1
|
Medvescek K, Allen AM. Feasibility of Remotely Assessing Hormonal Contraceptive Use and Smoking-Related Symptomatology: Evidence from a Preliminary Prospective Cohort Study. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 7:100145. [PMID: 37009029 PMCID: PMC10060171 DOI: 10.1016/j.dadr.2023.100145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023]
Abstract
Background Half of women who smoke cigarettes also use hormonal contraceptives (HCs). Prior research suggests that variations in ovarian hormones may undermine smoking cessation efforts made by premenopausal women. However, clinical findings of these hormonal effects are inconsistent, potentially due to methodological limitations. The goal of this preliminary prospective cohort study is to determine the feasibility and acceptability of a fully remote protocol to longitudinally examine changes in smoking-related behavior and symptoms in relation to hormone use in women of reproductive age. Methods Eligible participants (n = 60) were biologically female, current age 18-35 years old, smokes ≥ 5 cigarettes/day, and classified into three groups: naturally-cycling (NC; n = 17), using a monophasic oral contraceptive (OC; n = 21), or using depot medroxyprogesterone acetate (DMPA; n = 22). Participants completed daily surveys and weekly dried blood spot collections. Results Overall, 92% (55/60) participants completed the study with 90% of daily surveys completed and 87% of participants collecting at least 5 of the 6 dried blood spot samples. Participants were "somewhat" (13%) or "extremely" (87%) likely to participate in the study again. Preliminary observations also suggested differences in self-reported cigarettes/day and premenstrual pain over time by study group. Conclusions This study outlines a fully remote protocol that may be used to clarify the relationships between hormonal contraceptive use and smoking-related outcomes over time. Preliminary results add to existing evidence that HC use may reduce relapse risk for premenopausal women.
Collapse
|
2
|
Polak K, Nora P, Perry B, Martin C, Dillon P, Thacker L, Nance S, Kornstein S, Svikis D. Licit Substance Use and Premenstrual Syndrome Symptom Severity in Female College Students. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:443-449. [PMID: 35651989 PMCID: PMC9148642 DOI: 10.1089/whr.2021.0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Premenstrual syndrome (PMS) affects the majority of women and is characterized by physical, behavioral, and mood symptoms, which can have a profound impact on quality of life. PMS symptoms have also been linked to licit substance use. This study examined the relationships between daily/problem use (DPU) of caffeine (Caf+), alcohol (Alc+), and tobacco (Cig+) and PMS symptomology in a sample of college women. METHODS Participants (N = 196) completed an anonymous one-time health survey. Demographic, PMS symptomatology, and DPU of licit substance variables were examined. Independent t-tests compared PMS symptom scores in women with and without Caf+, Cig+, and Alc+ use. One-way analysis of variances examined the associations between PMS symptom severity and number of DPU-positive substances. RESULTS PMS subscale severity (pain [F(2,190) = 4.47, p = 0.013], affective [F(2,192) = 8.21, p < 0.001], and water retention [F(2,191) = 13.37, p < 0.001]) and total PMS symptom severity [F(2,189) = 10.22, p < 0.001] showed a dose response effect, with the number of licit substances with DPU significantly associated with PMS symptom severity. CONCLUSIONS This study findings provide important new information about the relationship between PMS symptoms and at-risk substance use. These are cross-sectional data, however, and affirm a need for longitudinal research to better understand the associations, with a focus on potential benefits of education and intervention.
Collapse
Affiliation(s)
- Kathryn Polak
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Pamela Nora
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Caitlin Martin
- Department of Obstetrics and Gynecology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Pam Dillon
- Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Leroy Thacker
- School of Nursing, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sarah Nance
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Susan Kornstein
- Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Dace Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
- Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
3
|
Sakai H, Ohashi K. Effects of past environmental tobacco smoke exposure on the menstrual cycle and menstrual phase-related symptoms: A cross-sectional study. J Obstet Gynaecol Res 2020; 47:243-253. [PMID: 33103300 DOI: 10.1111/jog.14496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 08/12/2020] [Accepted: 09/02/2020] [Indexed: 11/30/2022]
Abstract
AIM This study examined the effects of current and past environmental tobacco smoke exposure on the menstrual cycle and menstrual phase-related symptoms in nonsmoking Japanese women of child-bearing age. METHODS Of 5000 women who agreed to participate, 3935 were analyzed (932 smokers, 2326 nonsmokers, and 677 past smokers). Nonsmokers were divided into three groups based on smoking status and environmental tobacco smoke exposure: nonsmokers without exposure (n = 352), nonsmokers with past exposure (n = 1196) and nonsmokers with current exposure (n = 778). Participants completed a questionnaire on background characteristics, environmental tobacco smoke exposure (location and relationship to smokers), abnormal menstrual cycle, days of menstrual cycle and menstrual cycle-related symptoms experienced in the past 3 months (assessed by the Menstrual Distress Questionnaire). RESULTS Mean age was 29.7 ± 7.0 (20-44) years. Compared with nonsmokers without environmental tobacco smoke exposure, current smokers had the highest risk of an abnormal menstrual cycle (adjusted odds ratio [OR], 1.74 [1.194-2.545]), followed by nonsmokers with past exposure (adjusted OR, 1.70 [1.171-2.464]), past smokers (adjusted OR, 1.60 [1.081-2.366]) and nonsmokers with current environmental tobacco smoke exposure (adjusted OR, 1.49 [0.901-1.212]). Irrespective of environmental tobacco smoke exposure, current smokers reported significantly more severe premenstrual and menstrual symptoms than nonsmokers, and nonsmokers with past environmental tobacco smoke exposure had significantly more severe premenstrual and menstrual symptoms than nonsmokers without environmental tobacco smoke exposure. CONCLUSION Past environmental tobacco smoke exposure, especially during childhood or adolescence, might harm women's reproductive health when they reach reproductive age.
