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    Smoking harms nearly every organ in the body and is the single greatest cause of preventable morbidity and mortality in the United States.1
    It is a modifiable risk factor in the development of the top three causes of female deaths in Maryland: heart disease, cancers, and stroke.

    Cardiovascular Disease

    Heart Disease
    • Heart disease is the leading cause of female deaths in Maryland.2
    • Compared to nonsmokers, the risk of myocardial infarction is increased six-fold in women who smoke.3
    • Regardless of what age a women stops smoking, smoking cessation substantially reduces the excess risk of coronary heart disease within 1-2 years.1


    • Stroke is the third leading cause of female deaths in Maryland.2
    • Women who smoke have an increased risk for ischemic stroke and subarachnoid hemorrhage.1
    • After 5 to 15 years of smoking cessation, the risk of stroke development approaches that of a women who has never smoked.1



    1 out of every 3 cancer deaths that occur in the United States annually could be prevented if nobody smoked.4
    Lung Cancer
    •  Lung cancer is the leading cause of female cancer deaths in Maryland.2
    •  Approximately 90% of all lung cancer cases are attributable to smoking or exposure to tobacco smoke.1,3
    • This risk for developing lung cancer declines with each year of smoking cessation.1


    Breast Cancer

    • Breast cancer is the second leading cause of female cancer deaths in Maryland.2
    • The risk of developing breast cancer is highest in women who began smoking at an earlier age, particularly if smoking is initiated before the birth of their first child.3,5


    Colon Cancer

    • Colon cancer is the third leading cause of female cancer deaths in Maryland.2
    • Long-term cigarette smoking is associated with an increased risk of colorectal cancer, even after accounting for other known risk factors.  The longer a person smokes, the greater their risk.3,6


    Gynecologic Cancer

    • Smoking does not increase a women’s risk of developing ovarian cancer overall, but it does increase the risk for the development of mucinous ovarian cancers.3,7
    • Both active and passive smoking are associated with an increased risk of cervical neoplasia.3,8


    Other Cancers:

    • Mouth4
    • Nose4
    • Larynx4
    • Trachearachea4
    • Esophagus4
    • Stomach4
    • Pancreas4
    • Kidneys and ureters4
    • Bladder4
    • Bone marrow4
    • Blood4


    Chronic Obstructive Pulmonary Disease (COPD)

    • Approximately 90% of female mortality from COPD in the United States can be attributed to cigarette smoking.1
    • Smoking cessation slows the rate of decline of lung function among women with COPD.1



    • Smoking is associated with more difficult glycemic control, which leads to higher risk of organ damage, e.g. heart disease, nephropathy, retinopathy, and peripheral neuropathy.4


    Reproductive Health

    • Smoking has been linked to increased incidence of:
      • Infertility9
      • Ectopic pregnancy9
      • Spontaneous abortion (miscarriage)9
      • Earlier onset menopause9



    • The antiestrogen effect of tobacco accelerates menopause, which increases the risk of osteoporotic fracture independent of bone mineral density score.2


    Secondhand Smoke

    • Inhaling even a little secondhand smoke exposes a person to the same dangerous mixture of chemicals as the smoker and increases a person’s risk for all of the same health impacts as primary tobacco use.10
      • Approximately 3,000 lung cancer deaths per year in the United States are due to secondhand smoke exposure.10
      • Approximately 46,000 deaths from heart disease in the United States each year are caused by secondhand smoke.

    This is not a comprehensive list of the adverse health effects of tobacco use, rather this is meant to highlight diseases with high morbidity and mortality and issues of particular interest to women’s health.


    1. Women and Smoking: A Report of the Surgeon General. Retrieved September 30, 2014 from Centers for Disease Control and Prevention Website: http://www.cdc.gov/tobacco/data_statistics/sgr/2001/complete_report/index.htm
    2. The Health of Maryland Women 2011.  Available Online: http://phpa.dhmh.maryland.gov/mch/Documents/2011-Womens_Health_DataBook.pdf.
    3. American College of Obstetricians and Gynecologists. (2011). ACOG Committee Opinion 503: Tobacco Use and Women’s Health. Washington, DC:  American College of Obstetricians and Gynecologists.  Available Online: http://www.acog.org/-/media/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/co503.pdf?dmc=1&ts=20141016T2150223316.
    4. A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You. Retrieved September 30, 2014 from Centers for Disease Control and Prevention Website: http://www.cdc.gov/tobacco/data_statistics/sgr/2010/consumer_booklet/pdfs/consumer.pdf.
    5. Gaudet, MM et al. (2013). Active Smoking and Breast Cancer Risk: Original Cohort Data and Meta-analysis. Journal of the National Cancer Institute 105. 515-25.
    6. Hannan LM, Jacobs EJ, Thun MJ. (2009). The Association Between Cigarette Smoking and Risk of Colorectal Cancer in a Large Prospective Cohort from the United States. Cancer Epidemiology, Biomarkers, and Prevention 18. 3362-7.
    7. Tworoger SS et al. (2008). Caffeine, Alcohol, Smoking, and the Risk of Incident Epithelial Ovarian Cancer. Cancer 112. 1169-77.
    8. Trimble CL et al. (2005) Active and Passive Cigarette Smoking and the Risk of Cervical Neoplasia. Obstetrics and Gynecology 105. 174-81.
    9. The Practice Committee of the American Society for Reproductive Medicine. (2012). Smoking and Infertility: A Committee Opinion. American Society for Reproductive Medicine 98. 1400-6.
    10. Secondhand Smoke. Retrieved October 6, 2014 from TobaccoFree.gov Website: http://betobaccofree.hhs.gov/health-effects/secondhand-smoke/index.html.
    The images on this page are in the public domain and were obtained from BeTobaccoFree.gov.

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    October 2014