1. Are women who smoke at increased risk of health problems?  

Yes. Women and men who smoke are at increased risk of developing cancer, heart disease, and lung disease and of dying prematurely (1, 2).

A pregnant smoker is at higher risk of having her baby born too early and with an abnormally low weight. A woman who smokes during or after pregnancy increases her infant’s risk of death from Sudden Infant Death Syndrome (SIDS) (1, 2).

In addition, some studies suggest that women who smoke are more likely to experience irregular or painful periods. Smokers are more likely than nonsmokers to go through menopause at a younger age. Women who smoke after menopause have lower bone density and a higher risk of hip fracture than do women who don’t smoke (1).

2. Does smoking increase cancer risk in women?

Yes. Smoking causes cancers of the lung, esophagus, larynx (voice box), mouth, throat, kidney, bladder, pancreas, stomach, and cervix, as well as acute myeloid leukemia (2). In 1987, lung cancer surpassed breast cancer to become the leading cause of cancer death in U.S. women. Unlike early breast cancer and many other types of cancer, lung cancer is rarely curable (3). Most deaths from lung cancer among U.S. women are caused by smoking (1).

3. What are the immediate benefits of quitting smoking for women?

The immediate health benefits of quitting smoking are substantial. Within a few hours, the level of carbon monoxide in the blood begins to decline. (Carbon monoxide, a colorless, odorless gas found in cigarette smoke, reduces the blood’s ability to carry oxygen.) Heart rate and blood pressure, which were abnormally high while smoking, begin to return to normal. Within a few weeks, women who quit smoking have improved circulation, don’t produce as much phlegm, and don’t cough or wheeze as often. Women can also expect significant improvements in lung function within several months of quitting (4).

Also, women who quit smoking reduce the risk of infertility, and pregnant women who quit early in their pregnancy reduce the risk of the baby being born too early and with an abnormally low weight (1, 5).

4. What are the long-term benefits of quitting smoking for women?

Quitting smoking dramatically reduces the risk of developing an illness caused by smoking (2, 6):

• The risk of death from heart disease is substantially reduced within 1 or 2 years after quitting, and eventually becomes the same as that of nonsmokers.
• The risk of death from lung cancer and other lung diseases declines steadily, beginning about 5 years after quitting.
• Quitting smoking as early in life as possible is likely to reduce the risk of fractures that would be caused by smoking in old age.

Regardless of age, women can substantially reduce the risk of disease, including cancer, by quitting smoking. For women who have already developed cancer, quitting smoking helps the body to heal and to respond to cancer treatment, and quitting reduces the risk of developing a second cancer.

5. Is the National Institutes of Health (NIH) supporting research on women, tobacco, and cancer?

Yes. The NIH is funding research that aims to prevent and reduce tobacco use among women, and to increase the survival rates of women suffering from cancers caused by smoking. The National Cancer Institute (NCI), a component of the NIH and the Nation’s lead agency for cancer research, formed the Women, Tobacco, and Cancer Working Group to stimulate scientific research and suggest approaches to prevent tobacco-related cancers among women in the United States and around the world. The Working Group, a public/private partnership that met in 2003, discussed the issues and made recommendations for progress in this area. The findings of the Working Group are summarized in the NCI report Women, Tobacco, and Cancer: An Agenda for the 21st Century, which can be found at http://women.cancer.gov/reports/wtobacco.shtml on the Internet.

The health effects of smoking in women are an area of concern for many other NIH agencies, including the National Institute on Drug Abuse, the National Institute of Dental and Craniofacial Research, the National Institute of Child Health and Human Development, the John E. Fogarty International Center, and the National Center for Complementary and Alternative Medicine. Some current and recent NIH-funded research projects in this area include the following:

• A survey of tobacco use among pregnant women in several developing countries.
• A study of the use of nicotine replacement products among pregnant smokers.
• A program to help women remain smoke free after giving birth.
• An examination of the effectiveness of the nicotine patch in male and female smokers.

In addition, the NCI is funding studies to investigate the effects of smoking and quitting on various cancers, including those of the lung, breast, uterus, and cervix. Studies are also investigating genetic/molecular differences between women and men and their effect on cancer risk.

6. What resources are available to help women quit smoking?

The NCI fact sheet Quitting Smoking: Why To Quit and How To Get Help, at http://www.cancer.gov/cancertopics/factsheet/Tobacco/cessation on the Internet, provides a list of Government and nonprofit organizations that have resources to help people quit smoking.

General Resources

Government resources that provide information about quitting for all smokers include the following:

The Tobacco Control Research Branch of the NCI established the Smokefree.gov Web site in collaboration with the Centers for Disease Control and Prevention and the American Cancer Society to help people quit smoking. The Web site provides an online guide, Clearing the Air: Quit Smoking Today, for smokers interested in quitting. The guide covers thinking about quitting, preparing to quit, quitting, and staying quit.

