Smoking ... cause of preventable death and disease among women

Fifty years ago smoking was thought of as a primarily male "pastime." But in the decades since, women have just about closed the gender gap while at the same time experiencing dire health consequences, just like men. According to the most recently available statistics 19.3 percent of  adults (45.3 million people) smoke. Every year, smoking kills an estimated 443,000 people through smoking-related diseases, including lung and other cancers, heart disease, stroke and chronic lung diseases such as emphysema.


Smoking has long been the leading cause of preventable death and disease among women. And, according to recent surveys, many women do not realize that lung cancer, once rare among women, surpassed breast cancer in 1987 as the leading cause of female cancer death.

In fact, it has been proven that smoking can cause disease in nearly every organ of the body, in women as well as men. The list of diseases caused by smoking has been expanded to include abdominal aortic aneurysm, acute myeloid leukemia, cataract, cervical cancer, kidney cancer, pancreatic cancer, pneumonia, periodontitis and stomach cancer. These are in addition to diseases previously known to be caused by smoking, including bladder, colorectal, liver, esophageal, laryngeal, lung, oral and throat cancers, chronic lung diseases, coronary heart and cardiovascular diseases, as well as reproductive effects and sudden infant death syndrome.

Smoking also harms many aspects and every phase of reproduction: menstrual function, oral contraceptive use, fertility, problems in pregnancy and giving birth to low-weight babies, among other conditions.

In addition, smoking increases your risk of developing osteoporosis. Smoking is related to an increased risk for hip fracture as well, especially among postmenopausal women (studies have shown that bone mineral density and body mass are lower in smokers). Smoking also affects your appearance. Long-term smoking will cause your skin to wrinkle prematurely and lose its elasticity, your nails and teeth to turn yellow and your breath to smell foul.

While smoking rates have fallen among women since 1965—33.9 percent of women were smokers in 1965, as compared with 18.3 percent in 2008—teenagers are still lighting up. According to the CDC, each day, more than 3,800 teenagers younger than age 18 smoke their first cigarette, and 1,000 teenagers younger than 18 begin smoking on a daily basis.

Adolescents who smoke are generally less physically fit and have more respiratory illnesses than their nonsmoking peers. In addition, smoking by adolescents hastens the onset of lung function decline during late adolescence and early adulthood. Smoking by adolescents is also related to impaired lung growth, chronic coughing and wheezing.

Why Teenage Girls Smoke Despite Known Risks
With all of the negative publicity about smoking, why do so many women and teenage girls continue to smoke? Teenagers vastly underestimate the addiction potential of nicotine. A woman who begins smoking when she is young will have a very difficult time quitting as she ages and becomes more concerned with the health consequences.

It is well documented that there are social, political and economic forces that influence tobacco use, particularly among youth. A major factor influencing susceptibility to and initiation of smoking among girls, in the United States and overseas, is the tobacco industry's long-standing (75 years or more) targeted marketing to women and girls. Tobacco marketers know that if they can hook children, these children are more likely to become lifelong customers.
The tobacco industry spends a lot of money annually to advertise and promote its products, including print media advertising (cigarette ads are banned from television and radio); distribution of free samples, cents-off coupons, T-shirts and other giveaways; movie product placements; cultural programs; donations to a wide range of national and local organizations; and political contributions to elected officials.

Women's Greater Vulnerability to Tobacco
Some research has revealed that women might be more susceptible to the addictive properties of nicotine and have a slower metabolic clearance of nicotine from their bodies than men. Also, women seem to be more susceptible to the effects of tobacco carcinogens than men.
Women also tend to smoke for different reasons than men, citing more emotional triggers, such as relief of stress, anxiety, anger or depression.

Smoking and Addiction
Nicotine is what keeps smokers addicted to tobacco, and it doesn't take long to get hooked. Nicotine is one of the most powerful addictive drugs—more addictive than heroin—yet it is also easily available and more socially accepted than other highly addictive substances.
Nicotine is the addictive chemical in tobacco but most of the negative health consequences of smoking are caused by the other 4,800 chemicals inhaled when tobacco products are burned. Carbon monoxide is also produced. It becomes attached to the red blood cells and decreases the oxygen available to the body tissues.

Nicotine's effect on the central nervous system is what makes smoking pleasurable. Nicotine has a calming effect and can relieve anxiety, boredom and irritability. Nicotine also has a stimulant effect, increasing alertness and improving concentration.
Within seven to 10 seconds of inhaling, your brain feels the effect of nicotine. Repeated inhalations maintain a steady blood level of nicotine. When you stop puffing, the blood level goes down. You light up again to deliver more nicotine to the brain. Pretty soon your brain and body consider it normal for you to have a certain blood level of nicotine. When that level goes down, you feel uncomfortable, irritable and unfocused. That's withdrawal. Now you are addicted. You smoke to keep from going into withdrawal, and you may find yourself smoking more and more.

Combined Effects of Smoking and Oral Contraceptives
Smoking cigarettes while taking birth control pills dramatically increases the risk of heart attack for women over 35. Smoking is far more dangerous to a woman's health than taking birth control pills, but the combination of oral contraceptive pill use and smoking has a greater effect on heart attack risk than when each factor is considered alone.
Smoking cigarettes while taking birth control pills increases a woman's risk of having an ischemic stroke (three times more likely in pill users than in nonusers) or a hemorrhagic stroke (three to four times that of nonusers), according to a large World Health Organization study.

Effects of Smoking on Reproductive Health and Pregnancy
Smoking affects ovarian function and decreases the female hormone estrogen. If you are planning to become pregnant, cigarette smoking can impair your fertility by adversely affecting ovulatory and tubal function, egg production and implantation. Smoking may cause you to have irregular menstrual cycles. Women who smoke also have an earlier menopause, which may increase their risk of osteoporosis, heart disease and other conditions for which estrogen provides a protective effect.
Nearly 11 percent of pregnant women continue to smoke throughout their pregnancies. If you smoke while you are pregnant, you are putting yourself and your unborn child at increased risk for complications. Risks of smoking during pregnancy include:

• complications from bleeding
• low-birth–weight babies
• increased risk of sudden infant death syndrome (SIDS)
• premature birth
• stillbirth
• placenta previa (the placenta grows too close to the opening of the uterus, a condition that often leads to Caesarean delivery)
• placental abruption (the placenta prematurely separates from the uterus wall)
• premature rupture of uterine membranes
• preeclampsia (a condition that results in high blood pressure and excess protein in the urine)
• reduction of the newborn's lung function

If you are a smoker and a nursing mother, it is important to know that nicotine is found in breast milk, and therefore enters your baby's system.

If you have children, your smoke puts them at risk, too. Secondhand smoke has been shown to make children more susceptible to infections, including colds and flu, ear infections and lower respiratory infections such as bronchitis and pneumonia. It also causes new cases of asthma, and it makes existing cases of asthma worse.