Among teen-age girls, much of the earlier decline was canceled out by an increase during the 1990s, though the rate in girls has begun to decline again. The average loss of life was 14 years. Less-educated women are also less likely to quit. More than 90 percent of lung cancer cases are a result of smoking. The number of cases peaked during the 1990s and is not increasing.
Smoking also raises the risk of cancer of the bladder, kidney and pancreas.
It is associated with an increased risk of cervical cancer as well, but that disease is almost always caused by a sexually transmitted virus, and the role of smoking is not clear. Smoking plays a major role in heart disease and stroke, the leading causes of death in women. It also leads to about 90 percent of the deaths from chronic lung diseases such as emphysema, which kill 56,000 women a year. But men had a sharper decline during the same period, from 52 percent to 26 percent. Most worrisome, according to the report, are the number of girls who smoke.