Research News

“Women who smoke like men, die like men”

BMJ 2013; 346 doi: (Published 30 January 2013) Cite this as: BMJ 2013;346:f543



Smoking has become substantially riskier for women during the past 50 years, say researchers. Analyses from two historical and five contemporary US cohorts suggest that the risks for women are now about the same as they are for men. Smokers of both sexes are now about 25 times more likely than never smokers to die of lung cancer, between 22 and 25 times more likely to die of chronic obstructive pulmonary disease (COPD), and nearly three times more likely to die of ischaemic heart disease.

Converging male and female risks may reflect changing smoking patterns in women, who now smoke like men (start earlier, smoke more), say the researchers. They also report an unexpected increase in deaths from COPD in male smokers and speculate that modern cigarettes that encourage deeper inhalation might be to blame.

A second cohort study linked smoking histories of around 202 000 US adults with mortality during seven years of follow-up to 2006. All cause mortality was three times higher for smokers than for similar adults who had never smoked (hazard ratio for women 3.0, 99% CI 2.7 to 3.3; hazard ratio for men 2.8, 2.4 to 3.1). The authors estimate that smokers lose a whole decade of life expectancy and halve their chances of surviving from 25 to 79 years (38% v 70% for women and 26% v 61% for men).

In further analyses, smokers who stopped before the age of 34 years regained the whole 10 years. Those who stopped at 35-44 years of age gained nine years of life expectancy, and those who stopped at 45-54 years and 55-64 years gained six years and four years, respectively.


Cite this as: BMJ 2013;346:f543