Tobacco smoke adverse effects comparison based on gender: Meta-analysis

Abstract

Several studies have suggested varying degrees of vulnerability to the detrimental effects of tobacco smoking between females and males. However, conflicting findings on sex-specific differences in the negative impact of tobacco smoking have emerged. This study conducts a comprehensive review of the available evidence to assess the adverse effects of smoking with respect to gender. From an initial pool of 99 primary studies conducted before 2010, 26 studies were selected for inclusion in this meta-analysis. Among these, 15 were cohort studies, 4 were cross-sectional studies, 4 were case-control studies, and 2 were systematic reviews. Fixed-effect models and meta-regression were employed to derive pooled risk ratios (RR), and P-value functions were utilized to assess the consistency of the results. The pooled risk ratio for men who were current smokers, concerning all-cause mortality, was 0.954 (95% CI 0.866-1.05). For women who were current smokers, the pooled risk ratio for cardiovascular disorders was 1.2 (95% CI 1.18-1.22). Notably, female current smokers exhibited a significantly more rapid annual decline in FEV% predicted with increasing age compared to their male counterparts (as indicated by linear regression analysis: R2 = 0.56; p = 0.008). However, the relative risk for bone-related disorders was found to be higher in male current smokers than in their female counterparts. The findings of this study underscore that both males and females face an elevated risk of experiencing the adverse effects of smoking. Nonetheless, the magnitude of these effects differs based on gender. Further research is warranted to validate the outcomes of this study.