Femmes et tabagisme: spécificités épidémiologiques et cliniques [Women and tobacco: epidemiological and clinical specificities]

Cigarette smoking amongst women is a major issue in daily clinical practice and in public health. Tobacco is the cause of gender specific diseases. From a psychosocial point of view, female smokers tend to be emotionally vulnerable and relationship sensitive. The risk of weight gain and depression must be anticipated and assessed throughout the smoking cessation process. Professionals involved in smoking cessation must be aware of these somatic and psychosocial specificities in order to be able to offer efficient smoking cessation treatments. Public health strategies must also be developed worldwide to control the expected dramatic impact of the female tobacco epidemic.

Impact de la prophylaxie hormonale sur les fractures du fémur proximal des femmes postménopausiques: une étude de simulation. [Impact of hormonal prevention on fractures of the proximal femur in postmenopausal women: a simulation study].

A simulation model of the effects of hormone replacement therapy (HRT) on hip fractures and their consequences is based on a population of 100,000 post-menopausal women. This cohort is confronted with literature derived probabilities of cancers (endometrium or breast, which are contra-indications to HRT), hip fracture, disability requiring nursing home or home care, and death. Administration of HRT for life prevents 55,5% of hip fractures, 22,6% of years with home care and 4,4% of years in nursing homes. If HRT is administered for 15 years, these results are 15,5%, 10% and 2,2%, respectively. A slight gain in life expectancy is observed for both durations of HRT. The net financial loss in the simulated population is 222 million Swiss Francs (cost/benefit ratio 1.25) for lifelong administration of HRT, and 153 million Swiss Francs (cost/benefit ratio 1.42) if HRT is administered during 15 years.