France - Smoking is more prevalent in French women than male counterparts..

December 9, 2010 - The prevalence of smoking and exposure to tobacco smoke among men in France has fallen by more than 15 per cent since the mid 1980s, but over the same 20-year period has increased among women.

As a result, investigators from the World Health Organization French MONICA (MONItoring trends and determinants in CArdiovascular disease) centre say the divergent smoking trends predict changes in death rates from coronary heart disease in French men and women since 1985 - estimated as a decline in men of 10-15 per cent, but an increase among women of 0.1-3.6 per cent.

PAPER: Characteristics of current smokers, former smokers, and second-hand exposure and evolution between 1985 and 2007, Tilloy, Emmanuelle; Cottel, Dominique; Ruidavets, Jean-Bernard; Arveiler, Dominique; Ducimetière, Pierre; Bongard, Vanina; Haas, Bernadette; Ferrières, Jean; Wagner, Aline; Bingham, Annie; Amouyel, Philippe; Dallongeville, Jean, European Journal of Cardiovascular Prevention & Rehabilitation. 17(6):730-736, December 2010.

Aims: The aim of this study was to assess trends in the prevalence of adult smoking habits between 1985–1987 and 2005–2007 in three distinct areas of France and their contribution to coronary heart disease (CHD) death rates.

Methods: Participants were recruited as part of the French Monitoring trends and determinants in Cardiovascular disease survey in 1985–1987 (n=3760), 1995–1997 (n=3347), and 2005–2007 (n=3573). They were randomly selected from electoral rolls after stratification for sex, 10-year age group (35–64 years), and town size. Smoking habits were analyzed by questioning the participants about earlier or current consumption, the number of cigarettes smoked per day, age at first cigarette, pipe tobacco and cigarillo consumption, quit attempts, age at quitting, and second-hand exposure. Predicted CHD death rates as a function of smoking were predicted with the SCORE risk equation.

Results: In men, a significant decrease in tobacco exposure (from 40 to 24.3%) between 1985–1987 and 2005–2007 was observed. In women, the prevalence of current smokers increased from 18.9 to 20% and that of former smokers rose from 8.7 to 25.5%. In both men and women, average daily cigarette consumption and second-hand exposure to smoke fell between 1995–1997 and 2005–2007. Predicted CHD death rates as a function of smoking trends decreased in men (range 10–15%) but increased in women (range 0.1–3.6%).

Conclusion: This study found divergent trends in the prevalence of smoking in men and women aged between 35 and 64 years over the period of 1985 to 2007. These changes may have contributed to the decline in CHD death in men but not in women.

Commenting on the results of the study investigator Dr Jean Dallongeville from the INSERM Institut Pasteur in Lille, France, said: "Men have reduced their exposure to tobacco from 40 to 24.3 per cent, representing a predicted fall in deaths from coronary heart disease. By contrast, women have increased their exposure resulting in a rise in the predicted heart disease death estimate. These results, he said, may partly explain the decline in coronary heart disease mortality in men over the study period, but not seen in women, but he acknowledged the effect of other factors on trends in heart disease mortality.

CVD (cardiovascular disease) is the main cause of death in women in all countries of Europe and is the main cause of death in men in all countries except France, the Netherlands and Spain. (Cardiovascular disease in Europe, European Journal of Cardiovascular Prevention & Rehabilitation: August 2009)

Reference: Smoking is more prevalent in French women than male counterparts, Source: World Health Organization, The Medical News, 12/8/2010.

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