Of all lifestyle behaviours, smoking caused the most deaths in the last century. Because of the time lag between the act of smoking and dying from smoking, and because males generally take up smoking before females do, male and female smoking epidemiology often follows a typical double wave pattern dubbed the ‘smoking epidemic’. Our research aimed to answer the questions: How are male and female deaths from this epidemic differentially progressing in high-income regions on a cohort-by-age basis? and How have they affected male-female survival differences?