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Analysis Women’s Health and Gender Inequalities

Protecting women and girls from tobacco and alcohol promotion

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1516 (Published 19 July 2021) Cite this as: BMJ 2021;374:n1516

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  1. Emma Feeny, advocacy director1,
  2. Katie Dain, chief executive officer2,
  3. Cherian Varghese, cross-cutting lead, NCDs and special initiatives3,
  4. George A Atiim, researcher4,
  5. Dag Rekve, senior technical officer3,
  6. Hebe N Gouda, project officer3 5
  1. 1The George Institute for Global Health, United Kingdom
  2. 2NCD Alliance, Switzerland
  3. 3World Health Organization, Switzerland
  4. 4United Nations University-International Institute for Global Health, Malaysia
  5. 5School of Public Health, University of Queensland
  1. Correspondence to: E Feeny efeeny{at}georgeinstitute.org

Gender transformative measures could curb the industries’ expansion into low and middle income countries, contain the burden of chronic disease, and promote gender equity, argue Emma Feeny and colleagues

Women have traditionally consumed less tobacco and alcohol than men because social and cultural norms have stigmatised their use of these products, particularly in low and middle income countries. The combination of changing gender norms, aggressive industry marketing, and continuing population growth in low and middle income countries, however, means that without urgent action, the number of women and girls consuming tobacco and alcohol is likely to rise substantially in the coming years.

This change has important implications for the burden of chronic or non-communicable diseases and injuries, for public health, service delivery, and—given the strong, reciprocal links between non-communicable diseases and poverty1—sustainable development. Consumption of tobacco and alcohol has repercussions throughout life, particularly when it begins at a young age, making it harder to stop or reduce consumption later in life. Such consumption increases women’s risk of developing cardiovascular diseases, cancers, and a range of other conditions (table 1). Risks can also be transmitted to the next generation: tobacco and alcohol use during pregnancy can have lasting effects on the health of children, who are also more likely to use tobacco and alcohol themselves if exposed to parental consumption.45

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Table 1

Examples of the health impacts of tobacco and alcohol consumption23

Non-communicable diseases already account for over 70% of all deaths worldwide, but this huge and growing burden among women is often overlooked by global health stakeholders, who continue to view women’s health from a reproductive viewpoint. The biggest killers of women globally are cardiovascular diseases, cancers, and chronic respiratory diseases.6 People living with non-communicable diseases are also at risk of severe covid-19 should they …

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