According to Women and Smoking: A Report of the Surgeon General, women now account for 39 percent of all smoking-related deaths each year in the United States, a proportion that has more than doubled since 1965.

Since 1980, nearly three million U.S. women have died prematurely from smoking.

The study found that increased marketing by tobacco companies has hindered progress in cutting smoking by women. Recent increases in smoking among teenage girls also threatens to overwhelm any progress that has been made in the last few decades.

"In the early decades, smoking prevalence was more prominent among men, and it took nearly 25 years before the gap narrowed and smoking became commonplace among women," Dr. Satcher said. "Women not only share the same health risk as men, but are also faced with health consequences that are unique to women, including pregnancy complications, problems with menstrual function, and cervical cancer."

The report examined patterns of tobacco use among women, factors associated with starting and continuing to smoke, the health consequences of smoking, tobacco marketing targeted at women, and cessation and prevention interventions.

"Smoking is a critical women's health issue that must be addressed on all fronts," said HHS Secretary Tommy G. Thompson. "We must begin this battle in schools before girls even begin to smoke, and we must share with teenage girls that smoking is not only harmful, but it is not glamorous. Society must not glorify smoking."

"In addition, we must provide information to women and minority groups detailing the harmful affects of smoking as well as the benefits of smoking cessation," he said. "The facts are clear: smoking significantly reduces life expectancy and hampers quality of life."

The report concluded that the increased likelihood of lung cancer, cardiovascular disease, and reproductive-health problems among female smokers makes tobacco use a serious women's-health issue.

The report recommended stronger national and local efforts, particularly from women's groups, to push for the implementation of proven solutions to reduce and prevent tobacco use among women and girls.

In particular, the report calls for:

• increasing public awareness of the devastating impact of smoking on women's health
• exposing and countering the tobacco industry's targeting of women
• encouraging public-health policymakers, educators, medical professionals, and women's organizations to work for policies and programs that deglamorize and discourage tobacco use
• reducing disparities related to tobacco use and its health effects among different ethnic/racial populations
• decreasing nonsmokers' exposure to environmental tobacco smoke
• implementing comprehensive statewide tobacco-control programs proven to be effective in reducing and preventing tobacco use.