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The Twitter accounts of two of the world’s largest tobacco companies, @InsidePMI (Philip Morris International) and @BATPress (British American Tobacco) posted multiple tweets in March 2019 celebrating International Women’s Day (IWD) and the International Week of Women, using the hashtags #IWD2019 and #BalanceForBetter (see figures 1–3). #BalanceForBetter was the official campaign theme of IWD 2019, which aims to ‘build a gender-balanced world’.1 This hashtag was used to amplify IWD content on social media.
These tweets draw on the themes of women’s equality, gender empowerment and equal pay. Accordingly, this attempt to embrace women’s equality is the latest example of how tobacco industry marketing has sought to use emerging cultural contexts and reference points to build positive associations with smoking as a feminist act.2 The media channels may have changed, but the strategy is the same: harness women’s aspirations to advance to sell more tobacco.
Tobacco industry attempts to co-opt the IWD narrative distracts from the devastating global impact of smoking on women’s health. One hundred seventy-five million women aged 15 or older around the world are estimated to currently smoke.3 In addition to causing a direct burden of preventable diseases, and associated premature morbidity and mortality, tobacco use is also associated with financial hardship and poverty resulting from increased spending on healthcare and reduced productivity that diverts limited family resources away from basic needs.4 At the population level, tobacco control measures are necessary to break the cyclical relationship between tobacco and poverty that undermines sustainable economic development. Women are also affected by the harms of tobacco from the beginning of the production cycle; while their labour is essential to tobacco farming, it is undervalued and often underpaid.5
While women’s smoking prevalence is lower than men’s globally,6 women are central to a business model that requires the continued recruitment of new smokers. Tobacco companies seek to position themselves as gender equality advocates, champions of women’s achievement and female-friendly employers, all in the service of marketing their products as desirable to women and girls. The World Health Organization (WHO) has noted that ‘women are one of the biggest targets’ of the tobacco industry, who use ‘richly-funded marketing campaigns … that draw on gender stereotypes and falsely link tobacco use to concepts of beauty, prestige and freedom’.7 Internal industry documents have found the tobacco industry has studied female smoking patterns, needs and product preferences,8 9 designed products in a manner likely to appeal to women through imagery, slogans and brand extensions10 and used marketing to target disadvantaged women.11
Despite being a minority of the world’s smokers, women also bear the greatest burden of illness and death from secondhand smoke exposure.12 Exposure to tobacco use and secondhand smoke during pregnancy also poses risks to the health and life of both the pregnant women and her baby. These include ectopic pregnancy, placental abruption, placenta previa, miscarriage, stillbirth, low birth weight, preterm birth and sudden infant death syndrome.13 The link between poverty and tobacco further increases the risk of adverse health outcomes for pregnant women and their babies.
Incorporating a comprehensive gender approach into tobacco control is essential to achieving rights-based gender equality, health and well-being.14 In March 2018, the President of the Conference of the Parties to the Framework Convention on Tobacco Control (FCTC) Preeti Sudan said:
Today, we are celebrating the International Women’ Day. It is a unique opportunity for me as the President of the Conference of the Parties to WHO FCTC, to call upon Parties to put every effort to break the vicious cycle of poverty that locks the tobacco workers, who are mainly women, in this hazardous industry…Let us address all gender issues while implementing comprehensive tobacco control laws in each of our countries with an objective to protect the health of women.15
Against this background, the tobacco industry actively appealing to women by hijacking the IWD hashtag is yet another example of the hollow use of gender equality to further its own agenda. The proliferation of social media has facilitated a new outlet for transnational tobacco companies to further their own narratives and provides an efficient way to counteract effective tobacco denormalisation strategies.16 As social media is being used extensively to promote tobacco company corporate social responsibility (CSR) initiatives,17 adopting and enforcing regulations that ban CSR promotions, as has been done in Mauritius,18 is urgently required.
Yet, these tweets form just one component of well-documented attempts by the tobacco industry to associate itself with values of women’s social progress. Such attempts have navigated multiple forms of advertising to reach women, capture them within the tobacco industry’s business model and profit from their resulting human misery. Alongside regulations to address tobacco industry CSR promotions on social media, the comprehensive implementation of Article 13 of the WHO FCTC concerning tobacco advertising, promotion and sponsorship is necessary, to capture all commercial communications with the aim, effect or likely effect of promoting a tobacco product or tobacco use.19
In the spirit of respect, the authors acknowledge the people and the Elders of the Aboriginal and Torres Strait Islander Nations who are the Traditional Owners of the land and seas of Australia.
Contributors All authors contributed to the drafting and editing of this manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.