Smoking and Girls: A Deadly Mix

Smoking and Girls: A Deadly Mix

When we think of the dangers facing children today, most adults think of violence, drugs, drunk driving, teen pregnancy, and AIDS. We know that smoking is unhealthy, but most kids will try it, and many adults don’t take it seriously. A new Surgeon General’s report entitled Women and Smoking, reminds us that there has been a 600% increase in women’s death rates from lung cancer since 1950, and that those deaths are a direct result of a smoking addiction that starts in childhood.

Smoking is a habit that almost always begins in youth -- usually before age 16. If a child graduates from high school without ever smoking regularly, he or she will probably never will.

We think of smoking as an equal-opportunity bad habit, but the theme of the report is that smoking is a woman’s issue. This theme has not yet been embraced by most women’s organizations or advocates for girls or women -- but the research is persuasive. Girls are more easily addicted to nicotine than boys, and female smokers are more likely to die of lung cancer than males who smoke the same number of cigarettes. And a great deal of advertising is aimed at persuading girls that smoking is sexy, fun, and a way to show their independence.

Girls are as likely to smoke as boys, and the decreases in smoking from the 1970’s to the early 1990’s were reversed a few years later. For example, 40 percent of girls smoked in 1977, and this decreased to 26 percent in 1992, and went back up 35 percent just five years later (1997). However, smoking went down to 30 percent in 2000.

The results for young children also resemble a roller coaster: 13 percent of 8^th grade girls smoked in 1991, compared to 21 percent in 1996, and then back down to 15 percent in 2000. Smoking rates are higher for 10^th graders, but the trend is similar (21 percent in 1991, 31 percent in 1997, 24 percent in 2000).

The report points out the racial discrepancies; for example, for high school senior girls, smoking is most common among the American Indians and Alaskan Natives (39 percent), and whites (33 percent), and lowest among Hispanics (19 percent), Asian (14 percent) and African Americans (9 percent). The greatest reduction in smoking has been among black girls: only 7 percent were smoking in 1992 compared to 38 percent in 1977, and then up to 12 percent in 1998. Smoking among white girls decreased less and then returned to earlier levels -- from 40 percent to 31 percent in 1992, and then back up to 41 percent in 1998.

Girls who smoke are more likely to have parents or friends who smoke; they tend to have weaker attachments to parents and family and stronger attachments to peers and friends. They tend to take risks and to be rebellious, are less committed to school or religion, and are more likely to believe that smoking can control weight and negative moods. They also have a positive image of smokers, which can come from advertising, celebrities, or other role models. This positive image may overcome any concerns about the health risks.

Smoking continues into the young adult years, and those numbers are also rebounding: 37 percent of 18-24 year or olds smoked in 1965-6, compared to 25 percent in 1997-8; recent trends suggest the numbers are increasing again.

Smokers may make the choice to start smoking, but not everyone who dies from smoking is a smoker. Second-hand smoke can cause death from lung cancer and heart disease among lifetime nonsmokers. Infants born to smoking mothers or to mothers exposed to second-hand smoke are at increased risk of small birth weight and other developmental problems.

The statistics in the report are somewhat overwhelming, and also a bit confusing -- the trends are going down again, so why make such a fuss now? The reason, the Surgeon General reminds us, is that smoking is the cause of more than 165,000 preventable deaths among women every year. The report is an important reminder that smoking -- the most common drug addiction in the U.S. -- starts as an innocent experiment among youth, and becomes a potentially lethal habit that is very difficult to overcome. If adults tolerate it or shrug it off, they contribute to kids’ perceptions that smoking is cool or at least acceptable, and not really dangerous.

Women and Smoking: A Report of the Surgeon General
April 2001

Available free at www.cdc.gov/tobacco or call 770 488-5705 or fax 1-800-CDC-1311