Women and Smoking

An Epidemic...
In March 2001, the Office of the US Surgeon General released a long-awaited, detailed report entitled "Women and Smoking," along with the following statement:

"When calling attention to public health problems, we must not misuse the word 'epidemic.' But there is no better word to describe the 600-percent increase since 1950 in women's death rates for lung cancer, a disease primarily caused by cigarette smoking. Clearly, smoking-related disease among women is a full-blown epidemic." -- David Satcher, MD, PhD

Smoking is the most preventable cause of early death in this country. According to the Centers for Disease Control and Prevention (CDC), smoking-related diseases caused the deaths of about 178,000 women in each year from 1995-1999. On average, these women died 14.5 years earlier because they smoked.

The most recent CDC survey (from 2004) showed that about 1 in 5 American women aged 18 years or older (19%) smoked cigarettes. The highest rates were seen among American-Indian and Alaska-Native women (29%), followed by white (20%), African-American (17%), Hispanic (11%), and Asian women (5%). The less education a woman has, the more likely she will smoke. For instance, women with less than a high school education are twice as likely to smoke as college graduates.

Overall, women are less likely to smoke than men, but it is a disturbing trend that smoking is more popular among younger than older women. About 22% of women ages 18 to 44 smoke, but only about 8% of women 65 and over do. As these younger women age and continue to smoke, they will have more smoking-related illness and disability.

Women who smoke typically begin as teenagers -- usually before high school graduation. And the younger a girl is when she starts, the more heavily she is likely to use tobacco as an adult. Teenage girls are just as likely to smoke as are boys. The most recent CDC survey (from 2004) showed that 22% of female high school students and 9% of girls in middle school had smoked at least one cigarette in the past 30 days.

Cancers
Tobacco use accounts for nearly one third of all cancer deaths. Tens of thousands of women will die this year from lung cancer, which has greatly surpassed breast cancer as the leading cause of cancer death among women. More than 90% of these deaths will be due to smoking.

In addition to increasing the risk for lung cancer, smoking is a risk factor for cancers of the cervix, mouth, larynx (voice box), pharynx (throat), esophagus, kidney, bladder, pancreas, and stomach. It is also connected to some forms of leukemia.

Environmental tobacco smoke (ETS), also known as secondhand smoke, has been shown to increase the risk of lung cancer. The 2006 Surgeon General's report on secondhand smoke concluded the following:

Secondhand smoke causes premature death and disease in children and adults who do not smoke.

Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), respiratory infections, ear problems, and more severe asthma.

Exposure of adults to secondhand smoke has immediate negative effects on the cardiovascular system and causes coronary heart disease and lung cancer.

The scientific evidence shows there is no risk-free level of exposure to secondhand smoke.

Many millions of Americans, both children and adults, are still exposed to secondhand smoke in their home and workplaces even though there has been substantial progress in tobacco control.

Getting rid of smoking in indoor spaces fully protects nonsmokers from exposure to secondhand smoke. Separating smokers from nonsmokers, cleaning the air, and ventilating a building cannot eliminate exposures of nonsmokers to secondhand smoke.

Heart Disease and Stroke
Women who smoke greatly increase their risk of heart disease (the leading killer among women) and stroke. Risk increases with the number of cigarettes smoked and the length of time smoked. Even though most of the women who die of heart disease are past menopause, smoking increases the risk more in younger women than in older women. Some studies suggest that smoking cigarettes dramatically increases the risk of heart disease among younger women who are also taking birth control pills. Smoking is also linked to peripheral vascular disease, a narrowing and hardening of major blood vessels in the body. These risks can be reversed after 10 to 15 years of quitting smoking.

Lung Function
Smoking damages the airways and small air sacs in the lungs, and is related to chronic coughing and wheezing. About 90% of deaths due to chronic bronchitis and emphysema -- collectively known as chronic obstructive pulmonary disease (COPD) -- are caused by smoking. The risk increases both with the number of cigarettes smoked each day and with the length of time a woman has been smoking. Female smokers aged 35 or older are almost 13 times more likely to die from emphysema or bronchitis. Smoking "low tar" or "light" cigarettes does not seem to reduce these risks, or any of the other health risks of tobacco. Teenage girls who smoke have reduced rates of lung growth and adult women who smoke have an early decline of lung function.

Other Health Problems
Women who smoke, especially after going through menopause, have lower bone density and a higher risk for fracture, including hip fracture, than women who do not smoke. They may also be at higher risk for developing rheumatoid arthritis and cataracts (clouding of the lenses of the eyes).

Your Reproductive Health
Tobacco use can damage a woman's reproductive health. Women who smoke have an increased risk for delayed conception and fertility problems. Smokers are younger at menopause than nonsmokers and may have more unpleasant symptoms while going through menopause.

Smoking can also cause complications during pregnancy that can hurt both mother and baby. Smokers have a higher risk of the placenta growing too close to the opening of the uterus. Smokers are also more likely to have premature membrane ruptures and placentas that separate from the uterus too early. Bleeding, premature delivery, and emergency Caesarean section (C-section) may result from these problems. Smokers are also more likely to have miscarriages and stillbirths.

Your Baby's Health
More than 10% of pregnant women smoke throughout their pregnancies. Smoking is linked to an increased risk of preterm delivery and infant death. Research also suggests that infants of mothers who smoke during and after pregnancy are 2 to 3 times more likely to die from sudden infant death syndrome (SIDS) than babies born to nonsmoking mothers. Even of the women who are able to stop smoking during pregnancy, only one third of those remain quit one year after the delivery. The risk is somewhat less for infants whose mothers stop smoking during pregnancy and resume smoking after delivery. But infants of nonsmoking mothers have the lowest risk of SIDS. As many as 10% of all infant deaths could be prevented if pregnant women did not smoke.

Smoking during pregnancy is responsible for 20% or more of cases of low birth weight infants. Smoking during pregnancy slows fetal growth, often causing babies to have health problems as a result of being born underweight. Quitting smoking during pregnancy reduces this risk.

Some harmful chemicals in tobacco smoke can also be passed on to a baby through breast milk.

Your Children's Health
Almost 3 million children in the United States under the age of 6 breathe secondhand smoke at home at least 4 days per week. Studies show that older children whose parents smoke get sick more often. Their lungs grow less then children who do not live around smokers. They get more bronchitis and pneumonia. They cough and wheeze more. Smoking can also trigger a child's asthma attack. More than 40% of children who go to emergency room for their asthma live with smokers. A severe asthma attack can be life threatening.

Children who live with parents who smoke also get more ear infections. They have fluid in their ears as a result and may have to undergo surgery to have ear tubes placed for drainage.

Parents who smoke are also more likely to have children who smoke.

Kicking the Habit
More than 75% of women say they want to quit smoking completely, and almost half report having tried to quit in the past year. The chance for quitting successfully is about the same for both men and women.

Quitting can help reduce the risk of many of the health effects listed above. The risk of heart disease is greatly reduced just 1 to 2 years after quitting. The risk of stroke returns to normal 10 to 15 years after quitting.

Many women are afraid to quit for fear of gaining weight. Some women who quit smoking do add a few pounds. However, the health benefits of quitting are considerably greater than any problems posed by a small weight gain. On average, a woman gains about 5 pounds after she quits, an amount that can be controlled through diet and exercise.