Smokingtwiceasdangerousforwomen

byPETERPALLOT,DailyMail
Awomanwhosmokesthesamenumberofcigarettesasamanistwiceaslikelyto
developlungcancer,doctorshavefound.
Researchsuggeststhatfemalesarehighlysusceptibletolungcancereventhoughthey
inhalelessdeeplyandstartsmokingatalateragethanmen.
Thekeytothedoubledtumourriskliesincruciallungtissuedifferencesfrommen,
andthepresenceofthefemalehormoneoestrogen,accordingtoProfessorDiane
Stover,headofthelungunitatSloanKetteringCancerCenter,NewYork.
Shedescribedthedatawhichrevealedthethreattowomenas'horrifying'.
Womenarealsomoresusceptibletothelethallungconditionchronicobstructivelung
disease,whichiscausedbysmokingandisrapidlyincreasinginincidence.
ForBritishwomen,thefindingsraisetheprospectofaleapinlungcancercases.
Recentresearchsuggeststhattheproportionofwomeninthiscountrywhosmoke
morethantencigarettesadayhasrisentooneinfour,bringingtheminlinewithmen
forthefirsttime.
DrStoversaidthatcancercasesamongwomeninAmericaandEuropewere
significantlyhigherthanthenumberoffemalesmokerswouldsuggest.
InJapan,astudyofcancervictimsamong1,000malesmokersand700female
smokersshowedthatwomendevelopedthediseasetwoyearsearlierthanthemen.
DrStovertoldaninternationalconference,attendedby17,000doctorsandorganised
bytheAmericanThoracicSociety,thatlungcancerwasmorecommoninnon
smokingwomenthantheirmaleequivalents.
Amassofresearchshowedthiswastruewhateverthewoman'scircumstancesfor
instancewhethershewasexposedtopassivesmokingathomeoratworkandunder
linedthevulnerabilityoffemalesmokers.
Partofthereasonwasthebiochemicalwaywomendealtwiththe50ormorecancer
producingagentsintobacco,saidDrStover.
'Menandwomendealwiththesecarcinogensdifferently,'shesaid.
'Thereareindividualvariations,butmentendtodetoxifythemandexcretethemin
theirurinewhereasinwomenthecarcinogenstakeadifferentpathway,theyare
transformedintoothercarcinogenicsubstances.'

Thesecouldleadtomutationsintumoursuppressinggenesor'cellsuicide',shesaid.
Othercompellingevidenceofgreaterfemalesusceptibilitywasthatagenepotentially
linkedtocancer,knownastheGRPR,wastwiceaslikelytotriggeratumourin
womenthanmenbecauseitattachedtotheXchromosome,whichwastwiceas
commoninfemales.
DrStoversaid:'Anotherwaytoputthisisthatacigarettesmokedbyawomanhad
doublethecarcinogeniceffectofacigarettesmokedbyaman.'
DrLesleyWalker,directorofcancerinformationattheCancerResearchCampaign,
said:'Thereareafewstudiesthatsuggestwomenareathigherriskthanmenfrom
lungcancercausedbysmoking.
'Themostlikelyexplanationisthatoestrogenpromotesthecancerprocessinsome
waybuttheunderlyingreasonsarenotclear.Therearenotenoughstudiesgoingonin
thisarea.
'Wewantbothsexestostopsmokingbutwomenmaybeathigherriskandthisisa
realconcernbecausetobaccocompaniesaretargetingwomenassmokersinthe
developingworld.'

Smokings Gender Gap Closes

Thetitleofarecentreportonsmokingandhealthmightwellhaveparaphrasedthe
popularadcampaignforVirginiaSlims,introducedin1968byPhilipMorrisand
aimedatyoungprofessionalwomen:Youvecomealongway,baby.
Todaythatsloganshouldinclude:...towardashorterlife.Tenyearsshorter,in
fact.
Thenewreportisoneoftworathershockinganalysesofthehazardsofsmokingand
thebenefitsofquittingpublishedlastmonthinTheNewEnglandJournalof
Medicine.Thedatashowthatwomenwhosmokelikemendielikemenwho
smoke,Dr.StevenA.Schroeder,aprofessorofhealthandhealthcareatthe
UniversityofCalifornia,SanFrancisco,wroteinanaccompanyingeditorial.
Thatwasnotalwaysthecase.Halfacenturyago,theriskofdeathfromlungcancer
amongmenwhosmokedwasfivetimeshigherthanthatamongwomensmokers.But
bythefirstdecadeofthiscentury,thatriskhadequalized:forbothmenandwomen
whosmoked,theriskofdeathfromlungcancerwas25timesgreaterthanfor
nonsmokers,Dr.MichaelJ.ThunoftheAmericanCancerSocietyandhiscolleagues
reported.
Today,womenwhosmokeareevenmorelikelythanmenwhosmoketodieoflung
cancer.Accordingtoasecondstudyinthesamejournal,womensmokersfacea17.8
timesgreaterriskofdyingoflungcancer,thanwomenwhodonotsmoke;menwho
smokeareat14.6timesgreaterrisktodieoflungcancerthanmenwhodont.
Womenwhosmokenowfaceariskofdeathfromlungcancerthatis50percent
higherthantheestimatesreportedinthe1980s,accordingtoDr.PrabhatJhaofthe
CenterforGlobalHealthResearchinTorontoandhiscolleagues.
Aftercontrollingforage,bodyweight,educationlevelandalcoholuse,thenew
analysisfoundsomethingelse:menandwomenwhocontinuetosmokedieon
averagemorethan10yearssoonerthanthosewhoneversmoked.
Dramaticprogresshasbeenmadeinreducingtheprevalenceofsmoking,whichhas
fallenintheUnitedStatesfrom42percentofadultsin1965(theyearafterthefirst
surgeongeneralsreportonsmokingandhealth)to19percentin2010.Yetsmoking
stillresultsinnearly200,000deathsayearamongpeople35to69yearsoldinthis
country.Aquarterofalldeathsinthisagegroupwouldnotoccurifsmokershadthe
sameriskofdeathasnonsmokers.
Therisksareevengreateramongmen55to74andwomen60to74.Morethantwo
thirdsofalldeathsamongcurrentsmokersintheseagegroupsarerelatedtosmoking.
Overall,thedeathratefromallcausescombinedintheseagegroupsisnowatleast
threetimesashighamongcurrentsmokersasamongthosewhohaveneversmoked,
Dr.Thunsteamfound.

