Women & cigarette smoking

Lee Smith sent me a useful link confirming that women are more susceptible to the adverse health effects of smoking than men. Chronic obstructive pulmonary disease (COPD) has risen among women killing 1900 in Australia in 1993 and 2300 in 2003 – you’ve come a long way baby. This compares to a drop from 4000 to 3200 deaths among men. About 60% of COPD deaths are attributed to smoking.

I have been accumulating a data file on young women and smoking. There are a few interesting facts that I think many are unaware of.

To summarise: Young women have a higher incidence of smoking than young men perhaps because they are more easily addicted to nicotine than young men and use smoking as a technique for weight control. But young women are also subject to increased health risks from smoking.

In more detail.

Among Australian 14-19 year olds, more women smoke (11.9%) than men (9.5%). It seems that females are more susceptible to the addictive character of nicotine. A study of 12-13 year olds showed that the median number of days from initial tobacco use to symptoms of dependence was 21 days for girls, and 183 days for boys (DiFranza et al (2002)).

Studies of adolescents aged 12-17 also find that females often believe that smoking controls weight (Bowles et al. (2001)). Moreover, girls who report trying diets were more likely to take up smoking (Austin et al (2001)). 12-15 year old girls who reported valuing thinness in a Massachusetts study were nearly five times as likely as those who did not value it to take up smoking in the following four years (Honjo et al. (2003)).

It is certainly true that smoking cessation is associated with weight gain. Quit programs typically report an expected weight gain of 2-3 kilograms, but studies report average gains of about 5kg, and unbiased estimates of nearly 10kg, after taking in to consideration the characteristics of successful quitters (Eisenberg & Quinn (2006)). In one study, subjects following a diet to reduce weight gain after quitting were more likely to relapse (Hall et al (1992)).

Young women may not be aware that they have a greater risk of contracting lung cancer than men who smoke the same amount. Studies show that, even taking into consideration body weight, women are more susceptible to tobacco carcinogens (Zhang et al (1996)).

For young women even more than men - don't smoke!

References

Austin, S. B. & Gortmaker, (2001). Dieting and smoking initiation in early adolescent girls and boys: A prospective study. American Journal of Public Health, 91, 446-450

Baker A; Ivers RG; Bowman J; Butler T; Kay-Lambkin FJ; Wye P; Walsh RA; Pulver LJ; Richmond R; Belcher J; Wilhelm K & Wodak A. (2006) Where there's smoke, there's fire: high prevalence of smoking among some subpopulations and recommendations for intervention. Drug and Alcohol Review, 25, 1, 85-96.

Bowles, S., & Johnson, P. (2001). Gender, weight concerns, and adolescent smoking. Journal of Addictive Diseases. 20, 2, 5-14.

DiFranza JR, Savageau JA, Rigotti NA, Fletcher K, Ockene1 JK , McNeill AD, M Coleman M & C Wood, (2002) Development of symptoms of tobacco dependence in youths: 30 month follow up data from the DANDY study. Tobacco Control. 11, 228 –235.

Eisenberg, D. & Quinn B.C. (2006) Estimating the Effect of Smoking Cessation on Weight Gain: An Instrumental Variable Approach. Health Services Research 41, 6.

Gilliland, F.D., Berhane, K., McConnell, R., Gauderman, W.J., Vora, H., Rappaport, E.B., Avol, E. and J.M. Peters (2000) Maternal smoking during pregnancy, environmental tobacco smoke exposure and childhood lung function. Thorax 55, 271-276

Hall, S.M., Tunstall, C.D., Vila K.L., & J Duffy. (1992), Weight gain prevention and smoking cessation: cautionary findings, American Journal of Public Health, 82, 6, 799-803.

Honjo, K. & Siegel, M. (2003) Perceived importance of being thin and smoking initiation among young girls. Tobacco Control 12, 289-295.

Zang EA, Wynder EL. (1997) Differences in lung cancer risk between men and women: examination of the evidence. Journal of the National Cancer Institute 21, 88, 3-4, 183-92.