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13th March 2019

Smoking and Women’s Health

On No Smoking Day 2019, Consultant Gynaecologist Narendra Pisal looks at the effect of smoking on women’s health, outlining overall risk levels for gynaecological cancer and the problems associated with smoking during pregnancy and the menopause.

What is the link between smoking and gynaecological cancers?

There is a strong link between smoking and cervical, vaginal as well as vulval cancers. These cancers are caused by Human Papilloma Virus (HPV) infection and smoking is known to affect immune response to HPV. As a result, smokers are less likely to shake off this infection.

Smoking paralyses ‘cells of Langerhans’ which are responsible for carrying the ‘HPV antigen’ to the immune system which then leads to ‘antibody’ formation. As these cells are paralysed, smokers are not able to mount an immune response to Human Papilloma Virus and are more likely to have persistent infection and hence higher risk of cancer.

Some types of ovarian cancers are also more common in smokers (e.g. Mucinous ovarian cancers). The exact mechanism of how this risk increases is not known.

How much more are you likely to develop these cancers if you smoke?

According to IARC (International Agency for Research on Cancer), 21% of cervical cancer cases in the UK are caused by smoking. Risk of developing the commonest type of cervical cancer (Squamous Cell Carcinoma) is 46% higher in current smokers when compared with women who have never smoked.

Will your risk decrease after stopping smoking?

Cervical cancer is not associated with past smoking, so stopping smoking is known to reduce the risk of developing cancer. This is because the effect of tobacco on the immune system is reversed after quitting smoking.

What are the dangers of smoking while pregnant?

Smoking when pregnant is associated with increase in the risk of miscarriage, ectopic pregnancy, small baby (growth restriction), still birth, premature labour and abrution of the placenta. Smoking can also affect the newborn child by increasing risk of asthma, chest infection, cot death and poor performance at school. All in all, it is best to quit smoking as soon as possible when you are planning a pregnancy. Stopping smoking will reverse all the above risks.

Can smoking affect menopause symptoms?

It is known that smoking can affect ovarian reserve and function and can lead to early menopause. Smokers are also likely to have lower oestrogen levels. Smokers also have more menopausal symptoms such as hot flushes and poor quality of sleep. Women who smoke often don’t know that they are prone to earlier menopause and more severe menopausal symptoms. It is important to get this message out so that women have another incentive to give up smoking.

If you’re looking to quit smoking, NHS Smokefree can help. If you have any questions or concerns, feel free to contact us on 0207 10 11 700.

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