Smoking and Women Fact Sheet

May 2009

Cigarette smoking was rare among women in the early 20th century and became prevalent among women after it did among men. In 2007, 19.8 million (17.4 percent) women smoked in the United States.¹ Although fewer women smoke than men, the percentage difference between the two has continued to decrease. Today, with a much smaller gap between men’s and women’s smoking rates, women share a much larger burden of smoking-related diseases.

• Smoking is directly responsible for 80 percent of lung cancer deaths in women in the U.S. each year. In 1987, lung cancer surpassed breast cancer as the leading cause of cancer deaths among women in the U.S.²
  
  
• Female smokers are nearly 13 times more likely to die from COPD (emphysema and chronic bronchitis) compared to women who have never smoked.³ In 2008, an estimated 71,030 women will die of lung and bronchus cancer.⁴
  
  
• Smoking is directly responsible for more than 90 percent of chronic obstructive pulmonary disease (COPD), or emphysema and chronic bronchitis deaths each year.⁵ In 2005, about 52 percent of all COPD deaths were in women. This is the sixth year in a row that women have outnumbered men in deaths attributable to COPD.⁶
  
  
• Annually, cigarette smoking kills an estimated 173,940 women in the United States.⁷
  
  
• Women who smoke also have an increased risk for developing cancers of the oral cavity, pharynx, larynx (voice box), esophagus, pancreas, kidney, bladder, and uterine cervix.⁸
  
  
• Women who smoke double their risk for developing coronary heart disease.⁹
  
  
• Postmenopausal women who smoke have lower bone density than women who never smoked. Women who smoke have an increased risk for hip fracture compared to never smokers. Cigarette smoking also causes skin wrinkling that could make smokers appear less attractive and prematurely old.¹⁰
  
  
• Women have been extensively targeted in tobacco marketing dominated by themes of an association between social desirability, independence, weight control and smoking messages conveyed through advertisements featuring slim, attractive, and athletic models.¹¹
  
  
• Teenage girls often start to smoke to avoid weight gain and to identify themselves as independent and glamorous, which reflect images projected by tobacco ads. Social images can convince teens that being slightly overweight is worse than smoking. Cigarette advertising portrays cigarettes as causing slimness and implies that cigarette smoking suppresses appetite.¹²
  
  
• Non-Hispanic black high school girls have had lower smoking rates than Non-Hispanic black high school boys since 1991. Non-Hispanic white high school girls and boys have had similar smoking rates during this period.¹³
  
  
• Cigarette smoking among black 12th grade girls decreased dramatically from 1976 to 1992 (from 37.5 percent to 7.0 percent) compared with that among white girls (from 39.9 percent to 31.2 percent). Between 1992 and 1998, smoking prevalence increased among white girls (from 31.2 percent to 41.0 percent).¹⁴
  
  
• Between 1999 and 2003, cigarette smoking prevalence among high school girls decreased by 37 percent. However, between 2003 and 2007, there was only a 2.3 percent decrease in prevalence of cigarette use among high school girls.¹⁵ While the overall trend in cigarette smoking among teenage girls has been decreasing, it is doing so at a slower rate.
  
  
• Middle school white girls had the highest percentage of smoking (8.6 percent) in 2004.¹⁶
  
  
• In 2005, 10.7 percent of women smoked during pregnancy, down almost 42 percent from 1990.¹⁷

• American Indian/Alaska Native women have the highest rate of smoking during pregnancy (17.8 percent).
• 13.9 percent of pregnant non-Hispanic white women were smokers compared with 8.5 percent pregnant non-Hispanic black women.
• The smoking rate for Hispanic and Asian/Pacific Islander women who are pregnant is generally substantially lower (2.9 and 2.2 percent, respectively).^I However, rates differ considerably within subgroups.
  

• Since 1990 teenagers and young adults have had the highest rates of maternal smoking during pregnancy.  In 2005, 16.6 percent of female teens aged 15-19 and 18.6 percent of women aged 20-24 smoked during pregnancy.¹⁸
  
  
• Neonatal health-care costs attributable to maternal smoking in the U.S. have been estimated at $366 million per year, or $740 per maternal smoker.¹⁹
  
  
• Mothers who smoke can pass nicotine to their children through breast milk.  Cigarette smoking not only passes nicotine on to the fetus; it also prevents as much as 25 percent of oxygen from reaching the placenta. Smoking during pregnancy accounts for 20 to 30 percent of low-birth weight babies, up to 14 percent of preterm deliveries and about 10 percent of all infant deaths.²⁰
  
  
• Additionally, infants are more likely to develop colds, bronchitis, and other respiratory diseases if secondhand smoke is present in the home or day care center.  Maternal smoking has also been linked to asthma among infants and young children. The odds of developing asthma are twice as high among children whose mothers smoke more than 10 cigarettes a day.²¹
  
  
• Reducing frequency of smoking may not benefit the baby. A pregnant woman who reduces her smoking pattern or switches to lower tar cigarettes may inhale more deeply or take more puffs to get the same amount of nicotine as before.²²
  
  
• The most effective way to protect the fetus is to quit smoking. If a woman plans to conceive a child in the near future, quitting is essential. A woman who quits within the first three or four months of pregnancy can lower the chances of her baby being born premature or with health problems related to smoking.²³
  
  
• Women who quit smoking greatly reduce their risk of developing smoking-related diseases and dying prematurely.²⁴
  
  
• Women who quit smoking relapse for different reasons than men.  Stress, weight control, and negative emotions, lead to relapse among women.²⁵
  
  
• A study found among middle-aged smokers and former smokers with mild or moderate chronic obstructive pulmonary disease breathed easier after quitting. After one year the women who quit smoking had 2 times more improvement in lung function compared with the men who quit.²⁶

For more information on tobacco, please review the Trends in Tobacco Use Report and Lung Disease Data in the Data and Statistics section of our website at www.lungusa.org, or call the American Lung Association at 1-800-LUNG-USA (1-800-586-4872).