In women, smoking is particularly harmful to the cardiovascular (CV) system, and smoking cessation (SC) is a key issue for CV prevention. From a large nationwide database on subjects who visited SC services between 2001 and 2018, we aimed to describe the profile and abstinence rate among female smokers at high CV risk. Observational study from the French CS services cohort CDT-net. Inclusion criteria were age ≥ 18 years, and ≥ 1 CV risk factor (i.e. body mass index ≥ 25 kg/m 2 , hypercholesterolemia, diabetes, hypertension, history of stroke, myocardial infarction or angina pectoris. Abstinence (≥ 28 consecutive days) was self-reported, and confirmed by measurement of exhaled carbon monoxide < 10 ppm. Among 37,949 smokers, 16,492 (43.5%) were women. Compared to men, women were 3-y younger (48 vs. 51 y, P < 0.001) and more educated (≥ Bachelor degree: 55 vs. 45%, P < 0.001). The burden of CV risk factors was high in women and men: hypercholesterolemia (30% vs. 33% P < 0.001), hypertension (23% vs. 26%, P < 0.001) and diabetes (10 vs. 13%, P < 0.001). Compared to men, women suffered more often from obesity (27 vs. 20%, P < 0.001), respiratory diseases (COPD: 24% vs. 21%, P < 0.001; asthma: 16 vs. 9%, P < 0.001) and anxio-depressive symptoms (37.5 vs. 26.5%, P < 0.001). Although women were less nicotine dependent than men, their abstinence rate was lower (52 vs. 55%, P < 0.001). Female smokers who visited SC services not only presented very high CV risk profile, but also elevated rates of lung diseases and anxio-depressive symptoms. Our findings highlight the need to strengthen CV prevention strategies, through comprehensive gender-tailored SC interventions.