Collapse
Affiliation(s)
- Hiroko Sakai
- Kansai Medical University Faculty of Nursing Graduate School of Nursing, Hirakata, Japan
| | - Kazutomo Ohashi
- Otemae University Faculty of Global Nursing, Nishinomiya, Japan
| |
Collapse
|
4
|
Warthen KG, Boyse-Peacor A, Jones KG, Sanford B, Love TM, Mickey BJ. Sex differences in the human reward system: convergent behavioral, autonomic and neural evidence. Soc Cogn Affect Neurosci 2020; 15:789-801. [PMID: 32734300 PMCID: PMC7511890 DOI: 10.1093/scan/nsaa104] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/23/2020] [Accepted: 07/11/2020] [Indexed: 11/16/2022] Open
Abstract
Several studies have suggested that females and males differ in reward behaviors and their underlying neural circuitry. Whether human sex differences extend across neural and behavioral levels for both rewards and punishments remains unclear. We studied a community sample of 221 young women and men who performed a monetary incentive task known to engage the mesoaccumbal pathway and salience network. Both stimulus salience (behavioral relevance) and valence (win vs loss) varied during the task. In response to high- vs low-salience stimuli presented during the monetary incentive task, men showed greater subjective arousal ratings, behavioral accuracy and skin conductance responses (P < 0.006, Hedges' effect size g = 0.38 to 0.46). In a subsample studied with functional magnetic resonance imaging (n = 44), men exhibited greater responsiveness to stimulus salience in the nucleus accumbens, midbrain, anterior insula and dorsal anterior cingulate cortex (P < 0.02, g = 0.86 to 1.7). Behavioral, autonomic and neural sensitivity to the valence of stimuli did not differ by sex, indicating that responses to rewards vs punishments were similar in women and men. These results reveal novel and robust sex differences in reward- and punishment-related traits, behavior, autonomic activity and neural responses. These convergent results suggest a neurobehavioral basis for sexual dimorphism observed in the reward system, including reward-related disorders.
Collapse
Affiliation(s)
| | | | - Keith G Jones
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
| | - Benjamin Sanford
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Tiffany M Love
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
| | - Brian J Mickey
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
| |
Collapse
|
5
|
Flores RJ, Cruz B, Uribe KP, Correa VL, Arreguin MC, Carcoba LM, Mendez IA, O'Dell LE. Estradiol promotes and progesterone reduces anxiety-like behavior produced by nicotine withdrawal in female rats. Psychoneuroendocrinology 2020; 119:104694. [PMID: 32540678 PMCID: PMC7423767 DOI: 10.1016/j.psyneuen.2020.104694] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/17/2020] [Accepted: 04/11/2020] [Indexed: 12/15/2022]
Abstract
This study assessed sex differences and the role of ovarian hormones in nicotine withdrawal. Study 1 compared physical signs, anxiety-like behavior, and corticosterone levels in male, intact female, and ovariectomized (OVX) female rats during nicotine withdrawal. Estradiol (E2) and progesterone levels were also assessed in intact females that were tested during different phases of the 4-day estrous cycle. Study 2 assessed the role of ovarian hormones in withdrawal by comparing the same measures in OVX rats that received vehicle, E2, or E2+progesterone prior to testing. Briefly, rats received a sham surgery or an ovariectomy procedure. Fifteen days later, rats were prepared with a pump that delivered nicotine for 14 days. On the test day, rats received saline or the nicotinic receptor antagonist, mecamylamine to precipitate withdrawal. Physical signs and anxiety-like behavior were assessed on the elevated plus maze (EPM) and light-dark transfer (LDT) tests. During withdrawal, intact females displayed greater anxiety-like behavior and increases in corticosterone levels as compared to male and OVX rats. Females tested in the estrus phase (when E2 is relatively low) displayed less anxiety-like behavior and had lower corticosterone levels versus all other phases. Anxiety-like behavior and corticosterone levels were positively correlated with E2 and negatively correlated with progesterone levels. Intact females displaying high E2/low progesterone showed greater anxiety-like behavior and corticosterone levels as compared to females displaying low E2/high progesterone. Lastly, OVX-E2 rats displayed greater anxiety-like behavior than OVX-E2+progesterone rats. These data suggest that E2 promotes and progesterone reduces anxiety-like behavior produced by nicotine withdrawal.
Collapse
Affiliation(s)
- Rodolfo J Flores
- Department of Psychology, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX, USA
| | - Bryan Cruz
- Department of Psychology, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX, USA
| | - Kevin P Uribe
- Department of Psychology, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX, USA
| | - Victor L Correa
- Department of Psychology, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX, USA
| | - Montserrat C Arreguin
- Department of Psychology, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX, USA
| | - Luis M Carcoba
- Department of Psychology, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX, USA
| | - Ian A Mendez
- School of Pharmacy, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX, USA
| | - Laura E O'Dell
- Department of Psychology, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX, USA.
