Sex/gender differences in smoking cessation: A review

Abstract

Data from treatment studies tends to show women are less likely to quit smoking than men, but these findings have been disputed, typically based on contradictory evidence from epidemiological investigations. The purpose of this review was to shed light on this conflict. We conducted a qualitative review in January, 2016 to examine sources of variation in sex/gender differences for smoking cessation. We identified 214 sex/gender difference tests from 190 studies through Medline and studies were categorized into efficacy trials (k=37), effectiveness trials (k=77), prospective observational studies of cessation (k=40; current smokers transitioning to former smokers), prospective observational studies of relapse (k=6; former smokers transitioning to current smokers), cross-sectional investigations of former smoker prevalence (k=32), and community-based interventions (k=4). We also summarized evidence across time periods, countries, outcome assessments, study sample, and treatment. Evidence from efficacy and effectiveness trials, as well as prospective observational studies of relapse, demonstrated that women have more difficulty maintaining long-term abstinence than men. Findings from prospective observational studies and cross-sectional investigations were mixed and demonstrated that bio-psycho-social variation in samples across place and time may determine whether or not women or men are less likely to quit smoking. Based on these findings, we consider whether sex/gender differences in quitting meet criteria for a disparity and outline directions for further research.

Effect of Selective Inhibition of Reactivated Nicotine-Associated Memories With Propranolol on Nicotine Craving

“…We recognize that this approach is no longer tenable 70 because of sex differences in nicotine’s effects and smoking cessation, 50,51,71 and we plan to address it in the future.…”

Gender Differences in U.S. Adolescent E-Cigarette Use

“…Female adolescents smoke to control weight [29, 30]; conversely, male adolescents report smoking because of the taste and smell of cigarettes and the “buzz” they feel from smoking [30]. Third, female smokers have lower smoking cessation rates relative to male smokers [21–23, 31, 32]. The gender smoking cessation could be related to concerns about gaining weight [33], negative mood when trying to quit [34], and greater reinforcement for smoking from behavioral and non-pharmacological factors (also described above) [32].…”

Gender and Menthol Cigarette Use in the USA: A Systematic Review of the Recent Literature (2011–May 2017)

“…For example, the FDA’s summary report on the public health consequences of mentholated tobacco products places comparatively little emphasis on the issue of gender and menthol cigarette use while focusing primarily on race and ethnicity in relation to menthol use (6). This difference is perhaps due to less general concern over gender-based disparities in tobacco-related outcomes among the tobacco control community (8, 9) as well as the comparatively smaller difference in menthol use prevalence among women versus men than is seen between Black and White smokers in the U.S. Yet, the approximately ten percentage point difference in prevalence of menthol cigarette use among women compared to men in the U.S, for example, is not marginal in terms of public health relevance.…”