We're not doing enough to get women off tobacco

February 1, 2004



1987 is a year to be ashamed of: It was the point at which the number of women dying from lung cancer exceeded the number dying from breast cancer. It probably comes as no surprise to learn that smoking was the main culprit in this situation, according to a report by the National Women's Law Center and Oregon Health and Science University.

The report, "Women and Smoking: A National and State-by-State Report Card," found that 20.7% of adult women smoke. Compared to the national health objectives set by the US Department of Health and Human Services' Healthy People 2010, the nation falls far short of the goal to reduce smoking among adults to 12%.

Although advice from physicians to quit smoking has been shown to increase cessation rates, the report found that only 61% of female smokers reported having received smoking cessation advice from a physician in the past year. The national goal is to have physicians give such advice to 75% of smokers.

Only one state—Rhode Island—exceeded the national goal with 75.7% of smokers receiving cessation advice from physicians. North Dakota ranked last with just 43.8% of smokers receiving such advice.

The report indicated that a key opportunity to discuss smoking cessation with women is during physician counseling on contraceptive risks and benefits. Because there is some evidence indicating that nicotine in tobacco can break down the estrogen in oral contraceptives, women should be counseled that smoking may make an OC less effective and increase the risk for unplanned pregnancy.

Moreover, smoking during pregnancy has serious risks. Yet, according to the report, 12.2% of women nationwide continue to do so. No state met the national goal to reduce this rate to less than 1%. However, the District of Columbia came the closest with 2.6% of women smoking during pregnancy. West Virginia had the highest percentage of women who smoke during pregnancy (26.3%).