Gender differences in the outcome of an unaided smoking cessation attempt

Ward, Kenneth D.; Klesges, Robert C.; Zbikowski, Susan M.; Bliss, Ryan E.; Garvey, Arthur J.

doi:10.1016/s0306-4603(96)00063-9

Cited by 163 publications

(127 citation statements)

References 48 publications

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“…However, success rates following attempts to quit smoking remain modest. One year after unaided attempts to quit smoking, abstinence rates are less than 5% 5,6 . Even with pharmacologic aids that include nicotine replacement therapy (NRT), bupropion and varenicline, long-term abstinence rates are less than 25% 7,8 .…”

mentioning

confidence: 99%

Personalized Smoking Cessation: Interactions between Nicotine Dose, Dependence and Quit-Success Genotype Score

Rose

Behm

Drgon

et al. 2010

Mol Med

131

104

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Improving and targeting nicotine replacement therapy (NRT) are cost-effective strategies for reducing adverse health consequences for smokers. Treatment studies document the efficacy of pre-cessation NRT and support important roles for level of nicotine dependence and pre-cessation smoking reduction in successful quitting. However, prior work has not identified the optimal pre-cessation dose or means for personalizing NRT. Genome wide association has identified groups of genomic markers that are associated with successful quitting, allowing us to develop a v1.0 "quit success" genotype score. We now report influences of v1.0 quit success genotype score, level of dependence and pre-cessation smoking reduction in a smoking cessation trial that examined effects of 21 vs 42 mg/24 h pre-cessation NRT. 479 smokers were randomized to 21 or 42 mg NRT, initiated 2 weeks prior to target quit dates.We monitored self-reported abstinence and end-expired air carbon monoxide (CO). Genotyping used Affymetrix arrays. The primary outcome was 10-week continuous smoking abstinence. NRT dose, level of nicotine dependence and genotype scores displayed significant interactive effects on successful quitting. Successful abstinence was also predicted by CO reductions during pre-cessation NRT. These results document ways in which smoking cessation strategies can be personalized based on levels of nicotine dependence, genotype scores and CO monitoring. These assessments, taken together, can help to match most smokers with optimal NRT doses and to rapidly identify some who may be better treated using other methods. Molecular Medicine www.molmed.org UNCORRECTED PROOFCigarette smoking is a significant cause of premature death and disease 1 . Successfully quitting and maintaining abstinence reduce risks to smokers [2][3][4] . However, success rates following attempts to quit smoking remain modest. One year after unaided attempts to quit smoking, abstinence rates are less than 5% 5,6 . Even with pharmacologic aids that include nicotine replacement therapy (NRT), bupropion and varenicline, long-term abstinence rates are less than 25% 7, 8 .Pre-cessation NRT initiates nicotine patch treatment two weeks prior to a target quit date 9, 10 . The 21 mg/24 hour dose pre-cessation dose used to date is well tolerated by most smokers 9, 10 and consistently enhances quit rates: recent meta-analyses show a 1.8-2.2 fold greater likelihood of success than conventional NRT 11,12 . However, neither dose/response data nor clear-cut recommendations for personalizing pre-cessation NRT have been reported.More effective smoking cessation might result from personalizing existing treatments based on characteristics of individual smokers. Previous research has identified phenotypic and genotypic variables that might aid in predicting likelihood of success in smoking cessation and/or differential responses to different treatment regimens. In smoking cessation trials, smokers who score higher on the Fagerström Test for Nicotine Dependence (FTND), and thus display ...

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mentioning

confidence: 99%

Personalized Smoking Cessation: Interactions between Nicotine Dose, Dependence and Quit-Success Genotype Score

Rose

Behm

Drgon

et al. 2010

Mol Med

131

104

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“…Data about this issue are mixed, with some studies supporting a gender difference in cessation success [19][20][21][22][23] and others not supporting this finding. [24][25][26] Furthermore, the presence of hardcore smokers, those most likely to have substantial difficulty quitting, may have far-reaching impact on how to best allocate cessation resources.…”

mentioning

confidence: 99%

Gender Differences among Hardcore Smokers: An Analysis of the Tobacco Use Supplement of the Current Population Survey

Augustson

Barzani

Rutten

et al. 2008

Journal of Women's Health

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Background: Despite significant declines in smoking rates in the United States, a substantial percentage of adults continue to smoke. Improved understanding of current smokers and their contact with sources of cessation support future tobacco control efforts. Recent evidence suggests that hardcore smokers, established smokers without a history of quit attempts, have less contact with cessation support. Although gender is among the major factors that influence smoking cessation, no research is available on gender differences among hardcore smokers. Methods: Demographic, environmental, and smoking-related characteristics of female hardcore smokers and male hardcore smokers and other female smokers were examined. Data from 17,777smokers from the 2003 Current Population Survey Tobacco Use Supplement were analyzed. Results: Compared with female hardcore smokers, male hardcore smokers were more likely to have contact with smoking restrictions at work (OR ϭ 1.69) and at home (OR ϭ 1.45). Compared with female hardcore smokers, female other smokers were more likely to have seen a healthcare provider during the past year who advised them to quit smoking (OR ϭ 1.39) and more likely to have smoking restrictions at work (OR ϭ 1.25) and at home (OR ϭ 2.32)). Measures of nicotine dependence suggested that female hardcore smokers were less dependent than male hardcore smokers but more dependent than other female smokers. Conclusions: The sociodemographic and healthcare access variations in tobacco use identified in our analyses have significant public health implications and underscore the vital need for clinical and scientific advances in tobacco use prevention and control efforts.

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“…[21][22][23][24][25][26] For example, women are more likely to use smoking to cope with negative affect than men. [27][28][29] Female smokers report more distress after exposure to acutely stressful nonsmoking situations as well as in response to smokingspecific stimuli than male smokers.…”

Section: Introductionmentioning

confidence: 99%

“…30,31 Women are also less likely to maintain abstinence. 25,32 Research also suggests that women and men have different sensitivity to reinforcing and rewarding effects of nicotine. [33][34][35][36] The heightened negative affective responses to stressful situations reported by women may exacerbate withdrawal symptoms and predispose women ex-smokers to relapse.…”

Section: Introductionmentioning

confidence: 99%

Sex Differences in Hormonal Responses to Stress and Smoking Relapse: A Prospective Examination

Al’Absi

Nakajima

Allen

et al. 2015

Nicotine & Tobacco Research

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Gender differences in the outcome of an unaided smoking cessation attempt

Cited by 163 publications

References 48 publications

Personalized Smoking Cessation: Interactions between Nicotine Dose, Dependence and Quit-Success Genotype Score

Personalized Smoking Cessation: Interactions between Nicotine Dose, Dependence and Quit-Success Genotype Score

Gender Differences among Hardcore Smokers: An Analysis of the Tobacco Use Supplement of the Current Population Survey

Sex Differences in Hormonal Responses to Stress and Smoking Relapse: A Prospective Examination

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