Last update:
29-Sep-2025

Smoking is one of the leading causes of preventable death worldwide and constitutes a major public health issue with multiple dimensions. Although it is widely known that there are gender differences in smoking, the integration of gender into smoking research remains insufficient. Historical evidence on the spread of smoking in the Western World constitutes the first indication of the differential access to smoking in men and women and explains the later adoption of smoking habits by women. Even today, the prevalence of smoking among men is higher than that among women in almost all countries, with data revealing gender-related differences even from adolescence. The largest gap in smoking prevalence between men and women is found in low, lower-middle and upper-middle income countries. In Europe, and particularly in Greece, although smoking prevalence among men is higher, women smoke at a high rate, as well (Greece 2023: 40% and 32%, respectively). While smoking rates have declined for both men and women globally between 1990 and 2019, the decrease among women in Greece has been minimal (-18.9% in men and -0.6% in women). Pregnancy often changes women's smoking behavior, reshaping the population of female smokers. Educational level is another factor that significantly affects smoking tendencies, providing valuable insights alongside gender. Biological sex and hormonal factors play a role in smoking habits, including addiction, craving, and risk perception. Research indicates that women may face greater challenges in quitting smoking compared to men. In conclusion, ignoring gender in smoking research can mask important differences. Recognizing and further exploring these disparities may be the key to developing more effective strategies of targeted smoking prevention and cessation.

Key words: Prevalence, Sex/gender, Smoking, Trends.