Mental health

June 2011


Women who smoke

A review of the evidence

Volume 40, No.6, June 2011 Pages 403-407

Colin P Mendelsohn


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.

There is an increasing awareness of the special risks and needs of women who smoke. Women are at significantly greater risk of developing a smoking related disease than men, as well as being susceptible to gender specific health issues and pregnancy complications.1 Women also have more difficulty quitting smoking than men and may need extra support and advice to help them quit.2,3 In spite of this, women are less likely than men to be asked by their general practitioner about smoking or to be advised to quit.4 Even in pregnancy, GP intervention rates are well below recommended levels.5

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