other countries to adopt similar legislation.

· Make tobacco an issue in the forthcoming European Parliament elections.

· Support the appointment of a European commissioner solely responsible for public health.

· Encourage collaboration between the EU and WHO on tobacco control strategies for women in Europe to halt the epidemic, including the support of the proposed  International Framework Convention on Tobacco Control.

· To increase the role and influence of women tobacco control leaders in policy making at all levels in Europe in support of the recommendation from the 1997 10th World Tobacco or Health Conference.

· To encourage multi sectoral collaboration on tobacco issues.
 

These steps will reduce the burden of women's disease and death from tobacco.
Paris, November 24th  1998