Irish women were "passionate" about the availability of breast and cervical screening, but the benefits of these were far less than if they were to give up smoking, the WONCA conference was told.
Addressing a session on women's health, Ms Ruth Barrington, an assistant secretary at the Department of Health, said that the impact on health of giving up smoking was infinitely greater than the benefits of screening. But women did not see the habit in the context of a health issue.
During the consultation process undertaken for the women's health plan, published in 1997, smoking had not been identified as an issue of concern to women.
While smoking prevalence was falling nationally, 28 per cent compared to over 40 per cent in the late 1970s, Ms Barrington said, it was one of the greatest challenges facing the health services.
The health promotion unit of the Department of Health has teamed up with the Irish College of General Practitioners to start a national programme for GPs to help their patients give up smoking. Dr Michael Boland, a Skibbereen GP, who is president-elect of WONCA, said that this was expected to reduce the smoking rate by 5 per cent.
Ms Noreen Byrne, chairwoman of the National Women's Council, said that smoking was a class issue among women. "Women who are poor and attend their GPs have lots of problems and they often view smoking as the only thing they have."
Ms Barrington said the life expectancy for Irish women at birth was one of the lowest in the EU. Cardiovascular disease, as well as breast, lung and other cancers were the main causes of mortality.
Ms Byrne said that women were looking for improvement right across the board, particularly in relation to access to breast and cervical screening.
She said that the power imbalances in the relationships of women to health professionals and to the medical profession generally continued to have a major effect. "The health services are excellent in many technical ways, but overwhelmingly paternalistic. The mystery and elitism that continues to surround medical practice, the distance between policymakers and consumers of health services and the explicit role of all vested-interest groups must be addressed."
To shift these imbalances, the future of women's health care would have to be client-centred, not driven by any single interest or denominational definition, as had occurred in the past in Ireland.