The beginning of the new year is the perfect time to attack bad habits like smoking. Most smokers want to quit, but are overwhelmed by the thought of stopping. But is it different for men and women? In this article, we discuss whether women are facing more challenges than men in escaping nicotine addiction and being able to quit smoking for good.
Cravings, withdrawal challenges, and hormones make it more difficult for women to stop smoking.
Nicotine replacement therapy, such as nicotine patches or gum, works better for men than women.
Women struggle more to quit smoking, but medication can even their chances.
Behavioral therapy can improve a woman’s chances of quitting smoking and not returning to the habit.
Women can increase their success rate to that of men with the correct medication.
Tobacco use statistics
Tobacco causes over eight million deaths per year, and the World Health Organization (WHO) considers it “one of the biggest public health threats the world has ever faced.” Smokers are three times more likely to die than non-smokers. The Centers for Disease Control (CDC) considers tobacco use the leading preventable cause of death in the United States. Common causes of tobacco-related deaths include cancer, respiratory disease, and vascular or heart disease.
More men than women use tobacco, with 36.7% of the world’s men using tobacco versus only 7.8% of the world’s women using tobacco. Overall, 22.3% of the world uses tobacco in some form.
Cigarettes are the most popular form of tobacco. Still, tobacco exists in many forms, including cigarettes, cigars, cigarillos, self-rolled tobacco, pipe tobacco, bidis, kreteks, and smokeless tobacco. No form of tobacco use is safe.
The CDC reports that while most people want to quit and more than half have tried quitting, only one in ten smokers successfully stop smoking each year. The WHO estimates that four percent of smokers successfully stop without help, but having professional services and medications can double that success rate.
Consequences of smoking – men vs. women:
Women are at a higher risk than men for tobacco-related diseases. Women who quit smoking gain health benefits from not smoking quicker than men. However, continuing to smoke leaves women at an increased risk of long-term illness or death.
Smoking leads to heart disease, lung cancer, mouth cancer, possible infections, and more. Women who smoke can also have menstrual problems, difficulty getting pregnant, ectopic pregnancy, earlier menopause, and cervical cancer.
Who tries to quit smoking more – women or men?
More women try to stop smoking, but fewer succeed. Women who successfully stop also are more likely to start back. The struggle women face in quitting has been reported in multiple studies, but why?
A recent study in France of more than 35 000 smokers showed that women are less nicotine dependent yet had a lower abstinence rate. These results suggest women have a complicated psychological relationship with nicotine versus men who have a physical relationship with nicotine. Women do not get the same relief simply replacing nicotine that men do; therefore, women need an approach to quitting that factors in more than nicotine replacement.
Reasons why women struggle more to stop smoking
Since studies have shown that women face more challenges when trying to quit smoking, here we examine potential reasons why that might be the case.
A recent study in France suggested that women have more difficulty stopping smoking than men, possibly due to fear of weight gain, anxiety, depression, and hormonal imbalances.
Women smoke more to control their mood and weight than men, who smoke for the rewarding effects of nicotine. In periods of stress, women who smoke are likely to reach for a cigarette to control their anxiety or depression. Depression, anxiety, and a loss of sleep can occur when stopping smoking, increasing the challenge for women.
Additionally, many women started smoking to control their weight, fearing that stopping would cause weight gain. This weight gain fear adds to the anxiety associated with battling addiction.
A study in the Netherlands also suggests the psychological symptoms of stopping smoking are more important to women. According to the study, if anxiety, depression, weight gain fears, and hormonal issues were treated, women would be more successful in quitting smoking. Women also succeed more with emotional support, like group therapy.
Women seem to have more cravings, especially in periods of stress. Men’s cravings tend to be more due to the physical environment. Smokers who want to stop are often told to avoid places where people smoke or to change daily routines to prevent environmental cravings. This advice is helpful to men but doesn’t address the cravings women suffer since stress isn’t a location.
A study in Sweden reported that nicotine stops estrogen production in the brain. Estrogen is a primary sex hormone in women that affects mood and some brain functions, like memory and comprehension. As little as one cigarette showed this alarming effect on women’s brains.
