Smoking presents a huge risk to health - we know that the tar is not good for our lungs and airways, we know that carbon monoxide is bad for the blood, and we know that the vascular system is put under pressure, leading to a litany of issues.
Due to the biological differences between men and women though, there are health risks associated with smoking that are unique to women.
CANCERS AND OTHER RESPIRATORY CONDITIONS
Lung cancer is a problem shared between both genders, and investigations have been made into whether smoking affects men and women differently with regard to lung cancer.
Instances of lung cancer in non-smoking women are more frequent than instances of lung cancer in non-smoking men, and a meta-analysis concluded that ‘Smoking yields similar risks of lung cancer in women compared with men’.
According to the American Lung Association, instances of lung cancer diagnoses in women have increased by 87% over the past 41 years, while the number of diagnoses in men has decreased by 35%. This would appear to be a result of the increased prevalence of smoking in women since World War II.
It may be that women are more at risk of lung cancer in general, so smoking in women could be more detrimental to their health than in men.
When it comes to breast cancer, there are conflicting studies, one such study suggested there was no significant relationship between breast cancer and cigarette smoking except in women older than 50 who were light smokers.
Another found a ‘modest but significant’ increase in the risk of breast cancer among women who smoke, formerly smoked, had more than 5 cigarettes a day, and had over 10 ‘pack years’ - that’s 20 cigs a day for a year - of use, particularly in those who started smoking when they were young.
According to the American Centre for Disease Control and Prevention (CDC), smoking increases the risk of cervical cancer, and this is supported by the UK’s NHS, which suggests women who smoke are twice as likely to develop cervical cancer.
Other factors can play a part, such as using oral contraceptives for over 5 years, having more than 5 children (or having children when under 17 years of age), and a mother taking diethylstilbestrol while carrying can increase the child’s chance of developing cervical cancer.
Chronic obstructive pulmonary disease (COPD for short) is the name given to a collection of lung conditions that cause difficulty breathing. It includes emphysema, which is damage to the air sacs in the lungs, and chronic bronchitis, which is inflamed airways. Looking at how smoking affects men and women with regard to COPD, a study showed that women who smoke see a significantly accelerated decrease in their forced expiratory volume (FEV) as they get older, when compared to men.
CARDIOVASCULAR DISEASE AND OTHER HEART DISEASES
In the last 50 years, the number of women diagnosed with cardiovascular disease has increased to the same levels observed in men. The US Department of health has a wing known as the U.S Public Health Commissioned Corps, led by the Surgeon General, who has published several reports on women and smoking over the years. The report of the surgeon general illustrated that risk of cardiovascular disease among smoking women had reached the numbers observed in men, and this is because smoking was not commonplace among women until approximately 25 years after it had become commonplace among men.
The Surgeon General’s report discussed topics including coronary heart disease and how the number of cigarettes smoked and the duration of smoking leads to a greater risk of coronary heart disease, heart attacks and stroke. A report from the European Society of Cardiology acknowledged the protective effects of estrogen against coronary heart disease (CHD), but smoking has an ‘antiestrogenic’ effect, as well as increasing the level of low density lipoproteins (LDL) - the ‘bad’ cholesterol - which work together to strip women of their natural protection against CHD.
SMOKING'S EFFECT ON PREGNANCY AND REPRODUCTIVE HEALTH
Pregnancy is a very challenging time - not that I’m speaking from experience - but it must be a serious challenge for women as their diet and lifestyle can have a large impact on the safety of the pregnancy, and wellbeing of the unborn child.
A meta-analysis from the American Journal of Preventive Medicine found that smoking during pregnancy was a significant factor in instances of placental abruption (separating of the placenta from the uterus wall), placenta previa (the partial or complete covering of the cervix by the placenta), PPROM which is the preterm premature rupture of the amniotic membrane, and ectopic pregnancy which is when the egg implants itself outside the womb (normally in one of the fallopian tubes).
One of the most tragic events that can happen after birth is known as SIDS - sudden infant death syndrome - and it is the sudden death of a baby after birth. Since a link was established between infants sleeping in the prone position and SIDS, awareness campaigns have reduced the instances where sleeping position is a factor in SIDS events. Studies have linked smoking to SIDS too, and as the sleeping position is now reduced in significance, smoking is now a more important factor that needs to be addressed. One study suggested that approximately 30% to 40% of SIDS cases could be avoided if all women stopped smoking during pregnancy.
According to America’s National Center for Chronic Disease Prevention and Health Promotion, tobacco use during pregnancy increases the risk of premature birth, low birth weight and certain birth defects, as well as the risk of sudden infant death syndrome.
