In a recent research it has been found that in Europe smoking accounts for up to 60 percent of the gender gap in death rates. The reasons why women have been outliving men in developed European countries since the mid to late 18th century, in some cases, have been hotly contested. Smoking kills twice as many men as alcohol.
The gender gap in death rates is due to the fact that women seek out health care more readily than men.
But the magnitude and variability of the trends suggests a rather more complex picture, say the authors, who set out to explore this discrepancy in more detail.
They used World Health Organization figures on death rates among men and women from all causes as well as those attributable to smoking and drinking in 30 European countries for the years closest to 2005.
Smoking related deaths included respiratory tract cancers, coronary artery disease, stroke and chronic obstructive pulmonary disease. Those related to alcohol-included cancers of the throat and gullet and chronic liver disease as well as alcoholic psychosis and violence.
The proportion of the discrepancy in death rates for men and women attributable to smoking and alcohol was then calculated for all countries by dividing the gender gap for each cause by the gender gap for all causes.
Deaths from all causes were higher for men than for women, the figures showed, but the excess in male deaths varied considerably across the countries studied, ranging from 188 per 100,000 of the population a year in Iceland to 942 per 100,000 in Ukraine.
But despite large gender differences in alcohol consumption across Europe and the huge variation in alcohol related deaths, these were significantly lower than deaths caused by smoking.
There was a fivefold difference between countries with the lowest male death rates (Iceland at 97 per 100,000) attributable to smoking and those with the highest (Ukraine at 495 per 100,000).
But smoking was behind 40pc to 60pc of the gender gap in all countries, except Denmark, Portugal and France, where it was lower, and Malta where it was much higher (74pc).
The study has been published online in Tobacco Control.