Effects of Smoking on Women’s Health: A Review of Reviews

This systematic review synthesized domestic and international studies to compile evidence on the multifaceted health effects of smoking among women.Smoking reduces female fertility, advances the onset of menopause, and increases the risk of pregnancy complications, cardiovascular diseases, and several cancers.Several studies highlighted epigenetic modifications in genes associated with inflammation, reproductive outcomes, tumorigenesis, neurodevelopment, and cardioendocrine signaling.A Korean study reported a positive correlation between leukocyte count and urinary cotinine levels.Smoking adversely affects multiple stages of reproductive function and increases the risk of ectopic pregnancy, miscarriage, stillbirth, low birth weight, preterm delivery, and neonatal or perinatal death.However, maternal smoking was associated with a lower incidence of hypertensive disorders of pregnancy and no consistent association was found with gestational diabetes.Maternal smoking has also been linked to congenital anomalies and attention-deficit/hyperactivity disorder in offspring.Smoking increases the risks of breast and cervical cancers, whereas its contribution to lung and colorectal cancer appears lower in women than in men.Smokers exhibit higher rates of coronary artery disease and chronic obstructive pulmonary disease, with similar gender effects observed for diabetes, depression, and anxiety.Future research should investigate the effects of smoking on broader aspects of women's health beyond pregnancy-related outcomes, include sex-stratified analyses, and assess the impacts of emerging tobacco products.