A new study shows that women are nearly 50% more likely than men to develop chronic lung disease—even if they’ve never smoked. The research, published in BMJ Open Respiratory Research, questions long-held beliefs about the link between smoking and chronic obstructive pulmonary disease (COPD).
What Is COPD?
COPD is a group of lung conditions—including emphysema and chronic bronchitis—that cause breathing problems. Smoking is a major cause, but it’s not the only one.
Despite sharp declines in smoking over the past 50 years, COPD remains one of the top causes of death in the United States. The new research reveals that women are catching up to men in terms of COPD cases—even though they smoke less.
Study Details: Who Was Involved?
Researchers analyzed data from the 2020 National Health Interview Survey. They focused on 23,000 adults aged 40 and older—12,638 women and 10,390 men.
Participants were asked about:
- Cigarette, cigar, and pipe smoking
- Smokeless tobacco use
- E-cigarette (vaping) use
- Whether they had ever been diagnosed with COPD
Key Findings
COPD prevalence: 8% in women vs. 6.5% in men
Never smoked but diagnosed: 26.5% of women with COPD had never smoked vs. 14% of men
E-cigarette use: Similar in both genders
Cigarette habits: Women smoked fewer cigarettes daily (18 vs. 22 for men) and were less likely to start before age 15
Even among non-smokers, women had nearly double the COPD rate of men (3% vs. 1.5%).
After adjusting for other factors, women had a 47% higher chance of having COPD overall. This included:
- 62% higher risk among those who had never smoked
- 43% higher risk among those who had ever smoked
Why This Matters
Traditionally, experts believed that women’s increased COPD risk was due to higher sensitivity to cigarette smoke. But this study shows that the difference remains even when comparing men and women with similar smoking histories.
“If women were truly more sensitive to smoke, we would expect to see a stronger link between smoking intensity and disease—but we don’t,” the researchers explained.
Limitations of the Study
The study relied on self-reported data. Researchers did not have access to:
- Hormonal information
- Family medical history
- Environmental or workplace exposures
Still, the results raise important questions about how COPD develops, especially in women.
What’s Next?
The researchers call for:
- Better understanding of non-smoking-related causes of COPD
- More focus on diagnosing and treating women with COPD
- Public health strategies that consider gender differences
Takeaway:
Women face a higher risk of developing COPD—even without a history of smoking. The reasons remain unclear, but the findings suggest that other biological or environmental factors may be at play. Understanding these differences is key to better prevention and treatment for all.
