Tobacco Facts - Gender Differences
Are there gender differences in tobacco smoking?
Several avenues of research now indicate that men and women differ in their smoking
behavior. For instance, women smoke fewer cigarettes per day, tend to use cigarettes
with lower nicotine content, and do not inhale as deeply as men. However, it is
unclear whether this is due to differences in sensitivity to nicotine or other factors
that affect women differently, such as social factors or the sensory aspects of
The number of smokers in the United States declined in the 1970s and 1980s, remained
relatively stable throughout the 1990s, and declined further through the early 2000s.
Because this decline in smoking was greater among men than women, the prevalence
of smoking is only slightly higher for men today than it is for women. Several factors
appear to be contributing to this narrowing gender gap, including increased initiation
of smoking among female teens and women being less likely than men to quit.
Large-scale smoking cessation trials show that women are less likely to initiate
quitting and may be more likely to relapse if they do quit. In cessation programs
using nicotine replacement methods, such as the patch or gum, the nicotine does
not seem to reduce craving as effectively for women as for men. Other factors that
may contribute to women’s difficulty with quitting are that withdrawal may be more
intense for women or that women are more concerned about weight gain.
Although postcessation weight gain is typically modest (about 5 - 10 pounds), concerns
about this may be an obstacle to treatment success. In fact, research has found
that when women’s weight concerns were addressed during cognitive-behavioral therapy,
they were more successful at quitting than women who were in a program designed
only to attenuate postcessation weight gain. Other researchers have found that medications
used for smoking cessation, such as bupropion and naltrexone, can also attenuate
postcessation weight gain and could become an additional strategy for enhancing
It is important for treatment professionals to be aware that standard regimens may
have to be adjusted to compensate for gender differences in nicotine sensitivity
and in other related factors that contribute to continued smoking.