European Week Against Cancer: 29 May 2013, Aviva Stadium, Dublin, Ireland
In support of the European Week Against Cancer and in celebration of the Irish Presidency of the Council of the European Union, the European Institute of Women’s Health (EIWH) held a workshop entitled “Mind the Gender Gap: Smoking and Drinking in Girls and Women” at the Irish Cancer Society’s Healthy Lifestyle for Cancer Prevention Conference. The workshop, bringing together European and Irish experts in the field, sounded the alert about the serious health challenges facing women in the future due to their increasing consumption of tobacco and alcohol.
Speakers and delegates attending the EIWH’s workshop applauded the Irish Minister of Health, Dr. James Reilly’s announcement yesterday that Ireland will introduce plain packets for cigarettes and other tobacco products. It is expected that the new legislation will be in place by early next year. Minister Reilly stated that, standardised packaging will “remove the final way for Tobacco companies to promote their deadly product in Ireland.”1
Cancer is a major killer of European women and men. Yet, many people are unaware that some cancers can be prevented. The WHO estimates that about 40% of cancers are preventable. However, much depends on us, the citizens of Europe, how well we are informed about appropriate prevention measures and healthy lifestyles and if we are willing to act on evidence-based advice to change our behaviour. The European Week against Cancer presents each year an opportunity to highlight the European Code against Cancer, which sets out the major steps for evidence-based cancer prevention. The Code provides guidance, advice and encouragement for people to adopt healthy lifestyle and take appropriate action right now.
In the past, mostly men drove smoking and drinking trends, but with the changing societal role of women, their empowerment, emancipation, and fuelled by the tobacco and alcohol industries’ clever marketing tactics, more and more women are taking on what used to be considered male lifestyles. Smoking and binge drinking are becoming alarming risk factors for the health of women not only in Ireland, but also across the whole of Europe. “These behaviours threaten not only the future health of women, but also affect their children’s health; this is the reason why we are raising these issues at our workshop today,” explained Peggy Maguire, Director General of the EIWH.
Smoking is the leading cause of preventable disease and death in Europe for women and men.
Gerhard Steffes, Policy Officer of the Programme and Knowledge Management Unit at the Directorate for Health and Consumers (DG SANCO) presented the creative Commission initiative entitled “Ex-smokers are unstoppable.” This programme has been rolled out across Europe and targets young smokers through positive prevention messages and images of young people who state their reasons for giving up smoking. The Ex-smokers initiative supports these individuals in their efforts to stop smoking.
“During the last decades, smoking has become more popular among younger women with potentially disastrous consequences for their future health,” said Joanne Vance, the Senior Health Promotion Officer at the Irish Cancer Society. Although overall the smoking prevalence is lower among women than men, the smoking gap has been narrowing across the EU-27 due to a decrease in male and an alarming increase in female smokers, with up 50% of women now smoking in some European countries. Women appear to smoke for different reasons than men. Research suggests that women get locked into the habit faster and experience more difficulty stopping. They also seem to be more vulnerable to passive or environmental smoke.
Smoking is a major risk for a long list of cancers in women, including those of the lung, mouth and throat, stomach, colon, pancreas, liver and kidney, as well as female-specific cancers of the cervix, ovary and breast. Lung cancer—once considered a male cancer—is now overtaking that of breast cancer in Poland, England and Ireland. Linda Bauld, Professor of Health Policy at the University of Stirling, recommended: “We need to maximised access to effective support to stop smoking for women, but we also need prevent the tobacco industry from promoting cigarettes to women as an attractive product. A key policy is plain packaging, and I am delighted that Ireland has just now announced that it intends to be the first country in Europe to ban branding from cigarette packaging.”
