MORTALITY IN WOMEN AND MEN IN RELATION TO SMOKING

Background Mortality from smoking-related diseases in women is increas ing worldwide. Studies comparing hazards associated with smoking in wo men and men based on a sufficient number of heavy smokers of both gend ers are lacking. Methods We used pooled data from three prospective po pulation studies conducted in Copenhagen to compare total and cause-sp ecific mortality in relation to smoking habits. A total of 30 917 subj ects, 44% women, with initial. examinations between 1964 and 1992 were followed until 1994 for date and cause of death.Results During follow up, 2900 women and 5744 men died. Smoking characteristics differed co nsiderably with gender, particularly in the older subjects. Overall mo rtality rates in smelters were approximately twice those in people who never smoked. Positive associations with smoking in both men and wome n were confirmed for all-cause mortality as well as mortality from res piratory disease, vascular disease, lung cancer, and other tobacco-rel ated cancers. Despite large gender differences in age at smoking debut , total and cause-specific relative mortality in smokers was similar i n men and women, After excluding non-inhalers, relative risks associat ed with smoking for respiratory and vascular disease were higher for w omen than men whereas there were no gender differences in smoking rela ted risk of cancers. Conclusions The relative risks suggest that women may be more sensitive than men to some of the deleterious effects of smoking. However, because of lower baseline mortality rates in women, rate differences may be similar and results should be interpreted with caution.