Cigarettes: the dark side of gender equality

You've come a long way, baby," ran the 1968 Virginia Slims advertising slogan, and so women had. Increasingly likely to attend university and enter the fulltime workforce, women in the late 1960s were proving that biology is not destiny, that a woman could do anything a man could.

Unfortunately, that extended not just to education and work, but also to the freedom to choose bad habits. So many women took up smoking, to the point where, by the time Virginia Slims cigarettes were introduced, 38 per cent of Canadian women smoked. This still paled in comparison to the 61 per cent of men who smoked, but it represented a sea change, since not very long before, the smoker's lounge, like much else, had been seen as the exclusive domain of men.

Indeed, at the turn of the century, smoking was considered a sign of "loose morals" in women, and women could be - and were - fired and arrested for lighting up. The relaxation of such outdated proscriptions represented a kind of liberation, and something on which Virginia Slims and other tobacco companies capitalized. So we produced a generation of female smokers to join their male counterparts, in the workplace and the home - and in hospitals and cemeteries.

As it turns out, freedom to smoke has been particularly tough on women. Women who smoke have double the risk of lung cancer as male smokers, and now a newly published study suggests they are also at elevated risk of coronary heart disease.

The study, conducted by researchers at the University of Minnesota and Johns Hopkins University, assessed 86 previous studies involving four million subjects. And it found that women who smoke face a 25-per-cent higher risk of developing coronary heart disease than do male smokers.

Furthermore, the excess risk faced by women increases by two per cent each year, which means long-term female smokers are at dramatically increased risk as compared to long-term male smokers. And as bad as that sounds, it may be underestimating the risk to women, since men tend to smoke more cigarettes than women.

The researchers aren't clear as to why women are at greater risk, though they surmise it could be the result of women taking in more toxins while smoking. But whatever the reason, it's clear that addiction to cigarettes is not liberation, but bondage.

Women have clearly got that message, as smoking rates have decreased substantially. Although there remain concerns about smoking among adolescent girls, smoking rates for women in Canada have decreased from 38 per cent in 1965 to just 17.4 per cent in 2010. This also compares favourably to the 24.2 per cent of men who smoked in 2010, though men's smoking rates have decreased much more substantially.

But those numbers, we hasten to repeat, are Canadian. Things are very different in other parts of the world, particularly in low-and middle-income countries. Much like Canada a century ago, few women in developing countries smoke, and so, much like Canada 50 years ago, tobacco companies are courting young women.

According to the World Health Organization, a number of developing countries have experienced an increase in the number of female smokers even while the number of male smokers declines. The WHO estimates that the number of female smokers worldwide will double by 2025; this will add substantially to developing countries' health care costs and cost many women their lives.

Consequently, it's important that these countries implement aggressive anti-smoking campaigns, and that at least some of the campaigns be directed specifically at young women. Let them know they've come a long way, baby, and shouldn't go back to bondage of any sort.