The 84th Annual Meeting of the American Association of Physical Anthropologists (2015)

Female smoking prevalence and the fertility transition


Anthropology, Washington State University

March 27, 2015 1:15, Grand Ballroom A/B Add to calendar

Tobacco consumption is responsible for about 1 in 5 deaths in developed countries, and 1 in 10 deaths in developing countries. There is little difference in mean male smoking prevalence in developed vs. developing countries (30.1% vs. 32%, respectively). Female smoking prevalence, in contrast, differs dramatically (17.2% vs. 3.1%, respectively). This difference in female smoking prevalence is usually ascribed to differences in women's social and economic power in developed (high) vs. developing countries (low) and attendant norms regulating women’s substance use.

Nicotine and other constituents of tobacco, however, are potent teratogens. Moreover, nicotine activates virtually all neurophysiological toxin defense mechanisms, such as bitter taste receptors, nuclear receptors, xenobiotic transporter and metabolizing proteins, and conditioned aversions. This raises the possibility that, to protect their fetuses and nursing infants, women with reduced access to modern methods of birth control, high fertility, and extended periods of breastfeeding, as is seen in many developing countries, avoid regular consumption of teratogenic substances like tobacco, compared to women in populations with low fertility, such as most developed countries.

To test the socioeconomic vs. fetal protection hypotheses of female smoking prevalence, we examined female smoking prevalence in 186 countries. We found that high total fertility rate, low use of modern birth control, and high breastfeeding at two years predicted low female smoking prevalence even after controlling for indices of women’s social, economic, and educational status. We also found that, in developing countries, female smoking increased post-menopause. These results suggest that fetal protection helps explain female smoking decisions.

This investigation was supported in part by funds provided to EHH for medical and biological research by the State of Washington Initiative Measure No. 171