Gender, Social Change, and Global Patterns of Cigarette Use

University Of Colorado At Boulder, Boulder CO

Investigators

Abstract

ABSTRACT The decline of cigarette use in high-income, more developed countries (MDCs) contrasts with the growth of cigarette use in middle and low-income, less developed countries (LDCs). The contrast also involves gender differences: Although female and male smoking have converged in MDCs, female smoking remains low compared to male smoking in LDCs. Public health officials decry the rising use of cigarettes among men in LDCs, but also worry that the low rates of smoking among women means they have the potential for large future increases. Along with public health concerns, these global patterns of male and female smoking raise theoretical questions about the nature of social differentiation and health behavior. This study poses the following research questions: What are the underlying sources of converging gender differences in smoking in MDCs? Do these underlying sources have the same influence on gender differences in smoking in LDCs? And do they explain the larger gender differences in LDCs compared to MDCs? A common argument answers these questions by positing that movement toward gender equality produces converging male and female rates of smoking in MDCs. It further suggests that gender inequality and restrictions on female behavior account for low rates of female smoking in LDCs, and the varied size of the gender gap in smoking in MDCs and LDCs. In contrast, a diffusion argument suggests that variation in the gap between male and female smoking is the byproduct of a female lag in the general process of cigarette adoption, spread, and abatement, and has little to do with improvements in women's status. Still other explanations suggest the need to consider influences such as economic growth, life expectancy, trade liberalization, trade dependency, and public health policies. Few if any studies have evaluated these theoretical arguments with cross-national data for both MDCs and LDCs. This project improves on existing work by examining gender differences in tobacco use across nations that represent all regions and income levels of the world. It will gather aggregate data on cigarette smoking of men and women, gender equality, cigarette diffusion, and other economic and public policy influences on cigarette use for 22 MDCs and up to 87 LDCs. The data for the MDCs allow the over-time study of nations at middle to late stages of the movement toward gender equality and cigarette diffusion, while data for both the MDCs and LDCs allow the study of cross-sectional differences among nations that span both early and late stages of the movement toward gender equality and cigarette diffusion. With such data, the statistical models will test non-linear and non-additive hypotheses that follow from the theoretical arguments. The broader impacts of this research relate to the benefits of understanding the underlying sources of a major public health problem in both modern and developing societies - the use of cigarettes. Although many studies examine the causes of cigarette use, they tend to focus on individual risk factors and neglect the fundamental social forces that underlie the individual risks. The attention here to macro-level forces of social change highlights the importance of understanding these fundamental social forces, the spread of tobacco outside the United States, and the experiences of LDCs at the early stages of the epidemic. In addition, benefits to society come from the attention given by the proposed project to women, a group often under-represented in medical research, and deserving of special study in relation to cigarette use.