Women and smoking: issues and opportunities

In March 2001, the U.S. Surgeon General released Women and Smoking, the second Surgeon General's report to focus on tobacco use among women, compelling the nation to make reducing tobacco use among women one of the highest priorities for women's health. Since 1980, 3 million women have died prematurely from smoking-related diseases and injuries. Lung cancer mortality rates among U.S. women have increased about 600% since 1950, and now lung cancer is the leading cause of cancer death among U.S. women, having surpassed breast cancer in 1987. Although the report documents the devastating impact of the tobacco epidemic among women, a growing arsenal of science-based recommendations for implementing comprehensive tobacco control programs suggests that achieving the nation's ambitious Healthy People 2010 objectives, including cutting in half the rates of smoking among women and girls, is within our reach. While states continue to debate the use of tobacco settlement funds, it is important to note that when significant resources have been devoted to the implementation of evidence-based strategies, the results have been dramatic for the population overall and for women in particular. For example, in California, which has had a comprehensive tobacco control program for 11 years, smoking prevalence has declined throughout the 1990s at rates two or three times faster than in the rest of the country, and while lung cancer incidence rates increased by 13% among women in other parts of the United States, they decreased by 4.8% among women in California. These promising findings indicate that although tobacco-related diseases have become a women's health issue of epidemic proportions, we have the ability to reverse these trends.