The picture around alcohol consumption in young girls and women is echoing in many ways trends in the smoking field. More and more young women are adopting a lifestyle that includes drinking. Over 1/5 of Europeans aged 15 and older binge drink at least once a week. Alcohol is the third leading risk factor for disease and death after tobacco use and high blood pressure. Globally, the European Region has the highest proportion of ill health (7%) and early death due to alcohol. Historically, women have consumed alcohol less often and to lower amounts than men, but times are changing with relaxing of social taboos and increasing independence, women are adopting drinking as a lifestyle. “Disturbingly, the gender gap between men and women in binge drinking has shrunk on average from 12% in 1995 to 5% in 2011 with regard to binge drinking among youth. Irish girls had higher binge drinking rates compared to boys,” said Joe Barry, Professor of Population Health Medicine at Trinity College Dublin.2
Alcohol consumption is connected to over 60 diseases and health issues. For example, it increases women’s risk of breast cancer, a cancer many women know and fear. Women are more vulnerable to the effects of alcohol than men due to the biological factors of their body structure. Even at a low consumption rate, women still run the risk of many diseases, could endanger their own life through risky behavior such as getting involved in traffic accidents, engage in unsafe sex, exposing themselves to rape and unwanted pregnancy. Among the many different gender issues of alcohol consumption, drinking during pregnancy is a threat to the health of both the mother and of the child. “Our advice to women is to stop alcohol consumption when trying to conceive and during pregnancy, as there is no safe way of drinking for mother and child health,” said Mariann Skar, General Secretary for the European Alcohol Policy Alliance.
Hildrun Sundseth, Board Member of the EIWH summed up the lively audience discussion: “We must tackle smoking and alcohol consumption in women and men forcefully, by taking account of biological and behavioural factors. Robust market regulation of these products, flanked by gender-sensitive support programmes can create a healthier future for all. The revision of the EU Tobacco Products Directive is an opportunity for Europe to legislate plain packaging, banning the use of slim packages that specifically appeal to young girls, and include strong health warnings that are gender based. A new robust EU Alcohol Strategy must be agreed and implemented speedily. This Strategy should develop effective policies and enforce strict labelling and health warnings by the alcohol industry. Both tobacco and alcohol industry marketing practices that specifically target young girls must be banned.”
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Peggy Maguire, Director General, email@example.com
Hildrun Sundseth, Head of EU Policy, firstname.lastname@example.org
Gerhard Steffes is working as a Policy Officer for the European Commission Directorate for Health and Consumers (SANCO). Within the unit “Programme and Knowledge Management,” Gerhard Steffes is responsible for the development and the implementation of communication strategies, including the conceptual design and management of the European anti-tobacco campaign “Ex-smokers are unstoppable.”
He is working as a project manager for the European Commission since 1994 in various domains of Public Health (SANCO) and Environmental Statistics (European Statistical Office). In 2009, he has been seconded as a European Expert to the African Union Headquarter in Addis Ababa. His academic background includes management studies, social sciences and political sciences. He earned a Master Degree from the University for Administration and Legal Affairs in Berlin and was awarded a Ph.D. Degree for his interdisciplinary doctoral studies on the regional European integration process.
Professor Joe Barry has held the Chair of Population Health Medicine in Trinity College since 2009, having previously held the position of Senior Lecturer, with a concomitant post as Specialist/Consultant in Public Health in the Health Service Executive. Professor Barry takes a programmatic and thematic approach to research into problem substance use and addiction. The substances range from alcohol to illicit drugs such as heroin and cocaine and prescribed medications such as methadone and benzodiazepines.His research includes cross sectional surveys, intervention studies, cohort studies, health outcome studies such as mortality and survival analysis, general health, social and economic impact studies, prevalence of use studies, behavioural and attitude studies, policy analysis, neuroscanning and Cochrane reviewing.
