Smoking Among Girls and Young Women in ASEAN Countries-Regional Summary

A study published February 2009 by the Southeast Asia Tobacco Control Alliance (SEATCA), and co-funded by the Rockefeller Foundation and the Thai Health Promotion Foundation deserves revisiting, on the occasion of World No Tobacco Day (31 May 2010), with the theme:  “Gender and tobacco with an emphasis on marketing to women”.  Gender differences in the use of tobacco continues to be exploited by the tobacco industry to enhance their marketing strategies. While global numbers in male smoking prevalence is still approximately four times higher than females, it has reached a plateau or downturn, but smoking prevalence in women is increasing at a rapid rate.

The regional study on smoking among girls and young women provides significant local evidence to support policy changes in the ASEAN region, that eventually can lead to effective action to protect young women and girls, a critical segment in society.  Hopefully, this summary can also serve as a call to action among governments in Southeast Asia, to pay more attention to the over all health and well being of women, and to put in place policies that have significant implication to young females.

The study was conducted in 2007/08 among women between the ages 13-25 years from the seven countries in ASEAN:  Cambodia, Indonesia, Laos PDR, Malaysia, the Philippines, Thailand and Vietnam.  Objectives are to determine the extent of cigarette smoking among girls and young women and socio-cultural factors associated with it; exposure of respondents to tobacco advertising, promotion and sponsorship, and their levels of awareness and support for tobacco control policies.
 
Some key findings

• The Philippines recorded the highest ever-smoking rate, with Cambodia and Laos having the lowest.
Most females respondents within each country believed that smoking is bad, however, there are a sizeable proportion who hold a neutral opinion or who think that smoking is good.
Over eight in ten female youths in most countries were aware of smoking-related diseases such as lung cancer in both smokers and (through secondhand smoke) non-smokers, stroke and stained teeth in smokers, premature ageing and pregnancy-related complications in women smokers.
Most females within each country have been exposed to anti-tobacco advertising. While television emerged as one of the major sources of anti-smoking messages in Thailand, the Philippines and Vietnam, health warnings on cigarette packs is the other important channel.
Significantly, the level of exposure to tobacco industry’s marketing is closely linked to the degree such activities are controlled within each country.
Exposure to tobacco advertising and promotion is highest in Cambodia and Indonesia where there is no ban on such tobacco marketing, and in the Philippines where only a partial ban is in place.  Study results show that female students who are exposed to direct and indirect tobacco advertising and promotion are more likely to smoke.
despite a ban on distribution of free cigarettes in all countries, 5% to 16% of girls and young women in each country have been offered free cigarettes, with higher rates recorded among those from the urban areas. This promotional activity, usually conducted during cultural events sponsored by the tobacco industry, is particularly prevalent in the Philippines (16%) and Indonesia (15%).
Some socio-cultural factors such as parental and peer tobacco use and exposure to direct and indirect pro-tobacco advertising are important risk factors for smoking. This study found that mother’s smoking is a risk factor that predicted female smoking.  Female students with close friends who smoke are thirteen times more likely to smoke compared to those without.  Prohibiting smoking in public places would be an effective strategy to reduce peer influence.
About eight in ten young females in all countries (though only half of females in Malaysia) were aware of health warnings on cigarette packs.  When asked about smoking bans in public places, approximately eight in ten young females in all countries supported a complete ban on smoking in hospitals, educational institutions, air-conditioned restaurants and indoor places of worship, and most of the females in each country also emphasized the need to have effective implementation and enforcement of all the policies.

Conclusion

• Most girls remain non-smokers, have negative views on smoking, strongly support tobacco control policies and espouse strong enforcement.
• There is a large pool of untapped support for strong tobacco control policies among the youth, especially the girls, which can go far towards making such policies more palatable and acceptable to the general population.
• Women and girls are both threatened by the potential of a future high uptake of smoking, and are suffering greatly from high rates of passive smoking.
• Measures that will protect females from passive smoking will also reduce their likelihood to take up smoking themselves, and it is necessary to have these policies in place to protect the health and well-being of our women and girls.

Full citation:  Foong-Kin, PhD.  Smoking Among Girls and Young Women in ASEAN Countries:  A Regional Summary

Full report available from [English only]:   http://resources.seatca.org/Regional%20research%20summaries/

Other SEATCA country researches on Smoking in Young Women and Girls (Indonesia, Malaysia, Vietnam):  http://resources.seatca.org/Women%20&%20girls%20smoking/