Women who smoke - A review of the evidence

Women who smoke are at significantly greater risk of developing a smoking related disease than men. They are also at risk of pregnancy related complications due to smoking and have more difficulty quitting. There are important gender differences in smoking behaviour that have implications for the quitting process. Advice to female smokers should take these factors into account and support should be tailored to their needs.

This article presents a summary of the evidence and a range of gender specific strategies that general practitioners can use to optimise the support they give to female smokers.

Women may need more intensive behavioural and pharmacological support when quitting. Particular emphasis should be placed on addressing stress, social support, smoking cues and concerns about weight gain. Nicotine replacement therapy is less effective in women. However, it is still useful if used in adequate doses and can be used in pregnancy if the woman is unlikely to quit without it. Varenicline and bupropion are not approved in pregnancy or in lactation.