Cigarettes present a major dilemma for many young women. To some, smoking is "cool," it helps them stay thin, and many of their role models, from actresses to rock groups, can be seen in a blue haze.
Today, the smoking rate for high school girls is 30 percent, higher than the 24 percent for adult women. And the trend line for female smoking is up for all ages, signalling a rising concern about the future of women's health.
Indeed, with the news that smoking has now become the leading cause of preventable death and disease among women, antitobacco forces are gearing up for a public-information campaign aimed at young women. It is designed to combat what they see as pro-smoking messages perpetuated by tobacco ads and other media.
Public-health groups hope to use the report by the US Surgeon General, released yesterday, as a springboard to get get the word out about the dangers to women from smoking. "This really can help with reeducating personal physicians so they focus on the issue of women's health and tobacco," says Dr. Tom Houston of the Smokeless States program in Chicago.
While total cigarette use fell in 1999, the tobacco industry increased its advertising and marketing expenditures by 22 percent - with a lot of that money targeted toward women.
To counter such advertising, this summer pregnant women will start to see ads urging them to quit smoking for good. The idea is that pregnancy is a "teachable moment," when women smokers are willing to do something important for themselves and their unborn child.
"Many women when they are pregnant find it is a great time to quit smoking," says Lyndon Haviland, executive vice president of the American Legacy Foundation. "With these ads we want to empower women to act on their own behalf."
Currently, some 20 percent of women smokers who are pregnant continue to smoke while they're expecting, and two-thirds return to smoking after they have the baby, according to the foundation, which is paying for the ads with money from the national tobacco settlement.
The report by Surgeon General David Satcher recommends women quit smoking as soon as possible. It also encourages women to become more vocal on issues relating to their health and smoking. "Concerted efforts are needed from women's and girls' organizations, women's magazines, public health policymakers, medical groups, and volunteer organizations to call public attention to lung cancer... and to call for policies and programs that deglamorize and discourage tobacco use," says the report.
"Tobacco advertisements suggest that women who smoke are liberated, sexually attractive, athletic, fun-loving and slim, whereas in reality women who smoke are often nicotine dependent, physically unhealthy, socieoeconomically disadvantaged or depressed," says Dr. Satcher in the preface to the report.
Throwing a spotlight on these facts will be one of the aims of orange "truth buses" that the foundation hopes to dispatch this summer to places where young people hang out. "We are hoping to denormalize tobacco," says Ms. Haviland. "We are not planning on preaching, but helping young people learn the facts as well as the medical consequences."
Haviland hopes the campaign makes young people feel like they are part of a national antitobacco drive. "We're hoping that young women in particular don't look at any tobacco ad in the same way after they listen to our campaign."
She says that initial screening of their ads for pregnant women has been very good. "Women have been overcome with the desire to quit," she says. "They realize they can make a difference for themselves and their child, and we have struggled to give them inspirational images."
However, Cliff Douglas, a tobacco control consultant in Ann Arbor, Mich., says research in recent years has shown that it appears to be more difficult for women to overcome nicotine addiction. This is particularly worrisome, he says, since an increasing number of young teenage girls admit to using cigarettes.
According to a recent survey, smoking rates for high school girls exceeded 40 percent in such states as North and South Dakota, Wyoming, and West Virginia.
A spokesman for Philip Morris USA says it supports efforts by the Surgeon General to educate the public about the effects of smoking. On its website, the company has links to the report. "We believe people should rely on the public health community when making any or all smoking-related decisions," says Mike Pfeil, a spokesman for the company. But he says the company can't address specifics of the report since it hasn't had a chance to review it yet.
(c) Copyright 2001. The Christian Science Monitor