Women and Smoking: How Is It Different?

EphNotes

Questions and Answers

Q. What makes smoking different for women and men?

A. Not only do women suffer the same smoking-related health problems that men do, but smoking also represents an additional health threat to women from an increased risk of cervical cancer, reproductive and pregnancy complications, early menopause, and an increased risk of coronary heart disease if they smoke and use oral contraceptives. In addition, women who have HPV have a greater chance of developing cervical cancer if they smoke. Some evidence also suggests that women may have a harder time quitting than men, and recent data indicate that the message to avoid smoking has been less successful in reaching young women than young men. These factors make smoking a unique problem for women in the next several decades.

Q. What makes women take up smoking?

A. Many factors appear to influence why women start and stop smoking. Among teenagers, 75% of all first cigarettes are smoked with another teen, usually of the same sex. Girls report that peer pressure, aspirations to emulate the liberated and glamorous advertising images of female smokers, access to a perceived method of weight control, or the pressure of a smoking parent or sibling all influence that initial cigarette. Maintenance of the smoking habit is often reinforced by advertisement claims, hunger suppression, relief of depression, as a means to cope with stress, and for the simple pleasure of smoking.

Q. How do oral contraceptives and smoking interact?

A. Cigarette smoking increases the risk of such serious cardiovascular side effeccts from oral contraceptive use as stroke, heart attack, and sudden blockage of blood vessels (thromboembolism). Risk increases with age and with number of cigarettes smoked per day and is quite marked in women over 35.

Q. Doesn’t smoking help women keep their weight down?

A. Although many women report that they believe smoking helps keep their weight down, there is no consistent medical evidence to substantiate the benefit of smoking as a weight control measure. It is true that most people who quit smoking gain some weight because of changes in their metabolism and eating behaviors, but average weight gains are small. Too many quitters, especially women, panic when they begin to gain weight and don’t give their bodies and eating habits time to adjust.

Q. What about the relief of stress?

A. It is also true that women more often than men cite smoking as a way to cope with stress, including stress that many working women and mothers experience due to their multiple-role strains. However, methods of coping with stress other than cigarette smoking can be learned, such as exercise. Stress management is often incorporated into smoking cessation programs.

Q. How great a health problem is smoking for women?

A. Smoking is the number one health risk for American women. It now appears that a major reason why women live longer than men is the fact that in the past, fewer women smoked than men. Lung disease progressed more quickly in women than men because women have more lung damage and thus are at a higher risk (two times greater than men) of developing cancer). Because of the increased prevalence of smoking among women, lung cancer is now projected to have surpassed breast cancer as the leading cause of cancer deaths in females.

Q. What are the specific effects of smoking on pregnancy?

A. Women who smoke during pregnancy have a higher rate of spontaneous abortion (miscarriage), stillbirth, premature birth, sudden infant death, and low infant birth weight. Although 18% of women smokers will quit during pregnancy and 27% will cut back, almost all will relapse following the birth of their babies.

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