| |
Collapse
|
6
|
Pimentel E, Sivalingam K, Doke M, Samikkannu T. Effects of Drugs of Abuse on the Blood-Brain Barrier: A Brief Overview. Front Neurosci 2020; 14:513. [PMID: 32670001 PMCID: PMC7326150 DOI: 10.3389/fnins.2020.00513] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/24/2020] [Indexed: 12/17/2022] Open
Abstract
The use of psychostimulants and alcohol disrupts blood-brain barrier (BBB) integrity, resulting in alterations to cellular function, and contributes to neurotoxicity. The BBB is the critical boundary of the central nervous system (CNS) where it maintains intracellular homeostasis and facilitates communication with the peripheral circulation. The BBB is regulated by tight junction (TJ) proteins that closely interact with endothelial cells (EC). The complex TJ protein network consists of transmembrane proteins, including claudins, occludins, and junction adhesion molecules (JAM), as well as cytoskeleton connected scaffolding proteins, zonula occludentes (ZO-1, 2, and 3). The use of psychostimulants and alcohol is known to affect the CNS and is implicated in various neurological disorders through neurotoxicity that partly results from increased BBB permeability. The present mini review primarily focuses on BBB structure and permeability. Moreover, we assess TJ protein and cytoskeletal changes induced by cocaine, methamphetamine, morphine, heroin, nicotine, and alcohol. These changes promote glial activation, enzyme potentiation, and BBB remodeling, which affect neuroinflammatory pathways. Although the effect of drugs of abuse on BBB integrity and the underlying mechanisms are well studied, the present review enhances the understanding of the underlying mechanisms through which substance abuse disorders cause BBB dysfunction.
Collapse
Affiliation(s)
- Emely Pimentel
- School of Medicine, St. George's University, Great River, NY, United States
| | - Kalaiselvi Sivalingam
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX, United States
| | - Mayur Doke
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX, United States
| | - Thangavel Samikkannu
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX, United States
| |
Collapse
|
7
|
Suzuki S, Mell MM, O'Malley SS, Krystal JH, Anticevic A, Kober H. Regulation of Craving and Negative Emotion in Alcohol Use Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:239-250. [PMID: 31892465 DOI: 10.1016/j.bpsc.2019.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Alcohol use disorder (AUD) is a chronic, relapsing condition with poor treatment outcomes. Both alcohol craving and negative affect increase alcohol drinking, and-in healthy adults-can be attenuated using cognitive strategies, which rely on the prefrontal cortex (PFC). However, AUD is associated with cognitive impairments and PFC disruptions. Thus, we tested whether individuals with AUD can successfully recruit the PFC to effectively regulate craving and negative emotions, whether neural mechanisms are shared between the two types of regulation, and whether individual differences influence regulation success. METHODS During functional magnetic resonance imaging, participants with AUD completed the regulation of craving task (n = 17) that compares a cue-induced craving condition with an instructed regulation condition. They also completed the emotion regulation task (n = 15) that compares a negative affect condition with an instructed regulation condition. Regulation strategies were drawn from cognitive behavioral therapy treatments for AUD. Self-reported craving and negative affect were collected on each trial. RESULTS Individuals with AUD effectively regulated their craving and negative affect when instructed to do so using cognitive behavioral therapy-based strategies. Regulation was associated with recruitment of both common and distinct PFC regions across tasks, as well as with reduced activity in regions associated with craving and negative affect (e.g., ventral striatum, amygdala). Effective regulation of craving was associated with negative alcohol expectancies. CONCLUSIONS Both common and distinct regulatory systems underlie regulation of craving and negative emotions in AUD, with notable individual differences. This has important implications for AUD treatment.
Collapse
Affiliation(s)
- Shosuke Suzuki
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Maggie Mae Mell
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Stephanie S O'Malley
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Hedy Kober
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| |
Collapse
|
8
|
Allen SS. Reply to Dr Howe. J Addict Med 2019; 13:81-82. [PMID: 30688803 PMCID: PMC6363481 DOI: 10.1097/adm.0000000000000450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
9
|
Tosun NL, Allen SS, Eberly LE, Yao M, Stoops WW, Strickland JC, Harrison KA, al'Absi M, Carroll ME. Association of exercise with smoking-related symptomatology, smoking behavior and impulsivity in men and women. Drug Alcohol Depend 2018; 192:29-37. [PMID: 30199844 PMCID: PMC7257807 DOI: 10.1016/j.drugalcdep.2018.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 06/01/2018] [Accepted: 07/04/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Despite extensive efforts to develop effective smoking cessation interventions, 70-85% of American cigarette smokers who quit relapse within one year. Exercise has shown promise as an intervention; however, many results have been equivocal. This study explored how exercise is associated with smoking-related symptomatology, smoking behavior and impulsivity in male and female smokers. METHODS Participants were recruited throughout the United States using the on-line crowdsourcing platform, Amazon's Mechanical Turk. They completed a survey with self-report measures assessing exercise, smoking-related symptomatology, smoking behavior and impulsivity. Differences between men and women were tested using t- and chi-square tests. Regression analyses tested for associations between exercise and smoking-related symptomatology, smoking behavior and impulsivity. RESULTS Participants (N = 604) were, on average, 32 (SD = 6.2) years old, mostly Caucasian, with at least some college education and approximately half were women. Women exercised slightly less than men and had more negative affect, craving, physical symptoms and withdrawal. Women smoked more cigarettes per day, had greater nicotine dependency and more years of smoking. Positive affect was positively associated with exercise for both men and women; however, this association was significantly stronger in women. Negative affect and withdrawal were inversely associated with exercise for women only. Impulsivity was inversely associated with exercise for both men and women. CONCLUSION Exercise was significantly associated with several smoking-related symptomatology, smoking behavior and impulsivity variables for both men and women, suggesting that exercise may be a useful intervention for smoking cessation. Future prospective research should determine how exercise directly impacts smoking cessation.
