American women who smoke have a dramatically increased risk of death from lung cancer and chronic obstructive pulmonary disease (COPD) than they did 20 years ago.

Compared to women who never smoked, a female smoker's risk of death from lung cancer is almost 26 times higher now. In the 1980s it was about 13 times higher, and in the 1960s a female smoker's risk of death was only three times higher than a female nonsmoker's, according to new research.

This greater risk of death is likely because of women starting smoking earlier, smoking more each day and smoking for longer periods of time, said the study's lead author, Dr. Michael Thun, vice president emeritus at the American Cancer Society.

"It's a massive failure in prevention," said Thun. And it's likely to repeat itself in places like China and Indonesia where smoking is growing, he said. About 1.3 billion people worldwide smoke.

The risk of death for U.S. male smokers has increased less dramatically in recent years, and women and men now have comparable risks of death compared to nonsmokers. Male smokers face a 25 times higher risk of death from lung cancer than nonsmoking males. In the 1980s, that number was 24 times higher and in the 1960s, it was 12 times higher.

The U.S. has more than 35 million smokers — about 20 percent of men and 18 percent of women. The percentage of people who smoke is far lower than it used to be; rates peaked around 1960 in men and two decades later in women.

The research is in Thursday's New England Journal of Medicine. It is one of the most comprehensive looks ever at long-term trends in the effects of smoking and includes the first generation of U.S. women who started early in life and continued for decades, long enough for health effects to show up.

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