Tobacco use and cessation among women: research and treatment-related issues

Abstract

The prevalence of tobacco use in women has increased over the past century. This has resulted in dramatic increases in smoking-related lung diseases, such as chronic obstructive pulmonary disease (COPD) and lung cancer. There is growing literature suggesting that women may be more susceptible than men to the effects of tobacco and to the development of COPD. Women may also have specific barriers that interfere with smoking cessation. This article addresses possible differences in lung function decline and nicotine metabolism in women compared to men. Differences in COPD between the sexes are discussed. Finally, barriers to smoking cessation in women are presented.

FIG. 1.

Mean forced expiratory volume in 1 second (FEV₁) values by age (and 95% confidence intervals [CI]) in male (black line) and female (gray line) healthy never smokers, expressed (A) in absolute values and (B) as percentage of the FEV₁ value at the age of 25. The mean FEV₁ decline value (and 95% CI) for males was 19.6 ml (17.1-22.1) and for females was 17.6 ml (13.8-21.4), with a p value of 0.266. (From Kohansal et al. Reprinted with permission of the American Thoracic Society.)

FIG. 2.

Mean FEV₁ values (expressed as percent of its value at the age of 25) by age, for healthy never smokers (NS) and continuous smokers (CS). Data for (A) males and (B) females. The mean FEV₁ decline value (and 95% CIs) for males was 38.2 mL (33.9-42.6) and for females 23.9 mL (20.9-27.0), with a p value <0.001. *p < 0.05 vs. healthy NS. (From Kohansal et al. Reprinted with permission of the American Thoracic Society.)