Each year, more than 490,000 people in America die from tobacco use and exposure to secondhand smoke. So even though we are now more knowledgeable about the dangers, tobacco use remains the leading cause of preventable death worldwide. Positively, our annual State of Tobacco Control report shows that usage rates have begun to decline, but these improvements are not spread equally. While historically men have smoked at higher rates, the gender gap is closing, partly due to targeted marketing and changing social norms.
Research has found that women’s smoking rates have not declined as quickly as men, and each year more than 200,000 women will die of tobacco related disease in the U.S., and an estimated 1.5 million worldwide. Currently, more than 10% of women report smoking cigarettes regularly, meaning either every day or most days. This is particularly worrying because women face unique health risks from tobacco use. During Women’s History Month we are looking at how Big Tobacco has targeted women, and the impact tobacco has on women’s health.
The Dangers of Tobacco on Women’s Health
The consequences of tobacco use are dire for everyone, but women are at an increased risk of suffering from specific health issues. Women who smoke face significantly higher risks of developing cancer, particularly lung and cervical cancer. Though it’s not widely known, lung cancer has surpassed breast cancer as the leading cause of cancer-related deaths among women in America. This may be because research has shown women who smoke are 25% more likely to develop lung cancer than men who smoke, which may be attributed to differences in lung physiology and hormone interactions.
Additionally, smoking has been strongly linked to cervical cancer. According to the Centers for Disease Control and Prevention (CDC), women who smoke are twice as likely to develop cervical cancer compared to non-smokers. This is because tobacco weakens the immune system’s ability to fight off HPV infections, a primary cause of cervical cancer.
Besides increasing the risk of cancer, women’s reproductive health is negatively affected by smoking in many ways. Women who smoke are more likely to experience infertility, miscarriages and complications during pregnancy. Smoking before and during pregnancy increases the risk of preterm birth, abnormal fetal growth, low birth weight, miscarriage and even fetal death.
Women who smoke are also more likely to develop chronic respiratory illnesses, like COPD. In fact, smoking is directly linked to 80% of COPD deaths in women each year. Research suggests that smoking increases the risk of coronary heart disease in women by 25% more than in men, putting them at an increased risk for heart attacks and strokes.
Targeting Women in Tobacco Marketing
Big Tobacco has long considered women a target market, and their strategies have evolved over the years to exploit gender norms, societal expectations and fashion trends. In the 1920s, ads by cigarette brands like Virginia Slims, presented smoking as an act of female empowerment with slogans like “You’ve come a long way, baby.” During this time “light” or “slim” cigarettes were introduced as a way for women to lose weight. Additionally, beauty and fashion companies presented cigarettes as feminine and sexy.
One such ad, released in 2007 by R.J. Reynolds, introduced Camel No. 9, a name that mirrored a popular designer perfume. A study by the University of California at San Diego and Truth Initiative® found the brand was very effective in encouraging young girls to start smoking, with teen girls citing it as a favorite cigarette campaign.
Since then, Big Tobacco has used social media influencers and online platforms to subtly promote smoking and vaping. Women, particularly younger demographics, are bombarded with images of sleek, flavored e-cigarettes that are marketed as trendy, social and even “healthy” alternatives to traditional cigarettes. This has contributed to the troubling rise in e-cigarette usage among young women. According to a 2018 survey, about 7.3% of female high school students currently vape and 18.8% of female high school students use e-cigarettes.
Combating the Tobacco Epidemic Among Women
Given the severe health risks and predatory marketing tactics, public health initiatives must continue to focus on reducing tobacco use among women. Unfortunately, studies show that women have a harder time quitting because of a greater physical and emotional dependency on tobacco use. Women face gender-related barriers to quitting as well, such as weight gain concerns; menstrual/hormonal cycles influencing withdrawal; a greater likelihood of depression and mood variability; lack of social support; and caregiver burden. These barriers make quitting cold turkey increasingly difficult which is why actively participating in a cessation program is so pivotal. The American Lung Association’s Freedom From Smoking® program has helped over a million people quit for good. This program is particularly effective for women because the plans are personalized, and the group setting offers the support to help participants stay tobacco-free for life. Find more quit resources on our website.
Tobacco use among women is a significant public health issue, worsened by the aggressive marketing strategies of the tobacco industry. While smoking rates among women have declined in some regions, the rise of e-cigarettes presents new challenges. The health consequences of tobacco use—from cancer and reproductive issues to heart disease and COPD—underscore the urgent need for continued awareness, education and regulation. By addressing the unique risks that women face and counteracting the influence of Big Tobacco, society can move closer to a future free from the devastating impact of tobacco on our mothers, sisters, aunts and daughters.
Blog last updated: March 11, 2025
