“Lung cancer rates soaring for women after tobacco manufacturers target them by saying smoking helps you stay slim,” the Daily Mail claims.
Elsewhere, BBC News reports that over the next 30 years the number of women with lung cancer is set to rise significantly faster than the number of men with lung cancer.
Where does the news come from?
The news stories come from a study of projected trends in cancer rates and cancer survival overall that was originally published online in the British Journal of Cancer in August 2012.
The study, conducted by researchers at King’s College London and University College London, was funded by the charity Macmillan Cancer Support. It used existing information about trends in cancer rates and cancer survival in England to build a UK computer model to predict how these numbers will change over the next three decades.
The research looked at breast, lung, bowel and prostate cancer, and all cancers combined. Overall, the study authors predicted that the total number of cancer survivors in the UK could increase from 2.1 million in 2010 to 5.3 million by 2040.
The lung cancer figures were highlighted this week in a press release from Macmillan, which says that lung cancer is still a killer but that research into the disease is not as well funded as other types of cancer.
Macmillan highlights the fact that lung cancer receives a quarter of the research funding compared to breast cancer, even though lung cancer kills more than 13,000 women a year in England and Wales.
What does the report say about lung cancer?
The study predicts that lung cancer cases will double from 65,000 in 2010 to 137,000 in 2040.
The number of women with lung cancer in the UK is set to quadruple within the next 30 years, from around 26,000 in 2010 to about 95,000 in 2040. In contrast, lung cancer rates in men are predicted to increase by 8%, from 39,000 in 2010 to 42,000 in 2040.
The model used in the research is based on the assumption that current trends in lung cancer will remain the same, but this may not be the case.
However, this study does reinforce the importance of long-term planning in order to anticipate the health needs of an increasing ageing population.
What could explain the projected trends?
As is the case with cancer generally, the projected increase in lung cancer rates is largely due to an ageing population, say the researchers.
Lung cancer is more common in older people, probably because they have been smoking for longer than younger smokers and the longer you smoke, the higher your risk of lung cancer.
The difference in projected rates among men and women is thought to reflect the difference in smoking rates between the sexes in the past. It is well-established that smoking is the main cause of lung cancer and that current lung cancer rates generally reflect smoking rates among the population 20 to 30 years earlier.
The report does not cover this point in detail, but it does point out that male lung cancer incidence rates in England have declined, mainly because the number of men who smoke has reduced since the 1970s.
Other research has found that lung cancer incidence rates in men peaked in the 1970s and have decreased by more than 45% since then, reflecting the decline in smoking rates among men after World War II.
However, from the mid 1970s to the late 1980s lung cancer rates among women increased by around 45%, probably reflecting a later ‘peak’ in smoking among women, although they are now increasing more slowly.
What evidence is there that tobacco companies marketed cigarettes to women as a slimming aid?
A report from the World Health Organization (WHO) that looked at the history of tobacco marketing to women globally found that tobacco companies linked cigarettes to fashion and slimness as early as 1927. The report quotes an advertisement from the time that encouraged women to ‘Light a Lucky [Lucky Strike] and you’ll never miss sweets that make you fat’.
In the 1960s and 70s women became a major target for the tobacco industry. The launch of Virginia Slims by Philip Morris in 1968 deliberately targeted women by associating smoking with glamour, thinness and independence.
The WHO report points out that the tobacco industry has used promotional campaigns, sponsorship and the internet to market cigarettes to women. A recent article in the journal Tobacco Control highlighted the emergence of pro-smoking smartphone apps.
In the UK tobacco advertising is illegal but this is not the case globally, particularly in countries in the developing world.
The WHO report highlights the fact that tobacco companies are now aggressively targeting Asian women, quoting the cynical words of a Bensons & Hedges marketing strategy that says that men ‘represent the cigarette world of yesterday, rather than the market of tomorrow’.
The possible influence – or not – of cigarette marketing upon smoking rates in women is not addressed by the British Journal of Cancer study.
However, the Daily Mail should be congratulated for raising awareness about the issue of tobacco marketing aimed at women, especially those in the developing world.
Why has Macmillan focused on lung cancer?
Lung cancer is the leading cause of death from cancer in the UK. Ciarán Devane, Macmillan’s chief executive, says: “For most cancers in the UK, we are looking at how we can cope with a population of long-term survivors with health complications. With lung cancer we are a long way from even being able to consider these issues.”
He argues that lung cancer survival needs to improve, with more funding for research into the disease and its treatment.
- Maddams J, Utley M, Møller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. British Journal of Cancer. Published online September 25 2012
- World Health Organisation. Gender, women, and the tobacco epidemic. Published online 2010