Background

Smoking is the main modifiable risk factor for stroke and myocardial infarction, particularly in women; its prevalence in France is evolving, and new patterns of nicotine consumption have emerged.

Aims

To present contemporary data on smoking prevalence and the use of electronic cigarettes, and to describe current knowledge of the cardiovascular risk specificities and the effectiveness of withdrawal methods in women.

Method

We identified studies by searching the MEDLINE bibliographic database between 1995 and 2020, and the Weekly Epidemiological Bulletin (Bulletin Épidémiologique Hebdomadaire) published by the French health authorities.

Result

In recent years, smoking prevalence among French women has decreased overall, except in the oldest age group (aged > 55 years). At the same time, the incidence of hospitalization for cardiovascular events has increased worryingly among women smokers aged < 65 years. Active smoking in women is associated with an increased risk of premature myocardial infarction, and a risk of stroke that increases with the number of cigarettes consumed per day; it is also responsible for increased cardiovascular events in women taking oestrogen-progestin contraception. Quitting smoking reverses these effects in the long term, and women are just as likely to quit smoking as men.

Conclusions

Stopping smoking must be a priority objective for women smokers, for primary and secondary prevention, and they should systematically be offered a validated method of cessation or even electronic cigarettes.

中文翻译：

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女性烟草相关心血管风险：新问题和治疗观点

 背景

吸烟是中风和心肌梗塞的主要可改变危险因素，尤其是女性；它在法国的流行程度正在演变，新的尼古丁消费模式已经出现。

 目标

提供有关吸烟率和电子烟使用的当代数据，并描述当前对女性心血管风险特异性和戒烟方法有效性的了解。

 方法

我们通过搜索 1995 年至 2020 年间的 MEDLINE 书目数据库以及法国卫生当局出版的每周流行病学公报 (Bulletin Épidémiologique Hebdomadaire) 来确定研究。

 结果

近年来，除最高年龄组（年龄 > 55 岁）外，法国女性吸烟率总体下降。与此同时，年龄<65岁的女性吸烟者因心血管事件住院的发生率令人担忧地增加。女性主动吸烟会增加早发心肌梗塞的风险，并且中风的风险会随着每天吸烟数量的增加而增加；它还导致服用雌孕激素避孕药的女性心血管事件增加。从长远来看，戒烟可以逆转这些影响，女性戒烟的可能性与男性一样。

 结论

戒烟必须是女性吸烟者的首要目标，用于一级和二级预防，并且应该系统地向她们提供有效的戒烟方法，甚至电子烟。