The mechanism that causes hot flashes is unclear, although they have been linked to declining estrogen levels. Many women have found that they can deal with them nonmedically. By observing the conditions surrounding you at the time of a hot flash, you may be able to exert some control. You may wish to keep a record of the time and severity of a hot flash to see whether there is a pattern. Dressing (and undressing) in layers can help you tolerate overheated offices and meeting rooms: at least one study has confirmed that the frequency and intensity of hot flashes decline dramatically when women are in a cool environment. Recent research suggests that exercise and healthy eating habits may be just as effective in reducing hot flashes as estrogen and hormone replacement therapy. Smoking also plays a role; it has been shown to reduce estrogen levels, so quitting may help decrease the incidence of hot flashes along with decreasing the incidence of cancer, heart disease, and stroke.