Peters Sanne A E, Huxley Rachel R, Woodward Mark
Nuffield Department of Population Health, The George Institute for Global Health, University of Oxford, Oxford, UK.
School of Population Health, University of Queensland, Brisbane, Australia.
BMJ Open. 2014 Dec 30;4(12):e005663. doi: 10.1136/bmjopen-2014-005663.
Several studies have shown that smoking may confer a greater excess risk for chronic diseases in women compared with men. The reasons for this excess risk of smoking in women are unclear, yet sex differences in smoking habits may play a role. We, thus, characterised sex differences in smoking habits in a contemporary Western population.
Cross-sectional population-based study.
UK Biobank Resource.
499,797 (54% women) individuals with data on smoking habits.
Women-to-men prevalence ratios in smoking status, and the women-minus-men mean difference in age at smoking initiation, number of cigarettes smoked daily and age at smoking cessation in 5-year birth cohort bands.
The women-to-men ever-smoking ratio ranged from 0.57 in the oldest to 0.87 in the youngest birth cohort. In the oldest cohort, born 1935-1939, women started smoking 1.9 years (95% CI 1.7 to 2.1) later than did men, but in those born after 1959 there was no difference in the age at initiation. The oldest women smoked 5.3 (95% CI 4.7 to 5.9) cigarettes per day fewer than did the oldest men, compared with 2.0 (95% CI 1.7 to 2.3) fewer cigarettes smoked per day in the youngest, born 1965-1969. Among quitters, women born before 1945 were, on average, 1.5 years older than their male contemporaries, but this differential was 1 year or less among people born after 1949.
Differences in smoking behaviour between women and men have decreased over time. Even past differentials are unlikely to explain the increased susceptibility to smoking-related chronic disease in women compared with men that has previously been observed. Future studies are required to determine whether sex differences in the physiological and biological effects of smoking are responsible for the differential impact of smoking on health in women and men.
多项研究表明，与男性相比，吸烟可能使女性患慢性病的额外风险更高。女性吸烟额外风险增加的原因尚不清楚，但吸烟习惯的性别差异可能起了一定作用。因此，我们对当代西方人群吸烟习惯的性别差异进行了特征描述。
基于人群的横断面研究。
英国生物银行资源库。
499797名（54%为女性）有吸烟习惯数据的个体。
按5年出生队列分组，计算吸烟状况的女性与男性患病率之比，以及开始吸烟年龄、每日吸烟量和戒烟年龄的女性减去男性的平均差值。
曾经吸烟的女性与男性的比例在最年长出生队列中为0.57，在最年轻出生队列中为0.87。在1935 - 1939年出生的最年长队列中，女性开始吸烟的时间比男性晚1.9年（95%可信区间1.7至2.1），但在1959年以后出生的人群中，开始吸烟的年龄没有差异。最年长的女性每天吸烟比最年长的男性少5.3支（95%可信区间4.7至5.9），而在1965 - 出生的最年轻队列中，这一差值为每天少2.0支（95%可信区间1.7至2.3）。在戒烟者中，1945年以前出生的女性平均比同龄男性大1.5岁，但在1949年以后出生的人群中，这种差异为1岁或更小。
随着时间的推移，男性和女性之间的吸烟行为差异有所减小。即使是过去的差异也不太可能解释之前观察到的女性与男性相比对吸烟相关慢性病易感性增加的现象。未来需要开展研究，以确定吸烟的生理和生物学效应方面的性别差异是否是吸烟对女性和男性健康产生不同影响的原因。
