Cigarette advertising and female smoking prevalence in Spain, 1982-1997: case studies in International Tobacco Surveillance.
BACKGROUND
Compared with northern Europe and the U.S., the widespread initiation of cigarette smoking began 20-40 years later among young women in Spain because of strong cultural prohibitions against female smoking. In this study, the authors examined the correlation between the rapid increase in female smoking prevalence and tobacco industry cigarette marketing practices in Spain during a period of rapid social liberalization.


METHODS
The authors examined age-specific, period-specific, and birth cohort-specific increases in cigarette smoking among young women in Spain in relation to internal documents from Philip Morris beginning in 1971, cigarette advertising from 1982 to 1997, and the increase in the market share of blond tobacco and "light" cigarettes preferred by women.


RESULTS
Some increase in cigarette smoking occurred among Spanish women before 1970, but the increase was substantially smaller and occurred later than in many Western countries. However, after 1970, the prevalence of cigarette smoking increased rapidly in Spanish women of all ages < 50 years. The rapid increase in female smoking coincided with massive increases in television advertising, especially to women, and increases in the market share of blond tobacco, "light cigarettes," and international tobacco brands.


CONCLUSIONS
The increase in cigarette smoking among young Spanish women illustrates how aggressive marketing can exploit periods of social liberalization and rapidly increase cigarette smoking among women, even in countries in which female smoking traditionally has been unacceptable. Strategies are needed to prevent similar increases in smoking by women elsewhere.
Shafey
Omar
O
American Cancer Society, Department of Epidemiology and Surveillance Research, Atlanta, Georgia 30329, USA. omar.shafey@cancer.org
Fernández
Esteve
E
Thun
Michael
M
Schiaffino
Anna
A
Dolwick
Suzanne
S
Cokkinides
Vilma
V
D000293:Adolescent; D000328:Adult; D000329:Advertising / Q000266:history*; D005260:Female; D005783:Gender Identity; D049673:History, 20th Century; D006801:Humans; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology* / Q000266:history*; D012924:Social Conditions; D013030:Spain / Q000453:epidemiology; D019460:Tobacco Industry; D016387:Women's Health; D014933:Women's Rights