Citation: Hitchman SC, Fong GT. The Bad With the Good? The Relation Between Gender Empowerment and Female-to-Male Cigarette Smoking Rates Across 74 Countries. ITC Project Working Paper Series. University of Waterloo, Waterloo, Ontario, Canada.; 2010
Objective: Worldwide it is estimated that men smoke at nearly five times the rate of women. However, there is wide variation across countries in the gender smoking ratio (ratio of female-to-male smoking prevalence rates). Lower smoking rates among women have been attributed to social norms against women smoking, and women’s lower social status and economic resources. We tested the hypothesis that in countries with higher gender empowerment, the gender smoking ratio would be closer to 1.
Methods: We correlated the gender smoking ratio (calculated from the 2008 WHO Global Tobacco Control Report) and the United Nations Development Programme’s Gender Empowerment Measure (GEM). Because a country’s progression through stages of the tobacco epidemic and its gender smoking ratio has been attributed to its level of development, we also examined this relation partialling on economic development (Gross National Income (GNI) per capita), and income inequality (Gini).
Findings: The gender smoking ratio was significantly and positively correlated with the GEM. GEM was also the strongest predictor of the gender smoking ratio when controlling for GNI per capita and Gini in a multiple regression analysis.
Key Conclusions: The findings identify a challenge for countries undergoing economic development and greater gender equality: can such progress take place without a corresponding increase in smoking rates among women? These findings thus highlight the need for strong tobacco control in countries in which gender equality is increasing.