[Women and smoking: fatal attraction]

Slim cigarette smoking prevalence among Canadian youth smokers: Implications for federal standardized packaging legislation

OBJECTIVES

Tobacco companies market to females and young people through slim cigarette design features and packaging. This study assessed the prevalence and perceptions of slim cigarette smoking in grades 9-12 student smokers across Canada using multiple data sources.

METHODS

Data from three cycles of the Youth Smoking Survey (2008/2009 to 2012/2013) and one cycle of the Cancer Risk Assessment in Youth Survey (2015) were used. The prevalence and perceptions of slim cigarette smoking among current smokers were compared by sex and grade.

RESULTS

In all surveys, the rate of slim cigarette use was higher among females than males; however, this difference was not statistically significant. In the two most recent surveys, grades 9-10 students had a significantly higher prevalence of use compared with grades 11-12 students. The majority of students (59.8% of females and 53.3% of males) responded, "I don't know" to the survey item seeking to determine perceptions of harm of slim cigarettes compared with regular cigarettes.

CONCLUSION

Slim cigarette use among Canadian grades 9-12 students represents a small but growing problem. Youths' uncertainty around the harms associated with slim cigarette use and the effect of slim cigarette packaging and design on harm perceptions indicate the need for product design regulations and further education in Canada.

A qualitative study exploring women's journeys to becoming smokers in the social context of urban India

In India, the prevalence of smoking among women is increasing, and the reasons behind this are unclear. We aimed to study the factors leading to initiation and maintenance of the smoking habit in women in Pune, India. Twenty-seven urban women smokers, ranging from 21 to 60 years of age (31.96 ± 10.70 years), were interviewed between September 2015 and February 2016. The in-depth interviews consisted of questions on pre-decided categories, including initiation, motivation to continue smoking, and risk perception. Thematic analysis revealed that peer pressure, curiosity, fascination, experimentation, and belonging to a group were factors that led to initiation, while lack of alternatives for stress relief, work environments, and lack of leisure time activities provided circumstances to continue smoking. Participants recognized a sense of liberation and independence from smoking cigarettes and perceived health risks as minor and distant. These findings can be used to develop or modify interventions to prevent and control smoking among urban Indian women.

Gender empowerment and female-to-male smoking prevalence ratios

OBJECTIVE

To determine whether in countries with high gender empowerment the female-to-male smoking prevalence ratio is also higher.

METHODS

Bivariate and multiple regression analyses were performed to explore the relation between the United Nations Development Programme's gender empowerment measure (GEM) and the female-to-male smoking prevalence ratio (calculated from the 2008 WHO global tobacco control report). Because a country's progression through the various stages of the tobacco epidemic and its gender smoking ratio (GSR) are thought to be influenced by its level of development, we explored this correlation as well, with economic development defined in terms of gross national income (GNI) per capita and income inequality (Gini coefficient).

FINDINGS

The GSR was significantly and positively correlated with the GEM (r=0.680; P<0.001). In addition, the GEM was the strongest predictor of the GSR (β, adjusted: 0.47; P<0.0001) after controlling for GNI per capita and for Gini coefficient.

CONCLUSION

Whether progress towards gender empowerment can take place without a corresponding increase in smoking among women remains to be seen. Strong tobacco control measures are needed in countries where women are being increasingly empowered.