Clearing the Air: Quit Smoking Today is also available as a print publication. Other publications available from the Web site include the following:

• Clear Horizons for smokers over age 50.
• Forever Free™ for smokers who have recently quit.
• Guía para Dejar de Fumar for Spanish-speaking smokers.
• Pathways to Freedom for African American smokers.
  
  

  Internet Web site:

  http://www.smokefree.gov

The National Network of Tobacco Cessation Quitlines, an initiative of the U.S. Department of Health and Human Services, routes callers to a state-run quitline where they can receive help with quitting smoking, publications, and referrals to other resources. Information about this service can be found on the Smokefree.gov Web site.

Telephone:

1–800–784–8669 (1–800–QUITNOW)

The National Cancer Institute’s (NCI) Smoking Quitline offers a wide range of services, including individualized counseling, printed information, referrals to other sources, and recorded messages. Smoking cessation counselors are available to answer smoking-related questions in English or Spanish, Monday through Friday, 9:00 a.m. to 4:30 p.m., local time. Smoking cessation counselors are also available through LiveHelp (an online instant messaging service) at http://www.cancer.gov/help on the Internet. LiveHelp is available Monday through Friday, 9:00 a.m. to 11:00 p.m., Eastern time.

Telephone:	1–877–448–7848 (1–877–44U–QUIT)
Internet Web site:	http://www.cancer.gov

Resources for Women

Several organizations provide information specifically for women, including the following:

• The Office on Women’s Health of the U.S. Department of Health and Human Services has established a special section on its Web site called "A Breath of Fresh Air! Independence from Smoking." This section includes information about the health effects of smoking and provides resources to help women quit smoking.

  Address:	Room 712E 200 Independence Avenue, SW. Washington, DC 20201
  Telephone:	1–800–994–9662
  Internet Web site:	http://www.4woman.gov/quitsmoking



• The Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR) established the Office of Women’s Health (OWH) to promote and improve the health, safety, and quality of life of women. A section of the OWH Web site contains information about smoking and tobacco for women.
  
  

  Address:	CDC/ATSDR Office of Women’s Health Centers for Disease Control and Prevention Mail Stop E–89 1600 Clifton Road Atlanta, GA 30333
  Telephone:	404–498–2300
  E-mail:	owh@cdc.gov
  Internet Web site:	http://www.cdc.gov/women/az/smoking.htm



• The National Partnership for Smoke-Free Families, a program supported by The Robert Wood Johnson Foundation, is working to discover the best ways to help pregnant smokers quit, and to spread the word about effective, evidence-based treatments.
  
  

  Address:	National Dissemination Office Cecil G. Sheps Center for Health Services Research CB #7590 725 Martin Luther King, Jr. Boulevard University of North Carolina at Chapel Hill Chapel Hill, NC 27599–7590
  Telephone:	919–843–7663
  E-mail:	feedback@helppregnantsmokersquit.org
  Internet Web site:	http://www.helppregnantsmokersquit.org



• The American Legacy Foundation is a national, independent public health foundation that was established in March 1999 as a result of the tobacco settlement. The foundation collaborates with organizations interested in decreasing tobacco consumption among all ages and populations nationwide.
  
  

  Address:	American Legacy Foundation Sixth Floor 2030 M Street, NW. Washington, DC 20036
  Telephone:	202–454–5555 1–800–784–8669 (1–800–QUIT–NOW) (pregnant smokers)
  E-mail:	info@americanlegacy.org
  Internet Web site:	http://www.americanlegacy.org/

Selected References

1. U.S. Department of Health and Human Services. Women and Smoking—A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2001.
   
   
2. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004.
   
   
3. Ries LAG, Harkins D, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2003. Bethesda, MD: National Cancer Institute, 2006.
   
   
4. U.S. Department of Health and Human Services. The Health Benefits of Smoking Cessation. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1990.
   
   
5. Cnattingius S. The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine & Tobacco Research 2004; 6(Supplement 2):S125–S140.
   
   
6. National Cancer Institute (1997). Smoking and Tobacco Control Monograph 8: Changes in Cigarette-Related Disease Risks and Their Implications for Prevention and Control. Bethesda, MD. Retrieved July 30, 2007, from: http://cancercontrol.cancer.gov/tcrb/monographs/8/index.html.

