The impact of cigarette smoking on cardiovascular outcome in women.

Cigarette smoking should be considered the most important known modifiable risk factor for coronary heart disease (CHD). Globally, it is responsible for 10% of all deaths from cardiovascular disease. An emerging and alarming problem is the growing incidence of smoking among women. Smoking promotes cardiovascular disease and primarily atherosclerosis through multiple direct and indirect mechanisms including increased oxidative stress and vasomotor, rheological and hematological dysfunction. Cigarette smoking also acts by potentiating other risk factors for cardiovascular disease. It is now well documented that women are as vulnerable as men to the dangers of tobacco, if not more so: indeed, women using tobacco face virtually the same risks as men and even greater risks for some diseases. The exact mechanism of gender-related differences is unclear and several possible explanations have been offered. Moreover, the relative risk of CHD associated with smoking seems to be greater for younger women than for older women. All these data suggest that including women in tobaccocontrol strategies is crucial: an approach with a gender equality policy is the key to winning the battle against smoking