Women and Smoking

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An epidemic of smoking-related cancer and disease in women

In March 2001, the Office of the US Surgeon General released a long-awaited, detailed report called Women and Smoking, along with this statement:

    When calling attention to public health problems, we must not misuse the word “epidemic.” But there is no better word to describe the 600-percent increase since 1950 in women’s death rates for lung cancer, a disease primarily caused by cigarette smoking. Clearly, smoking-related disease among women is a full-blown epidemic.

      – David Satcher, MD, PhD

Smoking is the most preventable cause of early death in this country. According to the Centers for Disease Control and Prevention (CDC), smoking-related diseases cause the deaths of more than 200,000 women in the United States each year. On average, women who smoke die 14.5 years sooner than non-smokers.

The most recent CDC survey (from 2012) showed that nearly 1 in 6 American women aged 18 years or older (15.8%) smoked cigarettes. The highest rates were seen among multi-racial women (24%), American Indian/Alaska Native women (18.7%), then white (18.4%), African-American (14.8%), Hispanic (7.8%), and Asian women (5.5%).

In general, the less education a woman has, the more likely it is she will smoke. For instance, women who are high school graduates are more than twice as likely to smoke as college graduates. Women with GED’s are more than three times as likely to smoke as women who graduated from college.

Overall, women are less likely to smoke than men. But smoking is more popular among younger than older women. Nearly 18% of women ages 25 to 44 smoke cigarettes. Cigarette smoking rates are somewhat lower among women aged 18 to 24, about 14.5%, but these numbers do not include women in these age groups who smoke other forms of tobacco, such as little cigars, hookahs, and electronic cigarettes. If these younger women continue to smoke as they get older, they will have smoking-related illnesses and disabilities. About 7.5% of women age 65 and over smoke.

Women who smoke often started as teenagers − in most cases before age 18. And the younger a girl is when she starts, the more heavily she is likely to use tobacco as an adult. The most recently published CDC survey, reporting by school grade, showed that 35% of 9th grade girls had smoked at least one cigarette. By 12th grade, it was nearly 54%. As early as middle school, about 3% of girls reported smoking at least one cigarette in the past month.

It’s not just cigarettes, either. In a 2013 drug use survey, 21% of 12th grade girls reported using a hookah in the past year. Asked about just the past month, more than 8% of high school girls (not just seniors) reported using small cigars, while 5% said they’d used a hookah. A newer trend is e-cigarettes − 10% of high school students have tried them at least once, and 2% of girls reported using e-cigarettes in the past month.

For more on kids and how they’re using tobacco, see our document called Child and Teen Tobacco Use.

Last Medical Review: 02/07/2014
Last Revised: 02/07/2014