The effect smoking has on fertility in women is also bad news, I’m afraid. A study looking at the effects of smoking on ovarian function and fertility during assisted reproduction cycles - these are medical procedures used to address infertility. The study found that cigarette smoke had a negative effect on ovarian function and the effect was dependent on the amount smoked and how long the subject had been a smoker. It is worth noting that they found the reduction in pregnancy rate after the assisted reproduction cycles was relevant to current smokers, but not past smokers.
OTHER DISEASES AND CONDITIONS RELATED TO SMOKING
Studies have looked into the association between smoking and bone mineral density, and while in men it appears that smoking at any age reduces the density of bone mineral a little at the sites investigated, women going through menopause or post-menopause stage who smoked or quit more recently had lower bone density than women who didn’t smoke. The World Health Organisation looked at 3 meta-analyses examining the association between smoking and risk of hip fracture, and the reported increase in risk ranged from 31% to 84% among the female study samples. This suggests that smoking is likely to increase the risk from any bone related issues such as osteoporosis (weakening of the bones) because smoking appears to further reduce bone density.
A study from the Division of Reproductive Health in Atlanta, Georgia, found a link between pelvic inflammatory disease and smoking, observing a significant increase in risk for current and former smokers. They did not observe a link between the amount smoked and the increase in risk, so while a link has been established, more investigation is required to establish if it is a causal relationship.
AGING EFFECTS OF SMOKING
In addition to the internal health risks, smoking has the effect of impacting our external features too. Our skin, for example, is made up of fibres with elastin in it, and this provides the spring back to position when our skin is moved out of shape. It would appear that smoking affects the elastin in our skin, damaging its elasticity - the skin doesn’t stretch and compress like it once did. This leads to sagging of skin, and more visible lines and wrinkles.
The risks to our skin don’t stop there: smoking increases the risk of skin cancer too. Squamous cell carcinoma is one of the most common forms of skin cancer, and smoking has been linked to increased rates - a study in the Netherlands conducted in 2001 demonstrated a significant increased risk for current smokers, with a less significant increased risk for former smokers.
The negative effect of smoking on hair is another area of interest, and it is supposed that the effect smoking has on circulation reduces the delivery of oxygen to the scalp, and that smoking damages the DNA of the hair follicles, causes the release of inflammatory chemicals, and creates an imbalance in the proteins that control growth in the hair growth cycle, all leading to the degradation of hair - going grey or bald, to put it bluntly!
While the damage from smoking may not be entirely undone, the body does start to repair after a short time upon quitting cigarettes. As mentioned earlier, current smokers are likely to have more trouble conceiving than someone who has quit tobacco, which demonstrates that some of the effects smoking has are present for current smokers, and not past smokers.
It stands to reason that as smoking has been linked to many of these issues, that to stop smoking would result in a reduced chance of these negative effects taking place. Indeed, that appears to be the case for smoking-related pregnancy issues, where the effect of smoking appears to be more short-lived, which means that stopping smoking prevents these effects from taking place.
Stopping smoking is a serious challenge, but there are forms of Nicotine Replacement Therapy (NRT) available to feed the body nicotine without all the harmful stuff found in tobacco smoke. Some forms of NRT can be used together, and studies have shown that stop smoking methods are often more successful when accompanied by behavioural support. Pregnant women should consult their doctor on forms of NRT that are OK for use during pregnancy.
E-cigarettes and vaping are also proving to be a useful smoking cessation tool and, when accompanied by behavioural support, could be up to twice as effective as other forms of NRT. If you want to improve your health then these methods are worth investigating. If you and your partner are planning a family, then these stop smoking methods are essential.
WOMEN AND SMOKING HEALTH RISKS CONCLUSION
America’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) tells us that ‘For every American who dies because of smoking, at least 30 are living with a serious smoking-related illness.’ Smoking is unequivocally bad for you, whether you are male or female.
There do appear to be many instances where women are more susceptible to the damage from smoking, and this damage can affect not only the person’s health, but the person’s reproductive ability and safety. Giving up smoking reduces many of these risks, with some factors being improved immediately but some only improving over time upon stopping. Women should be particularly aware of the dangers of smoking while pregnant, and the risk this presents to themselves, as well as the development of the unborn child.
Stopping smoking will not only prolong your life, but keep you more able to enjoy your life in the late stages by reducing your risk of disease and injury. Making the switch from tobacco to e-cigarettes is a good way to feed your nicotine habit while cutting out all the harmful rubbish found in tobacco, and may help you quit. At SMOKO, we pride ourselves on helping people with this journey, so give us a call and let’s get you started - for you, your partner and your family.
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