Women and Smoking

Are women at greater health risk from smoking? Why is this? If so, why do some keep smoking? What difference to your health risk does it make if you give up at 30, 40 or 50? 

Are women at greater risk from smoking? 

Two-thirds of all deaths among women smokers in their 50s, 60’s and 70s in the UK are caused by smoking. That’s one finding from a study of over a million women published in The Lancet in 2013. 

According to the NHS smoking increases the risk of more than 50 serious health conditions - from a range of cancers to heart attack, stroke and chronic obstructive pulmonary disease. 

Table 1   Relative risks of Lung Diseases for women smokers versus women non-smokers 

 

Lung Cancer

Chronic Lung Diseases

Relative Risk for smokers

35.3 times greater

21.4 times greater

Worryingly, a number of studies now suggest that smoking causes an even greater risk of chronic illness in women compared with men: 

So why do some women keep smoking? 

Scientists think this is because women are less physically dependent on nicotine than men but more behaviourally addicted, which is a more difficult type of addiction to kick.  

Socio-economic status may also be a factor. For low-income mothers smoking may be a time-out. This may encourage increasing emotional dependency on cigarettes. It would help explain why those who live in the most disadvantaged areas have a greater proportion of smokers and higher numbers of cigarettes smoked per day.

Another possible explanation is that women may believe smoking helps them control their weight. Stopping smoking can lead to weight gain, as nicotine acts as an appetite suppressant. However, one in six people actually loses weight after giving up smoking and other possible factors may be at work over and above giving up smoking. 

A desire to control weight is one possible reason why more girls than boys now smoke. Other suggestions include to look cool, to look older, to appear independent, emotional reasons and the way tobacco industry advertising appeals to girl’s fears and fantasies.

What’s different about the way women smoke? 

Women born in the late 1930’s usually started smoking later than men and also smoked fewer cigarettes a day. So this may have masked any greater risk they faced from smoking. 

However women born after the 1960’s usually started smoking around the same time as men and now smoke only two cigarettes less per day. So any protection women may have had due to starting later and smoking less has now been largely removed. 

Table 2. Changes in smoking habits of women versus men  

Ever Smokers

Born 1935 - 44

Born 1965 - 69

% Women

% Men

27.55

46.25

24.0

28.4

Age first started

Women

Men

 

19.00

17.25

 

17.4

17.3

Cigarettes per day

Women

Men

 

16.1

21.5

 

14.3

16.3

Rates of male smoking in the UK have fallen significantly. This helps explain why the UK is one of the countries where people have been most successful at giving up smoking. Unfortunately rates of female smoking have fallen very little. 

So why are women at greater risk? 

One possible explanation is that women are more susceptible to the adverse effects of smoking or may extract a greater quantity of carcinogens and other toxic agents from the same number ofcigarettes compared with men. The NHS reports that a gene responsible for the development of lung cancer growth appears to be more active in women. The female hormone oestrogen may also play a part in the development of lung cancer among women. However, more research is needed to confirm these possible explanations. 

What we do know is that, whatever the reason, if you are a woman and smoke you could be at greater risk than your male counterparts (who are already at significant risk themselves). 

Giving up smoking 

The good news is that the earlier you give up smoking, the more you can reduce its lethal effects.  

  • For those giving up before 30, the risk is reduced by up to 97%.
  • Giving up before the age of 40 can reduce the risk of dying early by as much as 90%.
  • Even giving up at 50 can reduce the risk by an encouraging 66%. 

There are also a range of organisations which can help you give up smoking, by providing information, support and resources, including: 

In the last few years e-cigarettes have emerged as an option. Some health professionals are concerned that e-cigarettes could end up leading young people into smoking. However, the weight of evidence is that e-cigarettes are much less harmful for health than tobacco – according to a 2015 report for the UK government.  

Conclusions 

  • Smoking increases your risk of serious health conditions and dying younger.
  • The risk is greater for women, possibly due to genetic or hormonal factors.
  • There has been a big reduction in smoking among men but not among women.
  • This may be because women believe smoking will help them control their weight or because they tend to become more emotionally dependent on smoking.
  • However, giving up smoking significantly cuts the health risks for women - by up to 97% if you quit before 30 and by two thirds if you quit before 50.
  • There are now a wide range of resources to help you quit, including e-cigarettes. 

Judith Barnes. Published January 13 and first updated March 2013. 

Reviewed and updated by Kayhan Nouri-Aria December 2015. Next review date August 2018. 

 

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