A large European epidemiological study has found that the harmful effects of tobacco smoke on atherosclerosis, one of the driving forces of cardiovascular disease, are greater in women than in men. In the improve study, authors examined 1694 men and 1893 women from Finland, Sweden, Netherlands, France and Italy, and used ultrasound technology to assess the presence of wall thickening and plaques in the carotids, the arteries that bring blood to the brain. The research shows that the amount tobacco exposure during the entire life significantly correlates with the thickness of carotid arterial walls (an index of atherosclerosis) in both genders. However, the impact is more than doubled in women than in men. Similarly, the effect of the number of cigarettes smoked per day on the progression of the disease over time is more than five-fold in women than in men. These associations are independent from other factors that may affect atherosclerosis, such as age, blood pressure, cholesterol level, obesity and social class. “This is a particular relevant finding, especially in view of the fact that educational campaigns carried out in the last years have been less successful in reducing the number of smokers in women than in men,” said Elena Tremoli, Professor of Pharmacology at the University of Milan, Italy, and scientific director of the Monzino Cardiology Centre in Milan who led the study.