Men smoke significantly more than women worldwide. Roughly four out of five tobacco users on the planet are male, with just under 1 billion men using tobacco compared to 206 million women. In 2024, 32.5% of men globally used tobacco versus 6.6% of women. That gap holds across most countries and most age groups, though the size of it varies dramatically depending on where you look.
The Global Numbers
The World Health Organization’s most recent tobacco trends report puts the scale of the difference in sharp relief. About 1 in 3 men worldwide use tobacco, while fewer than 1 in 15 women do. Both numbers have been falling over the past decade and a half: male tobacco use dropped from 41.4% in 2010 to 32.5% in 2024, and female use fell from 11% to 6.6% over the same period. The total number of female tobacco users shrank from 277 million to 206 million during that stretch.
So while the trend is heading in the right direction for both sexes, the gender gap remains enormous at the global level. Men are roughly five times more likely to use tobacco than women.
The Gap Varies by Region
That 5-to-1 global ratio masks huge regional differences. In parts of Europe, the gap has nearly closed. Countries like Denmark, Iceland, and Andorra now show less than a 5 percentage point difference between male and female adult smoking rates. The WHO projects that across the European Region in 2025, about 30.6% of men and 18.2% of women will use tobacco. That’s still a meaningful difference, but nothing like what you see in South and Southeast Asia, where the male-to-female ratio among adults has historically been 11 to 1.
The Eastern Mediterranean region also shows a wide gap, with adult male smoking rates roughly 8 to 9 times higher than female rates. Cultural norms play a major role in these differences. In many Asian and Middle Eastern societies, tobacco use by women has been socially unacceptable in ways it hasn’t been in Western Europe or North America.
Smoking in the United States
In the U.S., the gender gap exists but is relatively narrow. In 2022, 13.1% of adult men smoked cigarettes compared to 10.1% of adult women, accounting for a total of 28.8 million adult smokers. The Americas as a whole have one of the smallest male-to-female smoking ratios of any world region, largely because tobacco marketing targeted women aggressively throughout the 20th century and smoking became socially normalized for both sexes earlier than in many other parts of the world.
Why More Men Smoke
The reasons men smoke at higher rates are primarily cultural, not biological. In many societies, smoking has been tied to masculinity, social bonding, and professional networking. Research on gender differences in smoking behavior found that men are more compelled to smoke in socially relevant situations, treating cigarettes as tools for building and maintaining relationships. The greatest perceived advantage men reported was the enhancement of interpersonal connections.
Women, by contrast, were more likely to smoke in emotionally relevant situations, using cigarettes to cope with stress, sadness, anger, or depression. In many cultures, family expectations and social norms have historically discouraged women from smoking. Studies of Chinese and Taiwanese American students, for example, found that young women refused cigarettes or quit smoking to fulfill expectations of being dutiful and to avoid conflict at home. These cultural pressures suppressed female smoking rates in much of Asia and the Middle East, creating the wide gaps that still exist today.
Young People Tell a Different Story
Among teenagers, the gender gap shrinks considerably, and in many places it disappears entirely. A large WHO study of 13- to 15-year-olds across 120 survey sites found no significant gender difference in cigarette smoking in more than half of the locations studied. For other tobacco products, more than 70% of sites showed no meaningful difference between boys and girls.
The male-to-female smoking ratios among youth were consistently smaller than among adults in every world region. In Africa, the adult ratio was 7.2 to 1, but among teens it was 2.2 to 1. In Southeast Asia, the adult ratio of 11 to 1 dropped to 4.2 to 1 among young people. In Europe and the Americas, boys and girls smoked at nearly equal rates, with ratios close to 1.2 to 1. Europe’s youth tobacco use rates were particularly close: 11% among boys and 10% among girls.
This pattern suggests that as cultural norms around gender and smoking continue to shift, the global gap could narrow further in coming decades.
E-Cigarettes Follow the Same Pattern
Vaping mirrors the gender pattern of traditional smoking, though the gap is smaller. CDC data from the United States shows that in 2023, 7.6% of men used e-cigarettes compared to 5.5% of women. Both figures had risen since 2019, when rates were 5.5% for men and 3.5% for women. So while e-cigarette use is growing for everyone, men remain more likely to vape.
Health Risks Are Not Equal
Cigarette for cigarette, women may face at least some unique health risks. Early research on smoking and lung cancer was done almost entirely on men, so for decades scientists simply assumed the risks were equivalent. More recent data has suggested that the impact of a given amount of smoking on lung cancer risk might actually be greater among women, though this remains an open question.
What is clear is that women face smoking-related health consequences that men do not: risks related to pregnancy, interactions with hormonal contraceptives, disruptions to menstrual function, and increased cervical cancer risk. In the WHO European Region, the proportion of deaths from chronic diseases attributable to tobacco is almost three times higher for men (27%) than for women (10%), but that reflects the much higher smoking rates among men rather than a difference in biological vulnerability.
Women Have a Harder Time Quitting
When men and women try to quit, men tend to succeed at higher rates. In one tobacco cessation program, 25.2% of men reported quitting compared to just 16.2% of women. Women were roughly 73% less likely to quit than men, and that gap persisted even after researchers accounted for differences in demographics, income, mental health, physical health, and how much participants smoked.
Several factors may explain this. Depression, which is more prevalent among women, can reduce motivation to quit. Women are more likely to use smoking as a coping mechanism for stress, and their social networks sometimes reinforce that pattern. Emotional support from friends and family, which women generally report having more of, can paradoxically normalize smoking as a stress-relief strategy rather than encouraging cessation. The demands of balancing caregiving and employment may also make it harder for women to fully engage with quit programs.
Nicotine itself works the same way in both sexes. When adjusted for the number of cigarettes smoked, blood levels of nicotine’s main byproduct are similar in men and women. The barriers to quitting appear to be behavioral and social rather than chemical.