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Women and Smoking-Related Diseases:The Scope of the Epidemic

Women and Smoking-Related Diseases:The Scope of the Epidemic

Smoking-related diseases have reached epidemic levels among women in the United States. Since 1980, neoplastic, cardiovascular, respiratory, and pediatric diseases attributable to smoking—as well as cigarette burns—have been responsible for the premature deaths of 3 million American women and girls. Lung cancer is now the leading cause of cancer-related deaths among US women; it surpassed breast cancer in 1987.1

The first US Surgeon General's report on women and smoking was issued in 1980. In the past 20 years, numerous studies have shown that in addition to lung cancer, heart disease, and emphysema, a multitude of other health problems threaten the approximately 22% of American women who smoke. The results of these studies prompted the US Surgeon General to release a second report devoted to women and smoking. The Table summarizes the major smoking-related health risks listed in the report.

  Table — Health hazards of smoking for women
Health risk   Comments

Lung cancer   Among women smokers in the United States, about 90% of all lung cancer deaths result from smoking. Since 1950, lung cancer mortality rates in US women have increased approximately 600%. Lung cancer is now the leading cause of cancer-related deaths among women. Environmental tobacco smoke also causes lung cancer in women.

Cervical cancer   Smoking is associated with a heightened risk of cervical cancer, but whether this association is independent of human papillomavirus infection is unknown.

Cardiovascular disease   The primary cause of CHD in women younger than 50 years is smoking; oral contraceptive use further heightens the risk. Smoking also increases the risk of ischemic stroke, subarachnoid hemorrhage, and peripheral vascular atherosclerosis.

COPD   COPD mortality rates among women have increased in the past 20 - 30 years. Cigarette smoking is associated with about 90% of the deaths resulting from COPD.

Reproductive effects   Smoking increases the risk of primary and secondary infertility and is linked to delayed conception. In addition, the risk of stillbirth, neonatal death, and SIDS is greater for the children of mothers who smoke. Infants born to smokers are also more likely to be of lower birth weight and small for gestational age and to have reduced lung function.

Bone density   Postmenopausal smokers have lower bone density than nonsmokers. Women who are current smokers are at increased risk for hip fracture.

GI tract disease   Smoking increases the risk of Crohn disease and is associated with worsening of symptoms. Peptic ulcers are also linked to smoking.

Eye disease   Smoking is associated with an increased risk of cataracts.
Depression   Women smokers are more likely to be depressed than nonsmokers.

CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; SIDS, sudden infant death syndrome.
Adapted from Centers for Disease Control and Prevention. MMWR. 2002.1


1. Centers for Disease Control and Prevention. Women and smoking: a report of the Surgeon General. MMWR. 2002;51(RR-12):1-30.

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