BACKGROUND: Tobacco production and consumption are known to be harmful. In India, we see stark sex-based differences in tobacco consumption, disease burden and access to healthcare. Despite that, there is no substantive efforts within research and policy/programs to better understand and address the role of gender in tobacco epidemic. We aimed to use gender, as a social construct, to better understand tobacco epidemic and situate gender within the role of tobacco industry and State policy/programs related to tobacco.
METHODS: We conducted a narrative review of published literature to scope what is known about gender and tobacco link globally and in India. We analysed imagery of tobacco products and tobacco advertising to understand the role of gender in product development and promotion. We analysed tobacco-related policies/programs to understand whether and how gender has been considered in tobacco control interventions in India.
RESULTS: We find limited research exploring gender and tobacco link, with much of the work from Europe and the USA. Tobacco industry has considered gender in market segmentation studies and deployed campaigns targeting specific genders. Such campaigns enhanced tobacco consumption among targeted groups while reiterating conventional, and often harmful, gender stereotypes. At macro level, the neoliberal economic order worsened gender inequities by limiting women employment and their underrepresentation in decision making. We find some similarities in how gender was used by tobacco industry in India and ‘western’ contexts (e.g., industry targeting men by associating tobacco use with hegemonic masculinity, women and children in precarious employment) but also important differences (e.g., rarely portraying women smoking and women liberation/emancipation themes in India; optimizing on stereotype of a happy heterosexual married couples for advertising filtered cigarettes in India)
CONCLUSIONS: We are yet to fully understand how gender operates and industry employs it. Tobacco control policies/programs remain largely gender blind and ought to consider gender in their design/deployment.