Background:
Every woman will experience menopause at middle age, but those who smoke will have it much sooner. Previous studies have also shown that smoking can modify the health outcomes of menopausal women.

Objective:
We investigated whether smoking is associated with earlier age at menopause and adverse health outcomes among menopausal women in the district of Vlora, Albania.

Methods:
A cross-sectional study was conducted with a randomly selected sample among 350 women aged 30–60 years who visited primary health center No.4 in the city of Vlora for non/gynecological reasons, during the period April–September 2021. The severity of menopausal symptoms was measured using the menopause rating scale (MRS). The WHO STEPS Instrument was used to assess the risk profile of menopausal women. Regarding ‘smoking status’, ‘smokers’ were defined as those who currently smoked or ‘past smokers’, and ‘non-smokers’ as those who never smoked. We used the statistical program SPSS, version 20.0 for data analysis.

Results:
The mean age of menopause was 48.3±3.98 years, with 3.1% of the women experienced premature menopause and 8.3% early menopause; 39% of participants are smokers. Smoking was significantly associated with early menopausal age (OR=2.35, p<0.05), vasomotor symptoms (p<0.001), and elevated blood pressure (p=0.041).

Conclusions:
Smoking affects early menopause and worsens health outcomes of participants. Increased awareness on adverse effects of smoking in the menopausal population should be a priority of public health in the district of Vlora.