Collapse
Affiliation(s)
- Nicole L Tosun
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, United States.
| | - Sharon S Allen
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, United States.
| | - Lynn E Eberly
- Division of Biostatistics, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, United States
| | - Meng Yao
- Division of Biostatistics, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, United States.
| | - William W Stoops
- Department of Behavioral Science, University of Kentucky, 1100 Veterans Drive, Lexington, KY 40536, United States.
| | - Justin C Strickland
- Department of Psychology, University of Kentucky, 171 Funkhouser Drive, Lexington, KY 40506, United States.
| | - Katherine A Harrison
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, United States.
| | - Mustafa al'Absi
- Department of Behavioral Sciences, University of Minnesota, Duluth Campus, 1035 University Ave, Duluth, MN 55812, United States.
| | - Marilyn E Carroll
- Department of Psychiatry, University of Minnesota, MMC 392, 505 Essex St SE, Minneapolis, MN 55455, United States.
| |
Collapse
|
10
|
Role of Exogenous Progesterone in the Treatment of Men and Women with Substance Use Disorders: A Narrative Review. CNS Drugs 2018; 32:421-435. [PMID: 29761343 PMCID: PMC6235727 DOI: 10.1007/s40263-018-0525-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Substance use disorders (SUDs) remain problematic as many individuals are untreated or do not benefit from the currently available interventions. Thus, there is an urgent need to develop novel pharmacological interventions to treat SUDs. Evidence suggests that the female sex hormone, progesterone, attenuates the craving for and the euphoric effects of drugs of abuse. Research to date has demonstrated that progesterone may modulate responses to drugs of abuse and may have utility as a novel treatment for SUDs. A literature search was conducted to identify and examine studies that administered exogenous progesterone. Sixteen publications were identified, exploring the utility of exogenous progesterone or its metabolite, allopregnanolone, among a range of substances, including amphetamines (one study), benzodiazepines (one study), cocaine (nine studies), and tobacco/nicotine (five studies). Results indicated that exogenous progesterone and, its metabolite allopregnanolone, demonstrated preliminary efficacy as a treatment for substance use in both men and women. Notably, progesterone appears to target negative affect and augment cognitive functioning, especially among female substance users. Additional research is needed to explore the potential use of exogenous progesterone and allopregnanolone in the treatment of SUDs, including that associated with alcohol and opioids, but considering the current promising findings, exogenous progesterone and allopregnanolone may have utility as novel pharmacological treatments for SUDs.
Collapse
|
11
|
Allen SS, Allen AM, Lunos S, Tosun N. Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial. Nicotine Tob Res 2016; 18:2145-2153. [PMID: 27613934 PMCID: PMC5055745 DOI: 10.1093/ntr/ntw156] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/05/2016] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Pregnancy is a strong motivator to quit smoking, yet postpartum relapse rates are high. Growing evidence suggests a role of sex hormones in drug abuse behavior and given the precipitous drop in sex hormones at delivery, they may play a role in postpartum relapse. This pilot study evaluates the feasibility and potential role of exogenous progesterone in postpartum smoking relapse. METHODS This 12-week double-blind placebo-controlled randomized pilot trial randomized 46 abstinent postpartum women to active progesterone (PRO; 200mg twice a day) versus placebo (PBO) for 4 weeks. Participants were followed for relapse for 12 weeks. Main study outcomes include abstinence (point prevalence), feasibility (compliance per number of clinic visits attended, pill counts and Electronic Data Capture [EDC] completed) and self-reported acceptability. Safety was also measured by depressive symptom scores, adverse events, and breastfeeding. RESULTS Overall retention rate was 87% at week 12. At week 4, abstinence rates were 75% in the PRO group and 68.2% in the PBO group (p = .75). Medication adherence was 68% and clinic visit attendance was 80%, with no differences by randomization. Depressive symptom scores, adverse events, and breastfeeding did not vary by randomization. CONCLUSIONS Although the study was not powered to evaluate abstinence rates, we did observe a higher prevalence of abstinence at week 4 in the PRO group. Further, exogenous progesterone was well tolerated and did not adversely affect depressive symptoms or breastfeeding. Thus, the results of this pilot study indicate further investigation into progesterone as a postpartum relapse prevention strategy is warranted. IMPLICATIONS This innovative pilot trial determined the feasibility of delivering exogenous progesterone as a potential prevention of postpartum smoking relapse. We observed high retention and moderate adherence rates, as well as high acceptability among participants. Further, though not statistically significant, more women in the treatment group remained abstinent from smoking during follow-up. This project adds to the growing body of literature on the role of sex hormones in smoking relapse and also provides support for a fully powered clinical trial.
