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Tobacco use is a global epidemic with more than 5 million people dying every year from smoking-related causes.1 In the United States, tobacco use leads to 440,000 deaths per year2 and an annual economic burden of $96 billion in medical expenses and $97 billion in lost productivity.3 Smoking causes extensive medical consequences and many of these risks are greater for women compared to men, even after equating for tobacco exposure. Female smokers appear to be at a greater risk of developing lung cancer4,5 and are more susceptible to tobacco carcinogens5 than male smokers. Smoking is associated with an earlier age of breast cancer,6 and female smokers experience greater risks of oral cancer than male smokers.5 Even cancers that have historically been more prevalent in men (e.g., bladder cancer) are now demonstrating similar prevalence as rates continue to increase among female smokers.7 The risk of coronary heart disease is greater for female smokers than for male smokers.8–11 A meta-analysis examining the impact of smoking on coronary heart disease by gender in 76 cohorts from 1966–2010 (2.4 million participants) showed that, after controlling for other cardiovascular risk factors, female smokers demonstrated a 25% greater risk of coronary heart disease than male smokers.12

Innovations in Translational Sex and Gender-Sensitive Tobacco Research