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2001 Surgeon General's Report—Women and Smoking
Patterns of Tobacco Use Among Women and Girls
Disclaimer
Highlights
- Cigarette smoking was rare among women in the early 20th century.
Cigarette smoking became prevalent among women after it did among men,
and smoking prevalence has always been lower among women than among
men. However, the gender-specific difference in smoking prevalence narrowed
between 1965 and 1985. Since 1985, the decline in prevalence among men
and women has been comparable.
- Smoking prevalence decreased among women, from 33.9% in 1965 to 22.0%
in 1998. Most of this decline occurred from 1974 through 1990; prevalence
declined very little from 1992 through 1998.
- The prevalence of current smoking is three times higher among women
with 9–11 years of education (32.9%) than among women with 16 or more
years of education (11.2%).
- Smoking prevalence is higher among women living below the poverty
level (29.6%) than among those living at or above the poverty level
(21.6%).
- In 1997–1998, 34.5% of American-Indian or Alaska-Native, 23.5% of
white, 21.9% of African-American, 13.8% of Hispanic, and 11.2% Asian/Pacific-Islander
women were current smokers.
- Among white women and African-American women, smoking prevalence
decreased from 1965 through 1998. The prevalence of current smoking
was generally comparable, but from 1970 through 1985 it was higher—some
years significantly so—among African-American women. In 1990, it was
higher among white women.
- From 1965 through 1998, the decline in smoking prevalence among
Hispanic women was significantly less than among white and African-American
women.
- Among Asian-American or Pacific-Islander women, smoking prevalence
decreased from 1979 through 1992, but then increased from 1995 through
1998. Prevalence changed little from 1979 through 1998 among American-Indian
or Alaska-Native women.
- Among high school senior girls, past-month current smoking rates
decreased from 39.9% in 1977 to 25.8% in 1992, but increased to 35.3%
during 1997. In 2000, smoking prevalence declined again to 29.7%.
- Much of the progress in reducing smoking prevalence among girls
in the 1970s and 1980s was lost with the increase in prevalence in the
1990s. Current smoking rates among high school senior girls were the
same in 2000 as in 1988.
- In the late 1970s and early 1980s, the prevalence of smoking among
high school seniors was higher among girls than among boys, but the
decline in smoking prevalence from 1976 through 1992 was more rapid
among girls than among boys. Since the mid 1980s, smoking prevalence
among girls and boys has been similar.
- From 1991 to 1996, current smoking prevalence in the past 30 days
increased from 13.1% to 21.1% among 8th-grade girls but decreased to
14.7% in 2000. Among 10th-grade girls, current smoking prevalence in
the past 30 days increased from 20.7% in 1991 to 31.1% in 1997 but decreased
to 23.6% in 2000.
- Aggregated data from 1976–1977 through 1991–1992 showed a dramatic
decline in past-month cigarette smoking among African-American high
school senior girls (from 37.5% to 7.0%) compared with the decline among
white girls (from 39.9% to 31.2%). From 1991–1992 through 1997–1998,
past-month smoking prevalence increased among white girls (from 31.2%
to 41.0%) and African-American girls (from 7.0% to 12.0%)—but the
increase was statistically significant only among white girls.
- In 1990–1994, smoking prevalence for high-school senior girls was
highest among American Indians or Alaska Natives (39.4%) and whites
(33.1%) and lowest among Hispanics (19.2%), Asian Americans or Pacific
Islanders (13.8%), and African Americans (8.6%).
- Smoking among young women (aged 18 through 24 years) declined from
37.3% in 1965–1966 to 25.1% in 1997–1998. However, recent trends show
that smoking rates in this population may be rising.
- In 1998, nearly 14 million women of reproductive age were smokers,
and smoking prevalence in this group was higher (25.3%) than in the
overall population of women aged 18 years or older (22.0%).
- Despite increased knowledge of the adverse health effects of smoking
during pregnancy, survey data suggest that a substantial number of pregnant
women and girls smoke. Cigarette smoking during pregnancy declined from
19.5% in 1989 to 12.9% in 1998.
- Smoking prevalence during pregnancy differs by age and by race and
ethnicity. In 1998, smoking prevalence during pregnancy was consistently
highest among young adult women aged 18 through 24 years (17.1%) and lowest
among women aged 25 through 49 years (10.5%).
- Smoking during pregnancy declined among women of all racial/ethnic
populations. From 1989 to 1998, smoking among American-Indian or Alaska-Native
pregnant women decreased from 23.0% to 20.2%; among pregnant
white women from 21.7% to 16.2%; African-American pregnant women from
17.2% to 9.6%; Hispanic pregnant women from 8.0% to 4.0%; and Asian-American or
Pacific-Islander pregnant women from 5.7% to 3.1%.
- In 1998, there was nearly a twelvefold difference among pregnant women
who smoke—ranging from 25.5% among mothers with 9–11 years of
education to 2.2% among mothers with 16 or more years of education.
- The level of nicotine dependence is strongly associated with the
quantity of cigarettes smoked per day.
- When results are stratified by the number of cigarettes smoked per
day, girls and women who smoke appear to be equally dependent on nicotine,
as measured by first cigarette after waking, smoking for a calming and
relaxing effect, withdrawal symptoms, or other measures of nicotine
dependence.
- Of the women who smoke, more than three-fourths report one or more
indicators of nicotine dependence, and nearly three-fourths report feeling
dependent on cigarettes.
- More than three-fourths (75.2%) of women want to quit smoking completely,
and nearly half (46.6%) report having tried to quit during the previous
year.
- In 1998, the percentage of people who had ever smoked and who had
quit was lower among women (46.2%) than among men (50.9%). This finding
may be because men began to stop smoking earlier in the 20th century
than did women and because these data do not take into account that
men are more likely than women to switch to, or to continue to use,
other tobacco products when they stop smoking.
- Since the late 1970s or early 1980s, the probability of attempting
to quit smoking and succeeding has been equal among women and men.
- The use of cigars, pipes, and smokeless tobacco among women is generally
low, but recent data suggest that cigar smoking among women and girls
is increasing.
- A California study found that current cigar smoking among women
increased fivefold from 1990 through 1996.
- The prevalence of cigar use appears to be higher among adolescent
girls than among women. In 1999, past-month cigar use among high school
girls younger than 18 years was 9.8%.
- The prevalence of pipe smoking among women is low, and women are
much less likely than men to smoke a pipe.
- The prevalence of smokeless tobacco use among girls and women is
low and remains considerably lower than that among boys and men.
- For tobacco use other than cigarettes among high school girls, cigar
use is the most common, bidi and kretek use are intermediate, and pipe
and smokeless tobacco use are the least common.
Disclaimer: Data and findings provided on this page reflect the content of
this particular Surgeon General's Report. More recent information may exist
elsewhere on the Smoking & Tobacco Use Web site (for example, in fact sheets,
frequently asked questions, or other materials that are reviewed on a regular
basis and updated accordingly).
Page last updated March 27, 2001