Collapse
Affiliation(s)
- Sharon S Allen
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN;
| | - Alicia M Allen
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN
| | - Nicole Tosun
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN
| |
Collapse
|
12
|
Pang RD, Bello MS, Stone MD, Kirkpatrick MG, Huh J, Monterosso J, Haselton MG, Fales MR, Leventhal AM. Premenstrual symptoms and smoking-related expectancies. Addict Behav 2016; 57:38-41. [PMID: 26869196 DOI: 10.1016/j.addbeh.2016.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/20/2015] [Accepted: 01/29/2016] [Indexed: 11/16/2022]
Abstract
Given that prior research implicates smoking abstinence in increased premenstrual symptoms, tobacco withdrawal, and smoking behaviors, it is possible that women with more severe premenstrual symptoms have stronger expectancies about the effects of smoking and abstaining from smoking on mood and withdrawal. However, such relations have not been previously explored. This study examined relations between premenstrual symptoms experienced in the last month and expectancies that abstaining from smoking results in withdrawal (i.e., smoking abstinence withdrawal expectancies), that smoking is pleasurable (i.e., positive reinforcement smoking expectancies), and smoking relieves negative mood (i.e., negative reinforcement smoking expectancies). In a cross-sectional design, 97 non-treatment seeking women daily smokers completed self-report measures of smoking reinforcement expectancies, smoking abstinence withdrawal expectancies, premenstrual symptoms, mood symptoms, and nicotine dependence. Affect premenstrual symptoms were associated with increased negative reinforcement smoking expectancies, but not over and above covariates. Affect and pain premenstrual symptoms were associated with increased positive reinforcement smoking expectancies, but only affect premenstrual symptoms remained significant in adjusted models. Affect, pain, and water retention premenstrual symptoms were associated with increased smoking abstinence withdrawal expectancies, but only affect premenstrual symptoms remained significant in adjusted models. Findings from this study suggest that addressing concerns about withdrawal and alternatives to smoking may be particularly important in women who experience more severe premenstrual symptoms, especially affect-related changes.
Collapse
Affiliation(s)
- Raina D Pang
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA.
| | - Mariel S Bello
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
| | - Matthew D Stone
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
| | - Matthew G Kirkpatrick
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
| | - Jimi Huh
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
| | - John Monterosso
- University of Southern California Keck School of Medicine, Department of Psychology, Los Angeles, CA, USA
| | - Martie G Haselton
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Melissa R Fales
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Adam M Leventhal
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA; University of Southern California Keck School of Medicine, Department of Psychology, Los Angeles, CA, USA
| |
Collapse
|
13
|
Weinberger AH, Smith PH, Allen SS, Cosgrove KP, Saladin ME, Gray KM, Mazure CM, Wetherington CL, McKee SA. Systematic and meta-analytic review of research examining the impact of menstrual cycle phase and ovarian hormones on smoking and cessation. Nicotine Tob Res 2015; 17:407-21. [PMID: 25762750 DOI: 10.1093/ntr/ntu249] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION To determine the effect of ovarian hormones on smoking, we conducted a systematic review of menstrual cycle effects on smoking (i.e., ad lib smoking, smoking topography, and subjective effects) and cessation-related behaviors (i.e., cessation, withdrawal, tonic craving, and cue-induced craving). METHODS Thirty-six papers were identified on MEDLINE that included a menstrual-related search term (e.g., menstrual cycle, ovarian hormones), a smoking-related search term (e.g., smoking, nicotine), and met all inclusion criteria. Thirty-two studies examined menstrual phase, 1 study measured hormone levels, and 3 studies administered progesterone. RESULTS Sufficient data were available to conduct meta-analyses for only 2 of the 7 variables: withdrawal and tonic craving. Women reported greater withdrawal during the luteal phase than during the follicular phase, and there was a nonsignificant trend for greater tonic craving in the luteal phase. Progesterone administration was associated with decreased positive and increased negative subjective effects of nicotine. Studies of menstrual phase effects on the other outcome variables were either small in number or yielded mixed outcomes. CONCLUSIONS The impact of menstrual cycle phase on smoking behavior and cessation is complicated, and insufficient research is available upon which to conduct meta-analyses on most smoking outcomes. Future progress will require collecting ovarian hormone levels to more precisely quantify the impact of dynamic changes in hormone levels through the cycle on smoking behavior. Clarifying the relationship between hormones and smoking-particularly related to quitting, relapse, and medication response-could determine the best type and timing of interventions to improve quit rates for women.
Collapse
Affiliation(s)
| | - Philip H Smith
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Sharon S Allen
- Women's Health Research at Yale, Yale University School of Medicine, New Haven, CT
| | - Kelly P Cosgrove
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN
| | - Michael E Saladin
- Departments of Psychiatry, Diagnostic Radiology, and Neurobiology, Yale University School of Medicine, New Haven, CT
| | - Kevin M Gray
- Departments of Health Sciences and Research and Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Carolyn M Mazure
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT; Women's Health Research at Yale, Yale University School of Medicine, New Haven, CT
| | - Cora Lee Wetherington
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Sherry A McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| |
Collapse
|
14
|
Allen AM, Lunos S, Heishman SJ, al'Absi M, Hatsukami D, Allen SS. Subjective response to nicotine by menstrual phase. Addict Behav 2015; 43:50-3. [PMID: 25553511 DOI: 10.1016/j.addbeh.2014.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/09/2014] [Accepted: 12/10/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The luteal menstrual phase might be a favorable time for smoking cessation when non-nicotine interventions (e.g. counseling, bupropion) are used, whereas the follicular menstrual phase appears favorable when nicotine interventions are used. Thus, there may be an interaction between menstrual phase and response to nicotine. We sought to examine the role of menstrual phase on response to nicotine during acute smoking abstinence. METHODS In this controlled cross-over trial, women completed two identical experimental sessions (follicular [F] vs. luteal [L] phase) after four days of biochemically-verified smoking abstinence. During the sessions, nicotine nasal spray was administered, and participants provided a series of subjective assessments. RESULTS Participants (n=140) were 29.7±6.6years old and smoked 12.6±5.8 cigarettes per day. Compared to the F phase, the L phase was associated with a greater increase in stimulation (7.2±2.2 vs. 14.4±2.3, p=0.01, respectively) and greater decrease in urge to smoke (-13.6±2.3 vs. -21.1±2.5, p=0.02, respectively) after the first dose of nicotine. No other significant differences were observed. CONCLUSIONS Out of 13 total measures examined at two different time points, we observed only two significant menstrual phase differences in the subjective response to nicotine. Therefore, these data do not provide strong evidence for a menstrual phase difference in the subjective response to nicotine. Additional research is needed to confirm this relationship and explore how non-nicotine smoking reinforcements (such as sensory sensations) may vary by menstrual phase.
