Do women find it harder to quit smoking?
This past week I attended the annual meeting of the Society for Research on Nicotine and Tobacco, so I thought I’d share with you some of the new findings presented at the meeting. There was a lot of new research addressing the differences between men and women in stopping smoking. First of all, its worth noting that not all studies find a difference in quit rates between men and women, and some of the men who quit cigarette smoking actually switch to another tobacco product (e.g. cigars or snuff) and so they aren’t really quitting tobacco at all. However, it is fairly common for studies to find a lower cigarette quit rate in women than men and this has led researchers to try to figure out the reason why. One study reported by Dr Megan Piper from the University of Wisconsin found that women experience larger increases in craving for a cigarette and withdrawal symptoms (e.g. irritability) than men on the very first day of their attempt to quit. Dr Sharon Allen from the University of Minnesota compared the success rates of women planning to quit smoking in different phases of their menstrual cycle. She found that women were more likely to succeed in quitting smoking (23%) if they planned their quit date to coincide with the luteal phase of their menstrual cycle (i.e. the 2 weeks from ovulation until menstruation). Women were less likely to quit if they planned their quit day to occur in their follicular phase (from menstruation to ovulation), when only 9% succeeded in quitting. This result was somewhat surprising given that previous research had suggested that cigarette cravings may be strongest during the late luteal (premenstrual) phase. Two studies by researchers at Yale University found that women have 20% more brain nicotine receptors than men, and that women have increased sensitivity to nicotine effects.
So some of these new studies are providing potential explanations for why women seem to find it slightly harder to quit than men. In my experience, women do particularly well when they use the nicotine inhaler as an aid to smoking cessation, and many say that they really appreciate that the inhaler replaces the behavioral part of smoking (without delivering the 4000 toxic chemicals in cigarette smoking). When patients attend our tobacco clinic they typically attend a 6-week group and use a combination of medications (e.g. the patch, plus bupropion plus the nicotine inhaler) under medical supervision. With that treatment we find that women have the same high quit rates as men. The new research showing that women trying to quit without any medication experience stronger early cravings and mood disturbance underlines the importance for women to make use of effective FDA-approved medications (nicotine replacement, Zyban or Chantix) if they smoke at least 10 cigarettes per day. The research on quitting smoking in different phases of the menstrual cycle is interesting but the results don’t seem to be consistent enough to lead to clear recommendations. Someone planning a quit attempt should always consider and prepare for the challenges they can anticipate. For some women their menstrual cycle may be an important consideration. I’d be interested to hear from readers’ own experiences of what has helped them quit and whether any of these research findings ring true in your experience.