BACKGROUND: Tobacco use among women and girls in sub-Saharan Africa (SSA) has historically been lower than among men. However, recent trends indicate an alarming rise in smoking rates among this demographic, driven by the tobacco industry's aggressive marketing strategies. These trends coincide with cultural shifts, urbanisation, and regulatory gaps that allow the industry to exploit vulnerable populations. This study examines the evolution of marketing strategies targeting women and girls in Nigeria, South Africa, Rwanda, Kenya, and Senegal, assessing their implications for public health and policy.
METHODS: A mixed-methods approach was employed, combining quantitative surveys of 593 women aged 19–75 across the five countries, qualitative semi-structured interviews with 45 key informants, and a literature review. A historical analysis of 30 years of tobacco industry documents (TIDs) and a policy evaluation of tobacco control laws and regulations were conducted.
RESULTS: The findings reveal that the tobacco industry employs diverse strategies to target women, including the use of flavoured products, harm reduction narratives, influencer marketing, and proximity marketing near educational institutions and social venues. Television and movies emerged as dominant marketing channels, with 77.2% of respondents reporting exposure. Social media platforms, particularly Instagram and TikTok, were also significant, with younger women being the most exposed demographic. Key informant interviews highlighted the normalisation of smoking through depictions of tobacco use in entertainment and the framing of smoking as a symbol of empowerment and autonomy for women. Cultural stigmas against female tobacco use remain strong in countries like Senegal and Rwanda, driving women to smoke discreetly. However, these stigmas are eroding in South Africa and urban Nigeria.
CONCLUSIONS: Governments must adopt gender-sensitive policies, strengthen enforcement mechanisms, and proactively regulate emerging products to combat tobacco marketing targeting women in SSA. Public health campaigns should counter industry narratives of empowerment, emphasizing the health and economic risks of tobacco use.