Data from the World Health Organization’s “Health for All” database show that in all European countries (excluding Sweden) the prevalence of smoking is higher in men than it is in women. The difference in the prevalence of smoking between men and women is more marked in Eastern Europe than in Western Europe. For example, in Uzbekistan 24% of men smoke compared to only 1% of women, and in the Ukraine 62% of men smoke compared to only 17% of women.

The prevalence of smoking in men is generally higher in Eastern and former Soviet countries – of the six European countries where more than half of men smoke, five were part of the Soviet Union; the sixth is Albania. In contrast, the male smoking rate in Western and Northern Europe is in general less than 35%, with the exception of Germany (37%) and the Netherlands (35%). This pattern is reversed for women, where smoking rates are very low in former Soviet states (6% in Georgia, 2% in Kyrgyzstan, 1% in Uzbekistan), low in Eastern and Central European countries but higher in Western and Northern European countries.

Data from the Health Behaviour in School-aged Children survey on smoking among 15 year olds suggest that the traditional gender smoking patterns may be beginning to change. In more than half of the countries included in the survey in 2001/02, a greater proportion of 15 year old girls smoked than did boys. This was particularly the case for Western European countries (e.g. Portugal, 18% boys smoked at least once a week vs. 26% of girls). Smoking is more prevalent among 15 year old boys in Eastern European and former Soviet countries, but the gap between the sexes is less marked than is seen for adults (e.g. Russian Federation, 27% boys vs. 19% girls).