###

Related NCI materials and Web pages:

• National Cancer Institute Fact Sheet 10.17, The Truth About "Light" Cigarettes: Questions and Answers ¹
  (http://www.cancer.gov/cancertopics/factsheet/Tobacco/light-cigarettes)
• National Cancer Institute Fact Sheet 10.18, Secondhand Smoke: Questions and Answers ²
  (http://www.cancer.gov/cancertopics/factsheet/Tobacco/ETS)
• National Cancer Institute Fact Sheet 10.19, Quitting Smoking: Why To Quit and How To Get Help ³
  (http://www.cancer.gov/cancertopics/factsheet/Tobacco/cessation)
• Clearing the Air: Quit Smoking Today ⁴
  (http://www.smokefree.gov/pubs/clearing_the_air.pdf)
• Forever Free ⁵™
  (http://www.smokefree.gov/pdf.html)
• Pathways to Freedom ⁶
  (http://www.smokefree.gov/docs/pathways_final.pdf)
• Women, Tobacco, and Cancer: An Agenda for the 21st Century ⁷
  (http://women.cancer.gov/reports/wtobacco.shtml)
• Smoking and Cancer Home Page ⁸
  (http://www.cancer.gov/cancertopics/smoking)

NCI’s Cancer Information Service
Telephone (toll-free): 1–800–4–CANCER (1–800–422–6237)
TTY (toll-free): 1–800–332–8615
LiveHelp^® online chat: https://cissecure.nci.nih.gov/livehelp/welcome.asp

Glossary Terms

A quickly progressing disease in which too many immature white blood cells (not lymphocytes) are found in the blood and bone marrow. Also called acute myeloblastic leukemia, acute myelogenous leukemia, acute nonlymphocytic leukemia, AML, and ANLL.

The organ that stores urine.

A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

The force of circulating blood on the walls of the arteries. Blood pressure is taken using two measurements: systolic (measured when the heart beats, when blood pressure is at its highest) and diastolic (measured between heart beats, when blood pressure is at its lowest). Blood pressure is written with the systolic blood pressure first, followed by the diastolic blood pressure (for example 120/80).

A measure of the amount of minerals (mostly calcium and phosphorous) contained in a certain volume of bone. Bone density measurements are used to diagnose osteoporosis (a condition marked by decreased bone mass), to see how well osteoporosis treatments are working, and to predict how likely the bones are to break. Low bone density can occur in patients treated for cancer. Also called BMD, bone mass, and bone mineral density.

Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

A poisonous gas that has no color or odor. It is given off by burning fuel (as in exhaust from cars or household heaters) and tobacco products. Carbon monoxide prevents red blood cells from carrying enough oxygen for cells and tissues to live.

The lower, narrow end of the uterus that forms a canal between the uterus and vagina.

To heal or restore health; a treatment to restore health.

The muscular tube through which food passes from the throat to the stomach.

Inherited; having to do with information that is passed from parents to offspring through genes in sperm and egg cells.

The inability to produce children.

One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.

The area of the throat containing the vocal cords and used for breathing, swallowing, and talking. Also called voice box.

Cancer that forms in tissues of the lung, usually in the cells lining air passages. The two main types are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope.

The time of life when a woman's menstrual periods stop. A woman is in menopause when she hasn't had a period for 12 months in a row. Also called change of life.

The National Cancer Institute, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. The National Cancer Institute conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the National Cancer Institute Web site at http://www.cancer.gov. Also called NCI.

A federal agency in the U.S. that conducts biomedical research in its own laboratories; supports the research of non-Federal scientists in universities, medical schools, hospitals, and research institutions throughout the country and abroad; helps in the training of research investigators; and fosters communication of medical information. Access the National Institutes of Health Web site at http://www.nih.gov. Also called NIH.

A patch that sticks on the skin and contains a small dose of nicotine, which enters the blood by being absorbed through the skin. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. A prescription is not needed for nicotine patches.

A type of treatment that uses special products to give small, steady doses of nicotine to help stop cravings and relieve symptoms that occur when a person is trying to quit smoking. These products include nicotine gum, nicotine inhaler, nicotine nasal spray, nicotine lozenges, and nicotine patch. They do not contain any of the other chemicals found in tobacco products.

A glandular organ located in the abdomen. It makes pancreatic juices, which contain enzymes that aid in digestion, and it produces several hormones, including insulin. The pancreas is surrounded by the stomach, intestines, and other organs.

A more than normal amount of thick mucus made by the cells lining the upper airways and lungs. A buildup of phlegm may be caused by infection, irritation, or chronic lung disease, and can cause discomfort in the chest and coughing.

Refers to a new primary cancer in a person with a history of cancer.

An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.

The sudden and unexpected death of a healthy child who is younger than one year old, usually during sleep. The cause of sudden infant death syndrome is not known. Also called crib death and SIDS.

The hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The throat is about 5 inches long, depending on body size. Also called pharynx.

A plant with leaves that have high levels of the addictive chemical nicotine. The leaves may be smoked (in cigarettes, cigars, and pipes), applied to the gums (as dipping and chewing tobacco), or inhaled (as snuff). Tobacco leaves also contain many cancer-causing chemicals, and tobacco use and exposure to secondhand tobacco smoke have been linked to many types of cancer and other diseases. The scientific name is Nicotiana tabacum.

Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called womb.