Collapse
Affiliation(s)
- Alicia M Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 422, Minneapolis, MN, USA 55414.
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55414, USA
| | - Stephen J Heishman
- Nicotine Psychopharmacology Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mustafa al'Absi
- Department of Behavioral Sciences, Medical School, University of Minnesota, DuluthDuluth, MN 55812, USA
| | - Dorothy Hatsukami
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN 55414, USA
| | - Sharon S Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, Minneapolis, MN 55414, USA
| |
Collapse
|
15
|
Hinderaker K, Allen AM, Tosun N, al'Absi M, Hatsukami D, Allen SS. The effect of combination oral contraceptives on smoking-related symptomatology during short-term smoking abstinence. Addict Behav 2015; 41:148-51. [PMID: 25452059 DOI: 10.1016/j.addbeh.2014.10.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 08/12/2014] [Accepted: 10/19/2014] [Indexed: 12/20/2022]
Abstract
Although an estimated 25% of premenopausal smokers report using oral contraceptives (OC), little is known about how OC use may influence smoking cessation. The purpose of this study was to examine the difference in smoking-related symptomatology during acute smoking abstinence between women on a standardized combination OC (Tri-Sprintec(™)) compared to women not on OCs (no-OC). Participants were women aged 18-40 who smoked ≥5 cigarettes/day and reported regular menstrual cycles. Using a controlled cross-over design, participants completed two six-day testing weeks: Low Progesterone Week (LPW; Follicular (F) phase in no-OC or 1st week of pills in OC) and High Progesterone Week (HPW; Luteal (L) phase in no-OC or 3rd week of pills in OC). Each testing week included daily assessment of symptomatology and biochemical confirmation of smoking status. During smoking abstinence, the OC group (n=14) reported significantly lower levels of positive affect (21.56±7.12 vs. 24.57±6.46; β=3.63, p=0.0323) than the no-OC group (n=28). Further significant interactions between group and testing week were observed as follows: Smoking satisfaction was higher during LPW in the OC group (LPW: 4.29±1.30 vs. HPW: 4.10±1.37) but higher during HPW in the no-OC group (LPW: 3.91±1.30 vs. HPW: 4.23±1.30; β=-0.5499, p<0.0001). Similar interactions were noted in negative affect and psychological reward of smoking. These results suggest that women on OCs may have different patterns of smoking-related symptomatology during short-term smoking abstinence as compared to women not on OCs. Additional work is needed to examine how this may affect smoking cessation efforts.
Collapse
|
16
|
Mitchell MR, Potenza MN. Importance of sex differences in impulse control and addictions. Front Psychiatry 2015; 6:24. [PMID: 25762943 PMCID: PMC4332159 DOI: 10.3389/fpsyt.2015.00024] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/04/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marci R Mitchell
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA ; Department of Neurobiology, Yale University School of Medicine , New Haven, CT , USA ; Child Study Center, Yale University School of Medicine , New Haven, CT , USA ; CASAColumbia, Yale University , New Haven, CT , USA
| |
Collapse
|
17
|
Sex differences and menstrual cycle phase-dependent modulation of craving for cigarette: an FMRI pilot study. PSYCHIATRY JOURNAL 2014; 2014:723632. [PMID: 25478563 PMCID: PMC4248329 DOI: 10.1155/2014/723632] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 10/27/2014] [Accepted: 10/27/2014] [Indexed: 12/05/2022]
Abstract
While overall more men than women smoke cigarettes, women and girls take less time to become dependent after initial use and have more difficulties quitting the habit. One of the factors contributing to these differences may be that women crave cigarettes more than men and that their desire to smoke is influenced by hormonal fluctuations across the menstrual cycle. Therefore, the purpose of the present study was twofold: (a) to examine potential sex/gender differences in functional neuroanatomy of craving and to (b) delineate neural correlates of cigarette cravings in women across their menstrual cycle. Fifteen tobacco-smoking men and 19 women underwent a functional MRI during presentation of neutral and smoking-related images, known to elicit craving. Women were tested twice: once during early follicular phase and once during midluteal phase of their menstrual cycle. The analysis did not reveal any significant sex differences in the cerebral activations associated with craving. Nevertheless, the pattern of activations in women varied across their menstrual cycle with significant activations in parts of the frontal, temporal, and parietal lobe, during follicular phase, and only limited activations in the right hippocampus during the luteal phase.
Collapse
|
18
|
Fattore L, Melis M, Fadda P, Fratta W. Sex differences in addictive disorders. Front Neuroendocrinol 2014; 35:272-84. [PMID: 24769267 DOI: 10.1016/j.yfrne.2014.04.003] [Citation(s) in RCA: 180] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 04/04/2014] [Accepted: 04/04/2014] [Indexed: 12/16/2022]
Abstract
Gender-dependent differences in the rate of initiation and frequency of misuse of addicting drugs have been widely described. Yet, men and women also differ in their propensity to become addicted to other rewarding stimuli (e.g., sex, food) or activities (e.g., gambling, exercising). The goal of the present review is to summarize current evidence for gender differences not only in drug addiction, but also in other forms of addictive behaviours. Thus, we first reviewed studies showing gender-dependent differences in drug addiction, food addiction, compulsive sexual activity, pathological gambling, Internet addiction and physical exercise addiction. Potential risk factors and underlying brain mechanisms are also examined, with particular emphasis given to the role of sex hormones in modulating addictive behaviours. Investigations on factors allowing the pursuit of non-drug rewards to become pathological in men and women are crucial for designing gender-appropriate treatments of both substance and non-substance addictions.
