Tobacco smoking has serious negative effects on the body. A wide variety of diseases and medical phenomena affect the sexes differently, and the same holds true for the effects of tobacco. Since the proliferation of tobacco, many cultures have viewed smoking as a masculine vice, and as such the majority of research into the specific differences between men and women with regard to the effects of tobacco have only been studied in-depth in recent years.

In 2010 the Hamas-led Islamist government of Gaza imposed a ban on women smoking the popular nargilas in public. A spokesman for the Interior Ministry explained that "It is inappropriate for a woman to sit cross-legged and smoke in public. It harms the image of our people." The ban was soon lifted later that year and women returned to smoking in popular venues like the cafe of Gaza's Crazy Water Park. The park was burned down by masked men in September 2010, after being closed by the Hamas. The Committee for the Propagation of Virtue and the Prevention of Vice (Gaza Strip) has arrested women for smoking in public.

In Edo period or earlier than it, tobacco had come to Japan. Prostitutes (ja:遊女, yūjo) were the main smokers among Japanese women by the early 19th century.

According to the Centers for Disease Control and Prevention, cigarette smoking is the leading cause of preventable death in the United States and produces substantial health-related economic costs to society. During the time between 1995 and 1999, smoking resulted in approximately 440,000 premature deaths per year and about $157 billion in "health-related economic losses". Smoking has been known to increase to the risks of, and has been linked to, a plethora of adverse health effects. For instance, "Cigarette smoking accounts for about one-third of all cancers, including 90 percent of lung cancer cases. [Smoking also] causes lung diseases such as chronic bronchitis and emphysema, [and can] increase the risk of heart disease, including stroke, heart attack, vascular disease, and aneurysm." According to the Surgeon General's Report of 2004, titled "The Health Consequences of Smoking", other consequences of smoking include increased risk of cataracts, lowered levels of antioxidants, especially vitamin C, heightened inflammation, and periodontitis.

In the United States, although general rates of smoking are declining – "24.1% in 1998 to 20.6% in 2008", and there are higher rates among men – the gendered health consequences illustrate that women are at a greater disadvantage. "In 2008, smoking prevalence was higher among men (23%) than women (18.3%)"; however that gender gap appears to be narrowing. Prior to recent increasing smoking rates, women usually experienced different effects of smoking compared to men. For instance, a decrease in lifetime expectancy is greater for female smokers compared to male smokers. On average, while an adult male loses 13.2 years due to smoking, an adult female smoker loses 14.5 years of life. This decreased life expectancy for male smokers mirrors the gender differences in life expectancy overall. However, when it comes to smokers in particular, males tend to smoke more heavily than women do. Yet still women continue to show more deleterious results.

As previously mentioned, smoking is attributable to the majority of lung cancer cases. Over the years lung cancer mortality has dramatically increased among women. "In 1987, lung cancer surpassed breast cancer to become the leading cause of cancer death among U.S. women." Smoking now accounts for 80% of lung cancer deaths among women. Although there has been a more pronounced campaign to raise funds for breast cancer research and a possible cure, more women are dying from lung cancer. Research also continues to question whether women tend to be more susceptible to lung cancer, regardless of similar exposure as their male counterparts. However, making a definitive answer has been difficult, and the issue remains controversial. Chronic obstructive pulmonary disease (COPD) is another major issue among women who smoke. The risk of having COPD is increased with amount and duration and smoking accounts for 90 percent of COPD mortalities.

The effects of smoking on cardiovascular health also shows sex differences. Heart diseases continue to be the leading cause of death nationwide, and one of the risk factors is smoking. Unique to women, smoking lowers their estrogen and their high-density lipoproteins that prevent arteries from blockage. For many women the effects of smoking on the heart's health become obvious later on in life. Among current female smokers, "the chance of dying from heart disease or lung cancer exceeds the chance of dying from breast cancer from 40 on (and does so by at least a factor of 5 after age 55)." The habit becomes particularly crucial when women are also taking birth control because these two in concert increases, even more so, women's chances of having a stroke or a heart attack.

When observing older women, those who smoke in their postmenopausal stages tend to have a lower bone density along with more hip fractures when compared to their non-smoker counterparts. For the younger cohort of women, during their reproductive stages, smoking affects their reproductive health as well as pregnancy outcomes. Research has revealed that smoking makes it more difficult for women to conceive and it can also result in infertility. Women who smoke while they are pregnant increase their chances of having an early delivery and low-birth weight babies. One of the many serious effects on the fetus itself is sudden infant death syndrome (SIDS). Studies have shown that "infants of mothers who smoke during and after pregnancy are 3 to 4 times more likely to die from sudden infant death syndrome (SIDS) than babies to non-smoking mothers". Smoking during pregnancy could also cause stillbirth, preterm birth, placental abruption. It can also cause Premature menopause.