The incidence of coronary heart disease is increasing in women. Some of this may be related to increased smoking in women over the past decades. However, the mechanism mediating the smoking-coronary heart disease link is unclear. We therefore assessed the relationship of smoking habits to fasting plasma insulin, total and low-density lipoprotein (LDL) cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, including its subfractions HDL2 and HDL3, body mass index, and waist:hip circumference ratio in 1048 women aged 25-69 years. Compared with non-smokers, current smokers had higher plasma concentrations of LDL cholesterol by 0.2 mmol/l or 6%, total/HDL cholesterol ratio by 0.5 or 13%, triglyceride by 0.14 mmol/l or 13% and waist:hip ratio by 0.02 or 3%, but lower HDL cholesterol by 0.13 mmol/l or 9% and HDL2 cholesterol by 0.07 mmol/l or 13%, while ex-smokers had higher waist hip ratio by 0.01 or 1% but lower HDL cholesterol by 0.06 mmol/l or 4% and HDL2 cholesterol by 0.09 mmol/l or 16%. Ex-smokers for up to 5 years, compared with non-smokers, had higher plasma concentrations of total/HDL cholesterol ratio by 0.4 mmol/l or 11%, triglyceride by 0.22 mmol/l or 21% and waist hip ratio by 0.01 or 1%, but lower levels of HDL cholesterol by 0.12 mmol/l or 9% and HDL2 cholesterol by 0.14 mmol/l or 26%. Cigarette smoking is associated with adverse changes in lipoprotein levels; these changes decrease slowly after quitting.