Smoking cigarettes is dramatically worse for women’s hearts than it is for men’s, a new study reports. The research, presented at European Society of Cardiology, found that women smokers suffer from heart attacks on average about 14 years earlier than female non-smokers, while male smokers have heart attacks only about 6 years earlier than their non-smoking counterparts.

The researchers questioned 1784 patients admitted to a hospital in Lillehammer for experiencing a first heart attack. They found that men who smoked had their first heart attack at age 64, but for those who didn’t smoke, the average age was 72. For women, smokers experienced a first heart attack at age 66, whereas female non-smokers experienced a first heart attack at 81.

When the results were adjusted for other health factors that contribute to heart disease like cholesterol, blood pressure, and diabetes, the average difference for male smokers and non-smokers to have their first heart attack was 6 years, but for women it was markedly increased, to 14 years. Though women typically experience heart problems with less frequency and at an older age than men, this study draws attention to the ill effects of smoking, particularly for women.

The researchers underline that women’s natural protection from heart disease appears to be completely counteracted by smoking. It is thought that the female hormones like estrogen may be responsible for women’s natural heart health, perhaps by relaxing blood vessel walls and making blockage less likely to occur.

Head researcher of the study, Morten Grundtvig, suspects that female smokers may go through menopause earlier and, lacking the normal combination of female hormones sooner, may be left unprotected against heart attack. Grundtvig also points out that while smoking rates are dropping in men, they are rising in women – he speculates that the medical community may see increased heart problems in women in the future.

The study was conducted at the Innlandet Hospital Trust in Lillehammer, Norway.