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However, as smoking prevalence and intensity were higher in men compared with women in most studies included in this analysis, there may yet be an unrealised sex difference in the risk of smoking-related lung cancer that will only become fully manifest as the smoking epidemic reaches full maturity in women.2 The sevenfold higher RRs of lung cancer associated with smoking found in the present meta-analysis are considerably smaller than the 20-fold increased risks reported in the Million Womens Study 13 and the British Doctors Study.14 Both of these studies had the advantage of capturing smoking-related risks in populations that had smoked for long enough for the effects to become fully manifest, highlighting the importance of taking into consideration the stage of the tobacco epidemic in each sex

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