Women Smokers and Lung Cancer: Moving Past “You’ve Come a Long Way, Baby”

It comes as welcome news that women continue to stop smoking in increasing numbers. As a result, the rate of lung cancer in women, which in the 1980’s had surpassed the rate of breast cancer, is now below it once again. During the 20thcentury, the tobacco industry had considerable success in convincing women to view cigarette smoking as appealing. The situation now is very different. Not only has all doubt been removed about the negative health consequences, smoking cigarettes has, in many circles, become stigmatized. Even the more recent phenomenon of vaping e-cigarettes has begun to lose some of its industry-promoted cultural attractiveness. Our women patients describe to us, with some embarrassment, the extreme measures they take to try to keep their smoking hidden from their family, friends, and colleagues.

I have been surprised by the number of women who are seeking treatment with us to stop smoking – they currently make up over 80% of our patients, whereas women are typically in the minority in treatment programs for substance use disorders. What I find particularly interesting is the reason motivating these women to seek treatment. For many of them, taking care of children and other family members has been central to their lives. Concerns that their smoking will hurt them, expressed by their young children (and grandchildren) was a tipping point for many of them to take the difficult step of asking for help.

There is some evidence, however, that because of biological and psychological factors, quitting smoking is more difficult for women than for men. In our program, we address these difficulties is several ways. Biologically, we encourage them to take Chantix (varenicline), which is particularly effective for women. In addition, because women metabolize nicotine more rapidly than men, higher doses of nicotine patches, gum, and lozenges are necessary. Psychologically, individual therapy helps women track their use of nicotine to manage their moods, whereas nicotine use by men tends to be triggered by environmental cues. Group therapy is helpful because of the importance to women of interpersonal support in their effort to stop smoking.

If you are a woman who has been unsuccessful in previous quit attempts or is struggling with concerns expressed by family members, we would like to help. Please reach out to us here.