Stopping smoking could increase estrogen levels, which could affect emotions. Some experts recommend women attempt to quit in the second half of their cycle, between ovulation and the end of the cycle, to minimize this effect.
Nicotine addiction treatment options
It is evident that quitting smoking is challenging. Below, we discuss the available treatment options to help with nicotine addiction.
Nicotine Replacement Therapy (NRT)
Nicotine replacement therapy (NRT) replaces nicotine with a nicotine patch or chewing gum. Often, NRT is the first recommendation smokers get to help them stop smoking because it does not require a prescription, is easy to find, and is affordable.
Several studies have shown that nicotine replacement works better for men than women because men and women have a different relationship with nicotine. Men, unlike women, often smoke for the nicotine reward, so replacing the nicotine can help cravings.
In many studies, women do not respond to NRT, but professionals continue offering it to them.
- Bupropion. Bupropion is an antidepressant medication that is also used to aid smoking cessation. Women do not seem to respond as well to bupropion, although it should help with depression and smoking cessation symptoms. Bupropion can be combined with NRT, which seems to work better in men.
- Varenicline. A study showed women respond to varenicline, but varenicline is rarely offered. Varenicline works as a nicotine agonist and cannot be combined with NRT. The study showed that women who used varenicline had the same success rate at quitting as men. Women taking varenicline were also less likely to resume smoking than those without varenicline.
Women can also increase their chances of success with behavioral therapy. Women in a study in the Netherlands reported a desire for more positivity and support while quitting. Behavioral therapy could address depression, anxiety, and weight gain concerns that plague women who want to stop.
Study authors pointed out that other addictions have support groups, like Alcoholics Anonymous. Perhaps such a support group for nicotine would help women.
- Behavioral therapy combined with medication. Medication combined with behavioral therapy offers women a better chance to quit smoking for good.
- Support. Women can join online or in-person groups to stop smoking. There are also online support tools to help, like quitnow.com. And apps are also available to help, like the smoke-free app.
Winning tactics for women to stop smoking:
Women and men face different barriers and process nicotine differently. The current approach to smoking cessation is designed for men who smoke, but women need a tailor-made way to stop smoking. Offering women medication and support or therapy increases their chances of succeeding. Without medication and support, women struggle more to quit smoking.
Here are some tips to help women quit smoking easier:
- Make an appointment with your doctor to discuss medication options to help.
- Pick a day to stop, preferably in the second half of your menstrual cycle.
- Tell friends and family you plan to stop.
- Join a stop smoking group (in-person or online), find a friend who also wants to stop, or a virtual assistant to help you stop.
- Make a plan for how to deal with cravings, emotions, and withdrawal.
- Keep a list of the benefits of not smoking to look at when you are tempted to smoke.
- CDC. Tobacco-Related Mortality.
- CDC. Smoking Cessation: Fast Facts.
- CDC. Fast Facts and Fact Sheets.
- Oxford Journals Nicotine and Tobacco Research. Sex Differences in Varenicline Efficacy for Smoking Cessation: A Meta-Analysis.
- CNS Drugs Scientific Journal. Smoking cessation in women. Special considerations.
Show all references
- Addiction Biology Scientific Journal. Gender differences in the pharmacology of nicotine addiction.
- European Heart Journal. Specific risk factors profile and abstinence rate of female smokers at high cardiovascular risk from the nationwide smoking cessation services cohort CDT-net.
- Journal of Thoracic Disease. Cardiovascular risk of smoking and benefits of smoking cessation.
- Medscape. Nicotine Blocks Estrogen Production in Women's Brains.
- National Institute on Drug Abuse. Are there gender differences in tobacco smoking?
- Harvard Health. Quitting smoking during the second half of the menstrual cycle may help women kick the habit.
- BMJ Journals. Gender differences within the barriers to smoking cessation and the preferences for interventions in primary care a qualitative study using focus groups in The Hague, The Netherlands.