woman smoking a cigarette outdoors
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Walk past any large office building mid-morning and you're likely to see a line-up of people standing around, grabbing a quick cigarette. Ever notice how many of those sidewalk smokers are women?

Sure, there are a lot of female office workers. But there's something else going on as well: women have a harder time quitting smoking than men do.

"There are many reasons," says Sherry A. McKee, PhD, assistant professor of psychiatry and a principal investigator with the Transdisciplinary Tobacco Use Research Center at Yale University School of Medicine. "It appears that nicotine replacement is not as effective for women as for men."

It's not that women don't get addicted to nicotine. "Men smoke more for the nicotine itself and how nicotine makes them feel. Women are often smoking for weight control or to manage stress," Dr. McKee says. Her research shows that, compared to men, women worry more about risks associated with smoking cessation, such as gaining weight or not being able to handle stress. "Men don't worry about these as much as women," she says.

In addition, female smokers who are experiencing stressful life events are less able to quit smoking than males and more likely to relapse once they have quit.

So, if you're a smoker, or care about someone who is, what will help make quitting successful?

Understand the reality of weight gain related to smoking cessation, Dr. McKee advises. On average, those who quit gain five pounds. Many women think they'll gain 20 pounds or more, so they go back to smoking as soon as the numbers on the scale start climbing. Women who expect to gain about five pounds are the most successful and gain the least weight, she says.

Realize that you probably won't succeed the first time you try to quit. According to the Centers for Disease Control and Prevention (CDC), many people need two or three tries, or more, before becoming smoke-free. From each attempt, learn what works for you and what causes problems.

Focus on reducing stress and distracting yourself. When you feel like smoking, the CDC recommends going for a walk, taking a hot bath, getting busy with a task or reading a book.

Know that you can do it. "Most quit attempts don't last more than 24 to 48 hours," says Dr. McKee. "If you can get past the first week, your chances are much better."

Remember why quitting is so important. Cigarette smoking kills 178,000 U.S. women each year. More women die of lung cancer than of breast cancer. Smoking puts women at higher risk for cervical and other cancers, infertility, pregnancy complications, early menopause, osteoporosis, emphysema, coronary heart disease, diabetes, gastrointestinal disease, thyroid disease and more. Those risks begin to decline almost immediately when you quit:

  • After 20 minutes, blood pressure drops;
  • After eight hours, oxygen and carbon dioxide levels in blood are normal;
  • After 24 hours, risk of heart attack decreases;
  • After 48 hours, nerve endings start regrowing;
  • At two weeks to three months, circulation and lung function improve;
  • At one year, coronary heart disease risk is reduced by half;
  • At five to 15 years, stroke risk reduced to that of nonsmokers;
  • At 10 years, lung cancer risk cut to half that of smokers;
  • At 15 years, risk of death nearly same as for those who never smoked.
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