Smoking has significant negative effects on women’s health, many of which are distinct from those experienced by men. Below is a summary of the key health impacts of smoking on women.
Infertility: Smoking can cause infertility in women. For example, a survey was conducted by He and Wan to Investigate the associations between smoking status and infertility among childbearing women in the United States of America (USA). A total of 3,665 female participants (aged 18-45) from the National Health and Nutrition Examination Survey (NHANES) (2013-2018) were included in the analysis. The researchers concluded that current smokers were associated with a higher risk of infertility, and quitting smoking may reduce the risk of infertility.
Pregnancy Complications: Smoking increases the risk of ectopic pregnancy, miscarriage, stillbirth, and low birth weight in infants. For example, a case-control study by Hamadneh and Hamadneh in 2020 investigated the effect of active and passive smoking during pregnancy on adverse pregnancy outcomes in Jordan. The researchers found that offspring with active smoking mothers had significantly lower birth weight compared to neonates from passive and nonsmoking women, significantly lower head and chest circumferences compared to babies from passive smokers and significantly lower first-minute activity, pulse, grimace, appearance, respiration (Apgar) score compared to those from nonsmoking women.
Cancer Risks : Cigarette smoking remains the primary risk factor for lung cancer in both men and women. Additionally, some studies suggest a connection between smoking and breast cancer. For instance, a meta-analysis conducted by Macacu and colleagues in 2015 found evidence of a moderate increase in breast cancer risk among women who smoke tobacco. Similarly, a systematic review and meta-analysis involving Japanese women, led by Sugawara and colleagues, provided strong evidence that cigarette smoking elevates the risk of cervical cancer in this group. More research is needed to determine if similar findings are observed in women from other countries.
Cardiovascular Disease: Women who smoke are at higher risk of coronary heart disease. A systematic review and meta-analysis conducted by Huxley and Woodward in 2011 aimed to estimate the effect of smoking on coronary heart disease in women compared to men, taking into account sex differences in other major risk factors. The researchers found that smoking increases the risk of heart disease in women more than in male smokers. However, the researchers are unsure about the mechanisms behind these differences. Since this study is over a decade old, further research in this area is warranted.
Bone Health: Smoking leads to lower bone density and increases the risk of osteoporosis and fractures in postmenopausal women. For example, Bijelic, Milicevic and Balaban’s 2017 study shows that smoking is an independent risk factor for osteoporosis in postmenopausal women.
Mental Health: Women who smoke during pregnancy report more depressive symptoms after pregnancy. For example, a study by Anastasopoulou and colleagues in 2022 aimed to determine factors affecting smoking during pregnancy, revealing potential relationships between depression and smoking patterns during and after pregnancy. The researchers found that women who smoked during pregnancy reported significantly more depressive symptoms after pregnancy compared with nonsmokers and smokers who abstained during pregnancy.
Conclusion : In summary, smoking poses significant health risks to women that are often distinct and more severe than those faced by men. Addressing these risks is crucial for improving women’s health outcomes and promoting healthier lifestyles. By implementing tailored smoking cessation programs and emphasising the consequences that smoking can have on women’s health, we can work towards fostering healthier communities and empowering women to make informed choices regarding their health.
References :
Anastasopoulou, S. v., Bonotis, K. S., Hatzoglou, C., Dafopoulos, K. C., & Gourgoulianis, K. I. (2022). Smoking Patterns and Anxiety Factors Among Women Expressing Perinatal Depression. Women’s Health Reports, 3(1), 198–206. https://doi.org/10.1089/whr.2021.0111
Bijelic, R., Milicevic, S., & Balaban, J. (2017). Risk Factors for Osteoporosis in Postmenopausal Women. Medical Archives, 71(1), 25. https://doi.org/10.5455/medarh.2017.71.25-28
Hamadneh, S., & Hamadneh, J. (2021). Active and Passive Maternal Smoking During Pregnancy and Birth Outcomes: A Study From a Developing Country. Annals of Global Health, 87(1). https://doi.org/10.5334/aogh.3384
He, S., & Wan, L. (2023). Associations between smoking status and infertility: a cross-sectional analysis among USA women aged 18-45 years. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1140739
Huxley, R. R., & Woodward, M. (2011). Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies. The Lancet, 378(9799), 1297–1305. https://doi.org/10.1016/S0140-6736(11)60781-2
Macacu, A., Autier, P., Boniol, M., & Boyle, P. (2015). Active and passive smoking and risk of breast cancer: a meta-analysis. Breast Cancer Research and Treatment, 154(2), 213–224. https://doi.org/10.1007/s10549-015-3628-4
Sugawara, Y., Tsuji, I., Mizoue, T., Inoue, M., Sawada, N., Matsuo, K., Ito, H., Naito, M., Nagata, C., Kitamura, Y., Sadakane, A., Tanaka, K., Tamakoshi, A., Tsugane, S., & Shimazu, T. (2019). Cigarette smoking and cervical cancer risk: an evaluation based on a systematic review and meta-analysis among Japanese women. Japanese Journal of Clinical Oncology, 49(1), 77–86. https://doi.org/10.1093/jjco/hyy158
© 2025 Dr Mukta Bhattarai Pandey (MD, PGDip Public Health, MRCP(UK), MRes)