Women with less than a high school education were three times as likely to begin smoking as women who went to college. Less educated women were also less likely to quit. Senator Richard J. Durbin, Democrat of Illinois, introduced a bill yesterday to require Medicare, Medicaid and the Maternal and Child Health Program to pay for smoking cessation therapy, including counseling as well as prescription and nonprescription drugs like nicotine patches and chewing gum. More than 90 percent of lung cancer cases are because of smoking. The number of cases peaked during the 1990's and is not increasing.
Smoking also raises the risk of cancer of the bladder, kidney, pancreas and oropharynx.
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 like emphysema, which kill 56,000 women a year. But men had a sharper decline in the same period, from 52 percent to 26 percent. American Indian or Alaska Native women were the heaviest smokers, with a rate of 34.5 percent, followed by white women at 23.5 percent, black women at 21.9 percent, Hispanics at 13.8 percent and Asians and Pacific Islanders at 11.2 percent.