The risk of lung cancer death has risen dramatically among women smokers in recent decades, with women’s risk now nearly on par with men, a recent study finds.
Published in the Jan. 24 New England Journal of Medicine, the study found female smokers have much higher risks of death from lung cancer and chronic obstructive lung disease in recent years than 20 or 40 years ago. The increase corresponds with a rise in smoking rates among women.
“What we’re seeing in women now is just the maturation of the tobacco epidemic,” said study lead author Michael Thun, MD, vice president emeritus of the American Cancer Society. “Basically, there have been studies since the 1950s that have looked at the relationship between smoking and mortality in both sexes. Women have lagged about 20 years behind men because they started smoking 20 years later.”
Smoking gained wide popularity among men about the time of World War I, Thun told The Nation’s Health, with popularity increasing among women about the time of World War II.
“The relative risks in women have lagged behind those in men for really all of the ways that smoking kills you,” Thun said. “The last very large study that looked at this from the American Cancer Society was in the 1980s. The point of this study was to see how the absolute and relative risks have changed in the last 20 years.”
The researchers found that among women who smoked in the 1960s, the risk of dying from lung cancer was 2.7 times higher than for women who had never smoked. In 2000-2010, the risk was almost 26 times higher for women smokers than those who had never smoked. The risk of dying from chronic obstructive lung disease was four times higher for women smokers in the 1960s and nearly 23 times higher in recent years.
The study found male and female smokers in recent years had similar risks for death from chronic obstructive pulmonary disease, ischemic heart disease, stroke and all causes of death combined. Among men ages 55-74 and women ages 60-74, death rates were at least three times as high among current smokers than people who had never smoked.
“The first act of this tragedy was the epidemic of deaths from smoking among men in wealthy countries,” Thun said. “The second act is among women in wealthy countries. The third act, which we’re right on track to experiencing, is the same global epidemic among men.”
Underscoring the need for smoking cessation support for both women and men, the study confirmed that quitting smoking at any age dramatically lowers death rates from all major diseases caused by smoking such as lung cancer and heart disease.
“It is true that as you continue to smoke the damage accumulates, but when you stop smoking, the damage stops progressing,” Thun said. “You can avoid almost all the risk by quitting by age 30. You can avoid a substantial part even by quitting at age 50 or 60.”
The concern about smoking among women was highlighted in a 2001 U.S. Surgeon General’s report, “Women and Smoking.” Citing a 600 percent increase since 1950 in women’s death rates for lung cancer, then-Surgeon General David Satcher, MD, PhD, called smoking-related disease among women “a full-blown epidemic.”
While women still are less likely to smoke than men, a 2011 Centers for Disease Control and Prevention survey found almost 17 percent of U.S. women smoke, with rates as high as 29 percent among American Indian and Alaska Native women and 26 percent among multiracial women. Women with less than a high school education are more than twice as likely to smoke as college graduates.
“Probably the most important implication from our study is the international implication that unless smoking in developing countries can be reduced, they can expect to see, in another 20 or 30 years, the same sort of full consequences that first men and now women have experienced in our country,” Thun said. “This is a huge window of opportunity for prevention.”
For more information on the study, visit http://www.nejm.org/doi/full/10.1056/NEJMsa1211127.
- Copyright The Nation’s Health, American Public Health Association