Whilelungcanceristhemostinfamoushazardlinkedtosmoking,thehabitalso
raisestheriskofdeathfromheartdisease,stroke,pulmonarydiseaseandother
cancers,includingbreastcancer.
Furthermore,changesinhowcigarettesaremanufacturedmayhaveincreasedthe
dangersofsmoking.Theuseofperforatedfilters,tobaccoblendsthatareless
irritating,andpaperthatismoreporousmadeiteasiertoinhalesmokeand
encourageddeeperinhalationtoachievesatisfyingbloodlevelsofnicotine.
Theresultofdeeperinhalation,Dr.Thunsreportsuggests,hasbeenanincreasedrisk
ofchronicobstructivepulmonarydisease,orC.O.P.D.,andashiftinthekindoflung
cancerlinkedtosmoking.Amongnonsmokers,theriskofdeathfromC.O.P.D.has
declinedby45percentinmenandhasremainedstableinwomen,butthedeathrate
hasmorethandoubledamongsmokers.
Butthereisgoodnews,too:itsnevertoolatetoreapthebenefitsofquitting.The
youngeryouarewhenyoustopsmoking,thegreateryourchancesoflivingalongand
healthylife,accordingtothefindingsofDr.Jhasinternationalteam.
Theteamanalyzedsmokingandsmokingcessationhistoriesof113,752womenand
88,496men25andolderandlinkedthemtocausesofdeathsinthesegroupsthrough
2006.
Thosewhoquitsmokingbyage34lived10yearslongeronaveragethanthosewho
continuedtosmoke,givingthemalifeexpectancycomparabletopeoplewhonever
smoked.Smokerswhoquitbetweenages35and44livednineyearslonger,andthose
whoquitbetween45and54livedsixyearslonger.Evenquittingsmokingbetween
ages55and64resultedinafouryeargaininlifeexpectancy.
Theresearchersemphasized,however,thatthenumbersdonotmeanitissafeto
smokeuntilage40andthenstop.Formersmokerswhoquitby40stillexperienceda
20percentgreaterriskofdeaththannonsmokers.Aboutoneinsixformersmokers
whodiedbeforetheageof80wouldnothavediedsoyoungifheorshehadnever
smoked,theyreported.
Dr.Schroederbelieveswecandoalotbettertoreducetheprevalenceofsmoking
withthetoolscurrentlyinhandifgovernmentagencies,medicalinsurersandthe
publiccooperate.
Unliketheraces,ribbonsandfundraisersforbreastcancer,theresnopublicface
forlungcancer,eventhoughitkillsmorewomenthanbreastcancerdoes,Dr.
Schroedersaidinaninterview.Lungcancerisstigmatizedasadiseasepeoplebring
onthemselves,eventhoughmanyoldervictimswerehookedonnicotineinthe1940s
and1950s,whenlittlewasknownaboutthehazardsofsmokinganddoctorsappeared
inadsassuringthepublicitwassafetosmoke.
Raisingtaxesoncigarettescanhelp.Thestateswiththehighestprevalenceof
smokinghavethelowesttaxratesoncigarettes,Dr.Schroedersaid.Alsohelpful

wouldbeprohibitingsmokinginmorepublicplaceslikeparksandbeaches.Some
stateshavecriminalizedsmokingincarswhenchildrenarepresent.
Morecountermarketingofcigarettesisneeded,hesaid,includingantismoking
publicserviceadsontelevisionanddramatichealthwarningsoncigarettepacks,asis
nowdoneinAustralia.ButtwoAmericancourtshaveruledthattheproposedlabel
warningsinfringedonthetobaccoindustrysrighttofreespeech.
Healthinsurers,bothprivateandgovernment,couldbroadentheircoverageofstop
smokingaidsandbetterpublicizetelephonequitlines,anddoctorsshoulddomoreto
stimulatequitattempts,Dr.Schroedersaid.
AsNicolaRoxon,aformerAustralianhealthminister,putit,Wearekillingpeople
bynotacting.