His research findings have been widely published and presented at both national and international levels and have been used to influence policy. Professor Barry served as head of Public Health & Primary Care in Trinity College from 2006 – 2012. He acted as Interim Deputy Head of the School of Medicine in Trinity College during 2012 and is the School Director of Policy and Engagement. He has served in various capacities on a variety of public bodies, both academic and professional. He was Dean of the Faculty of Public Health Medicine of the RCPI for two consecutive terms, 1997 – 2002. He has served on the National Drug Strategy Team and the National Advisory Committee on Drugs. He is currently Chair of the North Inner City Local Drugs Task Force and is a board member of Alcohol Action Ireland and of the Irish Penal Reform Trust.
Professor Linda Bauld is Professor of Health Policy at the University of Stirling. She has a background in applied policy research and for the past 15 years her research interests have centered on the evaluation of public health interventions. She has conducted studies on drug and alcohol use, inequalities in health and on tobacco control and smoking cessation. She is a former scientific adviser on tobacco control to the Department of Health and currently chairs a number of public health advisory and funding committees for NICE, Cancer Research UK and the Scottish government.
Examples of her recent work include conducting the UK government’s 2011 review of the impact of smoke free legislation in England and examining the experiences of problem drug users accessing benefits to inform recent DWP welfare reforms. From June 2013 she will become Deputy Director of the UK Centre for Tobacco and Alcohol Studies, a UK Centre for Public Health Excellence that covers 13 Universities.
Joanne Vance is the Senior Health Promotion Officer at the Irish Cancer Society. A history graduate and social researcher, Joanne has worked for 20 years designing, delivering and evaluating community-based education and awareness raising programmes to promote equality and to address the exclusion of disadvantaged groups, particularly women, people with disabilities, and unemployed people.
Having completed her MSc in Economic Policy Evaluation, she moved into the health policy reform arena, with the National Women’s Council, specialising in health inequalities, and primary care. Joining the Irish Cancer Society in 2010, she co-designed the X-HALE Youth Awards, a smoking prevention initiative, which engages young people from communities where smoking is an issue. A strong interest in understanding how gender impacts in health service design and delivery; she is a member of the Health Service Executive’s Gender Mainstreaming National Advisory Group.
Kevin O’ Hagan is the Health Promotion Manager at the Irish cancer Society. He has worked in the field of Health Promotion in both the public and voluntary sector. He was seconded form his teaching position in 2000 to the post of Regional Manager for Social, Personal and Health Education (SPHE) in Post-primary schools. In this role he assisted schools in implementing the SPHE programme; delivering training to teachers and assisting schools in developing policies to promote the health and personal development of students.
Previous to joining the Irish Cancer Society Kevin was Programme Manager for the National Youth Health Programme where he managed the Health Quality Award process, which promotes quality youth health promotion practice within 40 community and voluntary youth organisations. He has postgraduate training in Education, Health Promotion, Youth and Community work and Psychotherapy.
Panel of experts
Liam McCormack is responsible for policy on alcohol in the Irish Department of Health. He graduated from UCD in 1993 (BComm) and spent a number of years working as a computer systems analyst in the Civil Service.
He joined the Department of Health in December 2000 and has worked in a number of policy areas; his last role involved drafting legislation. His current role is to develop policy on alcohol, especially in the context of the National Substance Misuse Strategy report.
Marion Rackard is an accredited addiction counsellor (IAAAC) and psychotherapist (IAHIP). Manager of a HSE community based alcohol counselling service for south west Dublin from 1990-2004. Director of a National Counselling service(ALBA) 2004-2006. Executive Director of Alcohol Action Ireland 2006-2008. Since 2008, she has been working in the national office for addiction in Social Inclusion on a variety of substance misuse projects with a remit for education and training and the substance misuse strategy.
Florence Berteletti Kemp is a public health and tobacco-control advocate. She works as a consultant on European Union health policy to the Smoke Free Partnership (SFP) in Brussels and was appointed to lead the organisation in 2009. Ms. Berteletti Kemp has worked on policies related to tobacco control in the European Union and at International since 2005 when she joined SFP.
