The ladies are lighting up
Studies show that the number of women aged 20 to 39 smoking in Shanghai is 4 percent higher than the national average. Photo: CFP
Women in China are trying for equality in an area that has professionals and experts shaking their heads. While it has long been established that half the men in China smoke, now there is evidence that the number of women aged between 15 and 24 smoking is on the rise, according to the 2010 China Tobacco Control Report, published by the China Disease Prevention and Control Center.
The situation is especially serious in key cities like Shanghai, where statistics from 2002 to 2009 show the smoking rate among women aged 20 to 39 increased from less than 2 percent to a bit over 7 percent while the national average is about 3 percent, according to a study by the School of Public Health at Fudan University.
This study focused on 2,000 residents in Shanghai and revealed that while the number of men smoking remained stable over the years, the number of women smoking soared three times in the same period.
Zheng Pinpin, an associate professor at Fudan University, led the study. "When the traditional tobacco market that targeted men was saturated and even beginning to decline, tobacco companies began looking for new consumers. Women have become their new profit growth target."
Zheng said that a 2010 WHO report suggested that tobacco companies had begun shifting their marketing to target women, especially in developing countries.
"It is frightening that more and more young women are taking up smoking now," Zheng said.
Massively underestimated
It's not just happening in first-tier cities like Shanghai. Cities like Kunming in Yunnan Province, another major tobacco production and sales center in the western part of China, are showing similar statistics.
It could even be worse than the official figures. "I think the number of women smokers is massively underestimated. Based on our long-term study, many women will not admit that they smoke," said Li Xiaoliang, a former professor at the Kunming Medical University, who has been a dedicated anti-smoking campaigner for 10 years.
From 2005 to 2009 Li studied 212 women smokers in Kunming. She found their average age was 24, 80 percent of them were unmarried and had started smoking in school. Half had begun smoking within the previous five years and 10 percent had started smoking before they were 17. The youngest woman surveyed had started smoking when she was 12.
"Our study showed women smokers were getting younger and younger and they worked in the police force, sales, fashion and entertainment, media or were students, especially art students," Li said.
Another study, which observed 3,000 people dining in restaurants in Kunming, found that 11 percent of the women dining smoked. Li said this reflected the society's growing tolerance for women smoking in public.
"In our study, more than 50 percent of the public accepted that women could smoke in public," Li said.
Figures from a 2010 WHO report showed that some 300 million women around the world now smoke every day, accounting for 20 percent of the total number of smokers. Up to 30 percent of the 5 million people, who die each year through smoking-related diseases, are women.
Professor Li said the main reasons women took up smoking were to copy others, out of curiosity or as a way to relieve stress. Regular smokers say the stress relief and social habits are why they keep smoking.
Young and addicted
Shanghai woman Li Ni became addicted to cigarettes when she was quite young but when she became pregnant she stopped smoking. Now her desire for cigarettes is growing again. And she sneaks the occasional smoke.
Her 8-year-old son watches her carefully. "Mom, my class teacher told me that if you continue to smoke, you would get sick. I don't want you to be sick." Mom has no answer.
Zhang Maomao is 26 and has been smoking for more than six years. She started by chance when she was a first-year student at university.
"One of my friends was smoking and I took one to keep her company. That was it," said the fashion designer. She gets through at least one pack a day. "I just need to smoke and I can't stop," she said.
Zheng Liang, a 30-year-old office worker, started smoking in high school but can't remember why she began. "I knew smoking is harmful but I don't smoke a lot. I only smoke when I am working - cigarettes help me think," the advertising company employee said.
Although Zheng admitted she sometimes had trouble sleeping probably because of smoking, she has never considered giving it up.
Behind the trend that sees more young women taking up smoking are the tobacco companies. According to the 2010 China Tobacco Control Report, China's domestic tobacco companies followed their overseas peers and adopted marketing strategies aimed at women and girls.
"The marketing related smoking with the desires of women to pursue independence and fashion. They suggested that 'smoking could make you lose weight.' They developed the so-called low-tar, menthol-flavored women's cigarettes, which they claimed were less harmful to the body. That was a lie. And they made the packets look like cosmetics to disguise any embarrassing health concerns," Li Xiaoliang said.
