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In the WHO European Region, smoking levels among women vary significantly, but countries tend to fall into three distinct groups.

• In the Nordic and some western European countries, smoking rates for women and men are similar and are declining. For example, the proportions of male and female smokers are 30% and 30% in Norway, 34% and 28% in Ireland and 33% and 28% in the Netherlands, respectively.
• In many countries in central and southern Europe, more men than women smoke, though rates among women are also high (63% of men vs 39% of women in Greece; 47% vs 41% in Austria and 49% vs 38% in Bulgaria).
• Finally, in the newly independent states (NIS) of the former USSR, smoking rates are high among men and relatively low among women (61% vs 3% in Armenia; 53% vs 24% in Latvia and 43% vs 9% in Kazakhstan). Nevertheless, smoking among women is rising rapidly in some of these countries.

Across the Region, the gender divide in smoking rates is narrower among young people. According to the Global Youth Tobacco Survey (GYTS) conducted from 1999 to 2009, 21% of boys and 17% of girls had smoked cigarettes in the previous 30 days.

The tobacco industry has adapted its marketing techniques to take advantage of the differences between countries, and focused its efforts on girls. It has taken gender roles and norms into account for almost a century, but more recent events, such as the dissolution of the USSR, have provided manufacturers with new marketing opportunities. In the Russian Federation, for example, cigarette consumption increased rapidly between 1992 and 2003, with smoking rates among women more than doubling.