Smoking-Related Deaths On The Rise Among American, French Women

"For American women, increased female smoking, especially among teenagers, has caused a steady increase in smoking-related disease and mortality," notes Dr. Gary King, associate professor of biobehavioral health in the College of Health and Human Development.

"The proportion of all deaths attributable to cigarette smoking among female smokers rose in the United States from 16.7 percent in the 1960s to 47.4 percent in the 1980s," he says. "Most of these deaths were due to lung cancer, emphysema and bronchitis and, to a lesser degree, heart disease."

A similar phenomenon has occurred in France, which, though different in language and some sociocultural traditions, shares many similarities with the United States as a major Western industrialized country.

Until recently the incidence of smoking-related diseases among women in France was relatively low and female mortality accounted for only 3.7 percent of all tobacco-related deaths in that country. However, if smoking continues to attract younger French women, female mortality rates attributable to smoking are projected to increase 10-fold, according to King.

"Increased smoking rates among young American and French women suggest the need to examine further the use of tobacco as an appetite suppressant and as a means to build self-esteem and gain approval from peers," says King. "Studies have documented that nicotine does indeed act as an appetite suppressant and that cigarette smoking helps women remain thin.

"The accelerated role of the tobacco industry in marketing and promoting cigarettes clearly has to be factored in too," he adds.

King is lead author of the paper, "Smoking Behavior among French and American Women," which recently appeared in the journal, Preventive Medicine. Co-authors are Danielle Grizeau, Comite Francais d'Education pour la Sante, Vanves, France; Dr. Robert Bendel, Center for Environmental Health, University of Connecticut-Storrs; Christiane Dressen, Comite Francais d'Education pour la Sante; and Steven R. Delaronde, Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, Conn.

The researchers studied nationally representative samples of 18 to 64-year-old French (1,956) and American (20,234) women between the ages of 18 and 64. This analysis used two years of data collected by the National Health Interview Survey in the United States and the Comite Francais d'Education pour la Sante (1992-93).

"According to our data, the proportion of French women who smoke was significantly higher than that of American women who smoke (30.8 percent vs. 26.3 percent), most of this difference being found among younger age groups," King notes.

"Almost half the French women surveyed between the ages of 18 and 24 were smokers, compared with less than a quarter of American women.This has ominous implications for future efforts to curb smoking in France," says the Penn State scientist. "American women in the 18-24 age group have been somewhat more receptive to educational programs designed to discourage smoking."

The smoking rate among American women does not exceed that of their French counterparts until the 45-54 year-old age range.

The average number of cigarettes smoked per day was significantly lower for French women of all ages (12.3) than for American women (18.2).This apparent irony can be traced in part to the fact that younger smokers may be less addicted to nicotine than older smokers: i.e. they need fewer cigarettes to satisfy their habit.

Tobacco consumption remains overall a major health problem for industrialized and developing countries alike. It is estimated that there are 1 billion smokers worldwide, resulting in 3 million smoking-related deaths per year. By the mid-2020s, smoking-related deaths are projected to increase threefold, says King.

He will be participating in an international conference titled "Tobacco and Women: Understanding the Past, Changing the Future" on Nov. 23-24 in Paris. He is also planning a joint French-American conference on smoking.