The 1964 surgeon general’s report1 indicated that smoking was the cause of the increase in men’s lung cancer rates, but only suggested an association with women’s lung cancer rates and with low birthweight. For many years thereafter, women were thought to be at less risk from tobacco. After all, a smaller percentage of women than men smoked, and those who did smoked fewer cigarettes. So while the subject of women’s smoking was a hot topic among tobacco marketing strategists, it often escaped the interest of public health specialists.

When women’s lung cancer mortality rates in the United States started soaring, to eventually become the most important cause of cancer mortality surpassing breast cancer, women’s risks were acknowledged to be the same as men’s. “Women who smoke like men die like men.” said former Surgeon General C Everett Koop. Indeed, recent research indicates that women don’t have to smoke like men to die like men, they may be at as much risk as men with lower smoking patterns.

Just what are the differences between men and women in relation to smoking? Do women smoke differently than men, do they smoke for different reasons, do they suffer health consequences differently, do they encounter more difficulty in quitting? Are the differences important, and will they indicate priorities for health policy makers? These are the questions that are finally being asked. It is therefore timely that a publication has recently been released as a professional teaching monograph, The female smoker: from addiction to recovery, by Joan A Christen and Arden G Christen, two experts with experience in cessation counselling and addiction in …