Collapse
Affiliation(s)
- Liana Fattore
- Institute of Neuroscience - Cagliari National Research Council of Italy, Cittadella Universitaria di Monserrato, Italy; Centre of Excellence "Neurobiology of Dependence", University of Cagliari, Monserrato, Italy.
| | - Miriam Melis
- Centre of Excellence "Neurobiology of Dependence", University of Cagliari, Monserrato, Italy; Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, Cittadella Universitaria di Monserrato, University of Cagliari, Monserrato, Italy
| | - Paola Fadda
- Centre of Excellence "Neurobiology of Dependence", University of Cagliari, Monserrato, Italy; Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, Cittadella Universitaria di Monserrato, University of Cagliari, Monserrato, Italy; National Institute of Neuroscience (INN), University of Cagliari, Italy
| | - Walter Fratta
- Centre of Excellence "Neurobiology of Dependence", University of Cagliari, Monserrato, Italy; Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, Cittadella Universitaria di Monserrato, University of Cagliari, Monserrato, Italy; National Institute of Neuroscience (INN), University of Cagliari, Italy
| |
Collapse
|
19
|
Allen SS, Allen AM, Tosun N, Lunos S, al'Absi M, Hatsukami D. Smoking- and menstrual-related symptomatology during short-term smoking abstinence by menstrual phase and depressive symptoms. Addict Behav 2014; 39:901-6. [PMID: 24594903 DOI: 10.1016/j.addbeh.2014.01.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/16/2014] [Accepted: 01/29/2014] [Indexed: 12/01/2022]
Abstract
Menstrual phase and depressive symptoms are known to minimize quit attempts in women. Therefore, the influence of these factors on smoking- and menstrual-related symptomatology during acute smoking cessation was investigated in a controlled cross-over lab-study. Participants (n=147) completed two six-day testing weeks during their menstrual cycle with testing order randomly assigned (follicular vs. luteal). The testing week consisted of two days of ad libitum smoking followed by four days of biochemically verified smoking abstinence. Daily symptomatology measures were collected. Out of the 11 total symptoms investigated, six were significantly associated with menstrual phase and nine were significantly associated with level of depressive symptoms. Two significant interactions were noted indicating that there may be a stronger association between depressive symptoms with negative affect and premenstrual pain during the follicular phase compared to the luteal phase. Overall, these observations suggest that during acute smoking abstinence in premenopausal smokers, there is an association between depressive symptoms and symptomatology whereas menstrual phase appears to have less of an effect. Further study is needed to determine the effect of these observations on smoking cessation outcomes, as well as to define the mechanism of menstrual phase and depressive symptoms on smoking-related symptomatology.
Collapse
Affiliation(s)
- Sharon S Allen
- Department of Family Medicine & Community Health Medical School, University of Minnesota, 420 Delaware Street SE, Room A682, Minneapolis, MN 55455, United States
| | - Alicia M Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 422, Minneapolis, MN 55414, United States
| | - Nicole Tosun
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 261, Minneapolis, MN 55414, United States
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, 717 Delaware Street SE, Suite 132, Minneapolis, MN 55414, United States
| | - Mustafa al'Absi
- Department of Behavioral Sciences, Medical School, University of Minnesota, Duluth 1035 University Drive, 236 SMed, D601A, Duluth, MN 55812, United States
| | - Dorothy Hatsukami
- Department of Psychiatry, Medical School, University of Minnesota, 717 Delaware Street SE, Room 256, Minneapolis, MN 55414, United States
| |
Collapse
|
20
|
Allen AM, Oncken C, Hatsukami D. Women and Smoking: The Effect of Gender on the Epidemiology, Health Effects, and Cessation of Smoking. CURRENT ADDICTION REPORTS 2014; 1:53-60. [PMID: 27213132 PMCID: PMC4871621 DOI: 10.1007/s40429-013-0003-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Smoking is still the leading cause of premature morbidity and mortality. This paper examines new research on gender differences and the epidemiology of smoking, smoking-related morbidity and mortality, and factors that affect smoking cessation. The rate of decline in the prevalence of smoking has been slowing, especially among adolescent girls. New research suggests that, compared with men, women may be more susceptible to smoking-related morbidity and mortality. Gender-related barriers to smoking cessation include weight gain, sex hormones, and mood. Furthermore, the sensory aspects of smoking may have more of an effect on smoking treatment for women than for men. We discuss new studies that examine smoking-cessation interventions that may be particularly beneficial for women, including exercise (as an adjunct intervention), very low nicotine content cigarettes, and a variety of pharmacotherapy. Further research is needed to identify and target the gender-specific needs of smokers.
