Female Smokers Have Higher Heart Disease Risk than Male Smokers

by Dr Sam Girgis on August 17, 2011

The negative health consequences of cigarette smoking are well known and include heart disease, stroke, emphysema, chronic bronchitis, and respiratory infections as well as others.  According to a new study, the health consequences may not be equal for both women and men.  Women smokers appear to have a 25% increased risk of developing coronary artery disease when compared to men.  The study was conducted by Dr. Rachel Huxley and Dr. Mark Woodward and recently published online ahead of print in The Lancet.  The authors performed a systematic review and meta-analysis of several prospective cohort studies that were published in the medical literature between the dates of January 1, 1966 and December 31, 2010.  The authors reviewed 8,005 abstracts and included 26 articles into the study and meta-analysis.  There was data for 3,912,809 individuals and 67,075 coronary artery disease events.  It was also found that the observed increased relative risk for women smokers increased by 2% for every additional year of follow up that was observed.  This resulted in a significantly increased risk of developing coronary artery disease when compared to men.  The authors wrote, “Thus, after allowing for classic cardiovascular risk factors, women had a significant 25% increased risk for coronary heart disease conferred by cigarette smoking compared with men. However, the precise mechanisms for this difference is unclear. Clinically, physicians and health professionals should be encouraged to increase their efforts at promotion of smoking cessation in all individuals. Present trends in female smoking, and this report, suggest that inclusion of a female perspective in tobacco-control policies is crucial”.  The accompanying editorial had the following comment, “As half the people who smoke will die from a tobacco-related disease, and half of those deaths occur in middle age, men and women urgently need help to quit smoking permanently.  Huxley and Woodward’s study reports a 2% increase in the female-to-male relative-risk ratio of coronary heart disease for every additional year of smoking, making the drive for cessation even more critical”.  Future studies should focus on determining whether there is a difference among the sexes with respect to the risk that smoking poses for other cerebrovascular diseases, cancer, and emphysema.  In additional, investigation of a possible mechanism for the observed difference may aid in the treatment of tobacco dependence among women and hopefully lead to higher smoking cessation rates.


Rachel R. Huxley and Mark Woodward “Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studiesThe Lancet early online publication August 11, 2011 doi:10.1016/S0140-6736(11)60781-2

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