Female Smokers At Greater Risk for COPD Than Male Smokers

Female Smokers Have Higher Risk of COPD For Same Amount of Smoking Than Male Smokers

Background: Narrowing of the breathing tubes is called airflow obstruction. This is determined by having a person blow into a machine (called pulmonary
Spirometry performed to assess why Breathing is Worse

Woman performing breathing test.

function testing). Airflow obstruction is required to diagnose COPD – which is the 3rd most common cause of death throughout the world. Some researchers have suggested that women are more susceptible to the harmful effects of tobacco than men. Study: Dr. Amaral and colleagues from the National Heart and Lung Institute in London, United Kingdom, analyzed over 149,000 women and over 100,000 men taking part in a study on smoking. All subjects had breathing tests performed. The results were published in the May 1, 2017, issue of the American Journal of Respiratory and Critical Care Medicine, volume 195, pages 1226-1235.
Female smokers are at increased risk of COPD

Two women smoking

Results: Airflow obstruction was higher in those currently smoking (women: 21%; men: 19%) than in ex-smokers. Overall, the association of airflow obstruction with smoking status was greater in women than men. Those who started smoking before age 18 years were more likely to have COPD. Conclusions: For the same exposure to cigarettes, female smokers had a greater risk of airflow obstruction. With increasing rates of smoking among women in developed and developing countries, the authors suggested that it is important to create anti-tobacco campaigns. My Comments: The reasons that women appear to be more susceptible to cigarette smoke is unclear. However, there are several possible explanations. 1. Women have smaller lungs than men and the concentration of cigarette smoke in the breathing tubes is therefore greater. 2. Genetic factors linked to the X chromosome may predispose women to greater damage to the lungs with smoking. 3. Hormonal factors may affect metabolism (break down) of cigarette smoke. 

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.