Collapse
Affiliation(s)
- Alicia M Allen
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 422, Minneapolis, MN 55414, USA
| | - Cheryl Oncken
- Department of Medicine and Obstetrics and Gynecology, University of Connecticut School of Medicine, 263 Farmington, Farmington, CT 06030, USA,
| | - Dorothy Hatsukami
- Department of Psychiatry, Medical School, University of Minnesota, 717 Delaware Street SE, Room 256, Minneapolis, MN 55414, USA,
| |
Collapse
|
21
|
Pang RD, Leventhal AM. Sex differences in negative affect and lapse behavior during acute tobacco abstinence: a laboratory study. Exp Clin Psychopharmacol 2013; 21:269-76. [PMID: 23834551 PMCID: PMC3962304 DOI: 10.1037/a0033429] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Heightened negative affect during acute tobacco abstinence in women relative to men could be an important factor underlying sex differences in smoking motivation. However, little controlled experimental work addresses this hypothesis. The current study investigated sex differences in withdrawal-related negative affect, time to start smoking on a lab analogue smoking lapse task, and the interrelation between sex, withdrawal-related negative affect, and smoking lapse behavior. Following a baseline session, current smokers (women: n = 68, men: n = 131) attended two counterbalanced lab sessions (16 hours smoking abstinence and ad libitum smoking) during which they completed self-report measures of mood and withdrawal symptoms followed by a laboratory analogue smoking lapse task. In this task participants are monetarily rewarded for delaying smoking. Performance on this task serves as an analogue model of smoking lapse behavior by measuring smoker's capability to resist temptation to smoke under conditions where abstinence is advantageous. Females showed greater abstinence induced increases in composite negative affect as well as several particular negative affect states (i.e., POMS Anger, Anxiety, Depression, and Confusion, ps < .05) but no differences in abstinence induced changes in other forms of affect or craving. Females also exhibited marginally greater abstinence induced decreases in their willingness to delay smoking for money (p = .10), which was mediated by abstinence induced increases in anger (p < .05). These results suggest that differential sensitivity to abstinence induced negative affect, particularly anger, could underlie sex specific smoking patterns. Negative affect during tobacco abstinence may be an important factor for understanding and treating nicotine addiction in women.
Collapse
Affiliation(s)
- Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
| | | |
Collapse
|
22
|
Wray JM, Gass JC, Tiffany ST. A systematic review of the relationships between craving and smoking cessation. Nicotine Tob Res 2013; 15:1167-82. [PMID: 23291636 PMCID: PMC3682845 DOI: 10.1093/ntr/nts268] [Citation(s) in RCA: 152] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 11/12/2012] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Craving is often portrayed as a defining feature of addiction, but the role of craving in the addictive process is controversial. Particularly contentious is the extent to which drug craving predicts subsequent relapse. METHODS This review synthesizes findings from 62 smoking cessation studies published through December 2011. Eligible studies measured craving for cigarettes in treatment-seeking smokers and related this to subsequent smoking status. The relationships of general craving and cue-specific craving with treatment outcome were examined separately. Further, analyses that related general craving to smoking status were divided into those that used craving data collected before the quit attempt, after the quit attempt, and those that used change in craving over time as a predictor. RESULTS Results across studies revealed a total of 198 indices of association with 94 (47%) of these being significant. In general, the findings indicated (a) there were only a few cases of significant associations between craving collected as part of cue-reactivity studies and treatment outcome, (b) postquit craving was a stronger predictor of treatment outcome than prequit craving, and (c) several moderators likely influence the relationship between craving and cessation outcome. CONCLUSIONS The overall results suggest that craving is not a necessary condition of relapse. In addition, inconsistent relationships between craving and treatment outcome call into question the value of craving as a target of treatment and underscore limitations in the prognostic utility of craving.
Collapse
Affiliation(s)
- Jennifer M Wray
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA.
| | | | | |
Collapse
|
23
|
Nakajima M, al'Absi M. Predictors of risk for smoking relapse in men and women: a prospective examination. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 26:633-7. [PMID: 22352701 DOI: 10.1037/a0027280] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current study examined whether prequit trait negative mood and smoking motives have different predictive patterns of smoking relapse in men and women. Thirty-three female (mean age±SEM: 34.9±2.5) and 38 male (mean age±SEM: 37.1±2.3) smokers interested in smoking cessation completed forms on smoking history, negative mood (i.e., depression, anxiety, and anger), stress, and smoking motives. Participants also provided samples for measurement of cotinine and carbon monoxide. Then, they set a quit date and were required to abstain from smoking at least for 24 hours. Participants were followed up for 12 months postcessation to measure their smoking status. Cox proportional hazard models revealed that motivation to reduce craving was a unique predictor of smoking relapse in men, while depressive mood, anxiety, anger, and perceived stress were predictive of time to relapse among women. These findings remained significant after statistically controlling for smoking-related variables, providing preliminary evidence that different factors may be associated with nicotine withdrawal and smoking relapse in men and women.
Collapse
Affiliation(s)
- Motohiro Nakajima
- Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School, Duluth, MN 55812, USA
| | | |
Collapse
|
24
|
Rahmanian SD, Diaz PT, Wewers ME. Tobacco use and cessation among women: research and treatment-related issues. J Womens Health (Larchmt) 2011; 20:349-57. [PMID: 21375414 PMCID: PMC3058892 DOI: 10.1089/jwh.2010.2173] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The prevalence of tobacco use in women has increased over the past century. This has resulted in dramatic increases in smoking-related lung diseases, such as chronic obstructive pulmonary disease (COPD) and lung cancer. There is growing literature suggesting that women may be more susceptible than men to the effects of tobacco and to the development of COPD. Women may also have specific barriers that interfere with smoking cessation. This article addresses possible differences in lung function decline and nicotine metabolism in women compared to men. Differences in COPD between the sexes are discussed. Finally, barriers to smoking cessation in women are presented.
Collapse
Affiliation(s)
- Shiva D Rahmanian
- Department of Medicine, College of Public Health, The Ohio State University, Grant Medical Center, 111 S. Grant Ave. #2, Columbus, OH 43215-4701, USA.
| | | | | |
Collapse
|