When it comes to the health consequences of smoking, women must be concerned. Lung cancer is one of the most serious consequences. Since 1950, lung cancer mortality rates for women in the United States increased an estimated 600 percent, according to the

"Most people are astonished to hear that fact because breast cancer is the disease women fear most," said Diane Blum, executive director of Cancer Care Inc., a national non-profit organization that helps people with cancer, their families and professional caregivers. "From 1974 to 1994, lung cancer deaths for women went up 147 percent compared to 20 percent for men because so many women took up smoking. Unfortunately, these trends are apt to continue because so many young women are becoming addicted." Currently, women account for 39 percent of all smoking-related deaths in the United States, according to a recent report on women and smoking by Surgeon General David Satcher, M.D., Ph.D. The report warns that tobacco use is a serious women's health issue because it poses increased likelihood of lung cancer, heart attack, stroke, and gynecological problems. "In the early decades of the 20th century, smoking prevalence was more prominent among men," said Dr. Satcher at a press conference in March. "It took nearly 25 years before the gap narrowed and smoking became commonplace among women. In 1997, about 165,000 U.S. women died of smoking-related diseases. On average, each woman had her life cut short 14 years." In 1998, 22 percent of American women smoked, the Surgeon General's report noted. When high school senior girls were surveyed in 2000, almost 30 percent said they had smoked within the past 30 days. The number of young female smokers is worrisome because some studies suggest that women develop lung cancer with less time smoking than men. There is also data that shows girls may be more susceptible to the effects of tobacco when they are adolescents as opposed to boys, whose lung growth span is much longer. Women who smoke are also at higher risk than non-smokers for cancers of the oropharynx and bladder. Evidence is also strong that women who smoke have increased risks for liver, colorectal, pancreas and kidney cancers. "Smoking also has a devastating impact on women's reproductive health," said Cheryl G. Healton, Dr.P.H., president and CEO of the American Legacy Foundation, a national, independent public health foundation in Washington, D.C., that is working with other organizations that are interested in decreasing the use of tobacco by Americans. "Smokers take longer to conceive, are more likely to suffer miscarriages and difficulties in pregnancy and enter menopause earlier. Smoking also accelerates the rate of bone loss in post-menopausal women so that they are more likely to develop osteoporosis, a painful condition that can result in fractures and loss of mobility." And that's not all. Smoking has been linked with everything from gastric ulcers and colds to chronic lung diseases such as bronchitis and chronic obstructive pulmonary disease (COPD). Just as smoking subtracts years from a woman's life, it adds years to her looks. Smokers often develop lines around their mouths and dry skin caused by the poisonous chemicals in tobacco. To quit smoking, the most effective methods are the same for women and men, according to the Office on Women's Health in the Department of Health and Human Services. The federal agency advises smokers to pick a definite date to quit to firm up their commitment. Cigarette smoking hooks people in three interlocking ways: physical addiction, habit and emotional dependence. That's why many women benefit from multi-faceted cessation programs. Dr. Healton, who also is a professor of public health at Columbia University in New York, and other experts say one reason why so many women are smoking today is that the tobacco industry has targeted women, especially young women, as replacement smokers for men who are quitting. Many brands are exclusively marketed to women. Research on cigarette marketing has shown that advertising linking fashion, beauty and independence with smoking may make the addiction particularly appealing to young women. Fortunately, a number of programs now directed to young people will also impact young women. To overcome these harmful effect of advertising images, the American Legacy Foundation has launched a major tobacco youth prevention and education effort known as the "Truth" campaign. Advertising, grassroots and promotional events and an interactive Web site allow teenagers to get the facts about tobacco use and tobacco marketing, and to become involved in an effort to overcome these pressures. Other groups are also working to free American youth from the lure of tobacco. The Campaign for Tobacco-Free Kids in Washington, D.C., is one of the nation's largest non-governmental initiatives to protect both girls and boys from tobacco addiction and exposure to secondhand smoke. Each year it sponsors events like Kick Butts Day to encourage elementary, middle school and high school students to adopt new ways to fight youth tobacco use in their communities. Students run tobacco-free sports competitions, hold mock funerals for Mr. Butts, and learn about the dangers of smoking in classroom activities.

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