A new study published in BMJ Open Respiratory Research reveals that women are about 50% more likely than men to develop chronic obstructive pulmonary disease (COPD), even if they have never smoked or smoked far less than men. This challenges the long-held belief that women’s greater vulnerability to cigarette smoke is the main reason for this disparity.
COPD is a group of lung diseases that includes emphysema and chronic bronchitis. It leads to breathing difficulties and worsens over time.
Although smoking is considered the main cause of COPD, the study shows that even with a significant drop in smoking rates over the past 50 years, COPD remains a major cause of death in the United States. Researchers noted that COPD prevalence in women is now close to that of men, despite women generally smoking less.
The researchers pointed out that women with COPD tend to experience more severe symptoms at a younger age compared to men. This observation has led to suggestions that women might have a greater biological sensitivity to the harmful effects of cigarette smoke. However, this new study questions that assumption and suggests there may be other factors at play.
To understand the connection between gender, smoking habits, and COPD, researchers analyzed data from the 2020 National Health Interview Survey (NHIS), which included 12,638 women and 10,390 men aged 40 and above. The survey asked participants about their smoking history, use of tobacco products, and vaping habits.
The data revealed that women had lower rates of cigarette, cigar, and pipe smoking compared to men. They also reported less use of smokeless tobacco but had similar rates of vaping. Despite smoking less, the prevalence of COPD was higher in women than men—just under 8% for women compared to 6.5% for men.
One surprising finding was that many women with COPD had never smoked cigarettes—26.5% of women with COPD had never smoked, compared to just over 14% of men with COPD. This suggests that factors other than smoking could be contributing to women’s higher risk.
Women with COPD also smoked fewer cigarettes daily, around 18 compared to men’s 22, and for fewer years. Additionally, fewer women started smoking before the age of 15—only 19% compared to 28% of men.
Yet, despite these differences, women who had ever smoked were still more likely to develop COPD than men who had smoked—16% versus 11.5%. Among non-smokers, the gap was even wider: just over 3% of women who never smoked had COPD, compared to just over 1.5% of men.
Further analysis showed that being female was linked to a 47% higher risk of being diagnosed with COPD after accounting for other factors. This difference held true regardless of smoking history. Women who had never smoked were 62% more likely to be diagnosed with COPD compared to men, while female smokers were 43% more likely to develop the disease.
The researchers acknowledged that their findings were based on self-reported data, which can sometimes be inaccurate. They also noted that the study did not include important information on other risk factors, such as hormonal differences, family history, or environmental exposures that could affect lung health. However, they still believe the findings are significant.
The study challenges the idea that women’s increased COPD risk is solely due to being more vulnerable to cigarette smoke.
The researchers explained that if women were truly more susceptible to smoking’s effects, the rates of COPD would not be nearly the same between men and women who smoked the same amount. Additionally, women’s higher COPD rates among non-smokers suggest that other factors might be at work.
The study’s authors concluded that their findings shed new light on COPD rates in women, especially those who have never smoked. They emphasized the importance of better understanding these risks to improve prevention, diagnosis, and treatment for women.
They called for further research to explore why women are more likely to develop COPD, even when their smoking history is less than that of men.
The study highlights the need to look beyond smoking as the only risk factor for COPD in women. Environmental exposures, genetic factors, or even biological differences might play a larger role than previously thought.
This insight could lead to more effective strategies for preventing and managing COPD in women, potentially reducing the high burden of the disease in the future.
If you care about lung health, please read studies about marijuana’s effects on lung health, and why some non-smokers get lung disease and some heavy smokers do not.
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The research findings can be found in BMJ Open Respiratory Research.
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