Her work involves leading the development of political strategies to ensure the implementation of the Framework Convention on Tobacco Control (FCTC), and in particular FCTC Art 11 & 13 (packaging, labeling and advertising of tobacco products), FCTC Art 6 (Tobacco Tax Directive and measures related to the price and affordability of tobacco), FCTC Art 5.3 (tobacco industry interference in tobacco control policy) and FCTC Art 8 (smoke free policies). Her work also involves leading and coordinating major pan-European projects, including TobTaxy, a capacity building project, which ran from September 2010 to November 2012.She is also a member of DG SANCO Stakeholder’s Dialogue Group.
Ger McHugh has worked with Foróige, the National Youth Development Organisation since 2007, as Drugs Misuse Prevention Project Officer. Ger facilitates Drug Awareness Training for Foróige staff and volunteers, policy review and development, consultancy and support for programme design and promotes best practice in drug prevention education initiatives. Ger is currently leading the development of and training in Foróige’s new Health and Well-being programme Be Healthy, Be Happy.
Ger holds a Degree in Social Science, a Certificate in Addiction Studies and a Specialist Certificate in Youth Health Promotion. Ger represents the National Youth Council of Ireland on the NACD prevention sub-group. Previous to her work in Foróige, Ger was employed in Focus Ireland, working with people out of home, for 8 years.
Norma Cronin is a tobacco control specialist with a particular interest in smoking cessation and training and over 20 years experience in this area. She is a board member of ASH Ireland and an advisory board member of INWAT Europe, the International Network of Women Against Tobacco.
A trained general and public health nurse, she is the former health promotion manager at the Irish Cancer Society with overall responsibility for cancer prevention and tobacco control. She is also a former chairperson of the Office for Tobacco Control.
European Institute of Women’s Health
Peggy Maguire, the Director General of the European Institute of Women’s Health, is a political scientist and has been working at EU level highlighting the need for gender equity in health. She has worked with the Commission on various expert committees including the External Advisory Group on ageing and disability and EU Commission expert group on gender in FP6 and WHO expert group on gender mainstreaming. Peggy has initiated many research projects and publications on behalf of the European Institute of Women’s Health, including the development of a cancer information site for women and families. Recently, she co-ordinated the Institute’s contributions to the DG SANCO co-funded ENGENDER project and DG CONNECT co-funded, iSAC6+information project. Peggy has been an evaluator for FP6 and FP7 funding programmes over the last numbero of years. Her publications include: Women’s Health in Europe-Facts and Figures across the EU; Discrimination Against Women and Young Girls in Health Sector; Reducing Health Inequalities, Dementia Care challenges for an Ageing Europe.
Hildrun Sundseth is the Head of EU Policy and a Board Member of the EIWH. She is responsible for the Institute’s strategy and advocacy for an equitable and gender-sensitive approach in health policy, research, treatment and care. In the past, Hildrun headed the Brussels office of the European Cancer Patient Coalition, a patient-led umbrella organisation representing cancer patient groups from across the EU.
She was instrumental in encouraging the European Parliament to set up the forum MEPs against Cancer, and worked with the Slovenian EU Presidency to make cancer control once more a priority for EU Action. This resulted in the European Partnership Action against Cancer (EPAAC) under whose patronage the European Week against Cancer is being held. Hildrun sits on the FP7 project EHR4CT Ethics advisory committee and the EUROmediCAT Patient advisory committee. She represents the EIWH at the European Medicines Agency.
Hildrun has made various presentations on women’s health including to the European Parliament Women’s Rights and Gender Equality (FEMM) Committee and the European Economic and Social Committee (EESC) hearing on Tobacco Control.
2European Monitoring Centre for Drugs and Drug Addiction. 2011. Summary: 2011 ESPAD Report. http://www.espad.org/Uploads/ESPAD_reports/2011/The_2011_ESPAD_Report_FULL_2012_10_29.pdf.