Global Tobacco Control Updates

Risk of Smoking-Related Deaths Among Women in United States Increased as Women Began to Smoke "Like Men"
06 Feb 2013
Research Alert

A new study in The New England Journal of Medicine documents large, persistent increases in the risks of smoking-related deaths among female cigarette smokers in the United States during the 20th Century. In the U.S. starting in the 1950s, women began to smoke more like men, starting at younger ages and smoking larger quantities. The researchers attribute the increased risk of death from smoking to these changing smoking habits.

Key findings:

  • The risk of death from cigarette smoking continues to increase among women in the United States and the increased risks are now nearly identical for men and women, as compared with persons who have never smoked.
  • Among women age 60 to 74 years and men age 55 to 74 years, deaths from all causes was at least three times as high among current smokers as among women and men who had never smoked.
  • Smoking cessation at any age dramatically reduced death rates.
  • Death rates for chronic obstructed pulmonary disease COPD and peripheral adenocarcinoma (a form of lung cancer) continue to increase among smokers in the United States, despite a decline in COPD deaths among non-smokers. The authors suggest that these increases may be attributable to cigarette design changes and related deceptive marketing of “light” and “low tar” cigarettes. These cigarettes promote deeper inhalation of smoke.

Key messages:

  • In the United States, the risks and numbers of smoking-related deaths among women increased dramatically over time as women increasingly smoked “like men.”
  • Countries with low smoking rates among women now can avoid similar massive smoking-related deaths by implementing strong tobacco control policies that encourage women to quit smoking and prevent girls from starting.
  • Banning tobacco advertising to prevent tobacco companies from recruiting female smokers, raising the price of tobacco products, implementing 100% smoke-free places and placing graphic warning labels on tobacco products are effective policies to prevent an epidemic of female smoking in countries with low female smoking rates and will assist women that already smoke to quit.

Full Citation: Thun M, Carter B, Feskanich D, Freedman N, Prentice R, Lopez A, Hartge P, Gapstur S. 50-Year Trends in Smoking-Related Mortality in the United States. The New England Journal of Medicine. 2013 January; 368: 351-364.

Download the full article from the New England Journal of Medicine.

Additional Resources: For additional information about women and tobacco, including a fact sheet on the health harms of tobacco for women, visit:

The New England Journal of Medicine is the oldest continuously published medical periodical. Established in 1811, it employs a rigorous peer-review and editing process to evaluate manuscripts for scientific accuracy, novelty, and importance.

If you have questions about the report or how to use it in your advocacy efforts, please email


death, smoking rates, women