"Tobacco executives connected 'freedom, fashion, slim, sexy and romantic' with smoking in their advertising and promotions and spread the message that 'if you smoked, you would be charming,'" Li added. She said women stars smoking in films and in television series also had a big impact.
"The reasons why women want to smoke are very different from the reasons men want to smoke. For many women, smoking is a symbol of independence and a way to keep fit. They mistakenly relate smoking to a women's rights and beauty. In fact, they just become enslaved to cigarettes and their bodies get destroyed," Li said.
Although anti-smoking campaigns are not new in China, discussions about women smoking are rare.
"First we need to destroy the myths about smoking for women and then it might be possible to stop women becoming addicted before it is too late," said Wu Yiqun, a former deputy director of the Chinese Academy of Preventive Medicine. When she retired she set up an NGO in Beijing to focus on anti-smoking programs.
"Many people argue that smoking is a woman's own business and it is her right to do this if she wants to. Yes, it is. But a person should take responsibility for what they do and the bottom line is they should not harm anyone who doesn't want to smoke," Wu said. "Most of the time smokers are hurting the people closest to them, the people they love the most."
Wu wants to tell people just exactly how smoking can harm an individual and people nearby. She said that in the past the information describing the dangers was too broadly phrased and people were not properly advised of the potential problems.
"We found many women smoked because they didn't know how to handle their emotions. So they took up smoking to fill the void. We need to help them get to know themselves and to handle their emotions and then we can solve the problem in a positive way," she said. "And I want to tell anyone who really wants to give up smoking that it really is possible."
But Wu said modern culture is diluting and disguising the dangers of smoking for women and this is a key public health issue. Wu grew up in Shanghai and her mother and husband were both smokers.
"If I had known about the dangers of smoking earlier, my mother might not passed away so early and my husband might not have the incurable chronic pulmonary heart disease which has caused the family so much pain," she said sadly.
Since the 1950s many medical studies from around the world have confirmed that smoking is the major risk factor in the top eight causes of death for humans, Wu said.
A single cigarette, according to WHO, can contain thousands of chemical compounds and at least 69 of these could cause cancer.
"Although smoking causes harm to both men and women, we have found women are more prone to certain diseases if they smoke," Wu said. "Smoking will affect the babies of pregnant women. Research has shown smoking can cause carbon monoxide poisoning and a lack of oxygen which can stunt a baby's growth."
The real costs
The 2006 report - The Cost of Smoking, published by the Economic Development Center of Peking University, showed that China's economic losses from smoking had exceeded the financial contribution of smoking.
The report revealed that in 2005 the cost of medical services to treat smoking-related diseases in China was 166 billion yuan ($26.32 billion). This did not include indirect costs like lost working hours, treating diseases caused by passive smoking, fires and pollution, which could add as much as 252 billion yuan to the cost.
The State Tobacco Monopoly Administration website showed that in 2005 taxes and duties from the tobacco industry totaled 240 billion yuan. In 2011, China's tobacco industry paid 752 billion yuan in taxes and duties, an increase of 22 percent year on year. But behind this huge tax windfall were 350 million smokers and 740 million victims of passive smoking. About 1 million people die each year from tobacco-related diseases, according to the China Disease Prevention and Control Center.
Yang Gonghuan, the director of the anti-smoking office of the China Disease Prevention and Control Center, said that if no action is taken, the country could be looking at an annual death toll of more than 2 million, with 25 percent of the population over the age of 40 likely to die from smoking-related diseases.
"In the West, four methods have proved effective in controlling smoking: raising the taxes for tobacco companies so that they have to increase the price of cigarettes; banning smoking in public places; having large health warnings printed on cigarette packets; and banning tobacco companies from sponsoring sporting, cultural or charity events. So far none of these have been seriously introduced in China and this is our goal for the future," Wu said.
In New York smokers pay the equivalent of 75 yuan a packet, in London they pay the equivalent of 75 yuan a packet, in Sydney 86 yuan, in Oslo 90 yuan. In Shanghai an ordinary packet of cigarettes can be bought for just 14 yuan.