Sex differences in long-term smoking cessation rates due to nicotine patch.
ABSTRACT Compared to men, women may be at greater risk for smoking-related diseases and have greater difficulty quitting smoking. Sex differences in medication response could guide treatment for smoking cessation to improve women's quit rates. We conducted a meta-analysis of the 14 placebo-controlled nicotine patch trials (N = 6,250) for which long-term (6 months) clinical outcome results could be determined separately by sex. This analysis updated a meta-analysis of 11 of these trials that found no significant sex differences due to nicotine patch. The increase in quitting due to the nicotine vs. placebo patch was only about half as large in women as in men. Pooled absolute quit rates at 6 months for nicotine and placebo patch, respectively, were 20.1% and 10.8% in men, and 14.7% and 10.1% in women. The odds ratio for quitting due to nicotine vs. placebo patch was lower in women (OR = 1.61) than in men (OR = 2.20), with an interaction odds ratio of 1.40 (95% CI = 1.02-1.93, p = .04). This sex difference did not vary significantly by whether or not formal counseling was provided. Poorer outcomes in women vs. men treated with nicotine patch suggests that increasing the quit rates of women smokers may require supplementing patch treatment or use of other medications.
- SourceAvailable from: Marna Rayl Greenberg[Show abstract] [Hide abstract]
ABSTRACT: For many years, gender differences have been recognized as important factors in the etiology, pathophysiology, comorbidities, and treatment needs and outcomes associated with the use of alcohol, drugs, and tobacco. However, little is known about how these gender-specific differences affect ED utilization; responses to ED-based interventions; needs for substance use treatment and barriers to accessing care among patients in the ED; or outcomes after an alcohol-, drug-, or tobacco-related visit. As part of the 2014 Academic Emergency Medicine consensus conference on “Gender-Specific Research in Emergency Care: Investigate, Understand and Translate How Gender Affects Patient Outcomes,” a breakout group convened to generate a research agenda on priority questions related to substance use disorders.Academic Emergency Medicine 11/2014; · 2.20 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Reconfiguration of extracellular matrix proteins appears to be necessary for the synaptic plasticity that underlies memory consolidation. The primary candidates involved in controlling this process are a family of endopeptidases called matrix metalloproteinases (MMPs); however, the potential role of MMPs in nicotine addiction-related memories has not been adequately tested. Present results indicate transient changes in hippocampal MMP-2, -3, and -9 expression following context dependent learning of nicotine-induced conditioned place preference (CPP). Members of a CPP procedural control group also indicated similar MMP changes, suggesting that memory activation occurred in these animals as well. However, hippocampal MMP-9 expression was differentially elevated in members of the nicotine-induced CPP group on days 4 and 5 of training. Inhibition of MMPs using a broad spectrum MMP inhibitor (FN439) during nicotine-induced CPP training blocked the acquisition of CPP. Elevations in hippocampal and prefrontal cortex MMP-3 expression-but not MMP-2 and -9-accompanied reactivation of a previously learned drug related memory. Decreases in the actin regulatory cytoskeletal protein cortactin were measured in the HIP and PFC during the initial two days of acquisition of CPP; however, no changes were seen following re-exposure to the drug related environment. These results suggest that MMP-9 may be involved in facilitating the intracellular and extracellular events required for the synaptic plasticity underlying the acquisition of nicotine-induced CPP. Furthermore, MMP-3 appears to be important during re-exposure to the drug associated environment. However, rats introduced into the CPP apparatus and given injections of vehicle rather than nicotine during training also revealed a pattern of MMP expression similar to nicotine-induced CPP animals.Journal of Experimental Neuroscience 01/2013; 7:1-14.
- [Show abstract] [Hide abstract]
ABSTRACT: Background and Objectives Female smokers have greater difficulty quitting, possibly due to increased reactivity to smoking-related cues. This study assessed sex differences in craving, affect, and preference for immediate smoking after cue exposure.Methods Regular smokers (n = 60; 50% female) were exposed to smoking and neutral cues in separate, counterbalanced sessions. Outcomes included changes in craving and affect and preference for immediate smoking following cue exposure.ResultsFindings indicated that women exhibited greater preference for immediate smoking (p = .004), and reported greater cue-induced increases in cigarette craving (p = .046) and negative affect (p = .025).Discussion and Conclusions These data suggest that women may have greater difficulty inhibiting smoking after cue exposure, possibly as a consequence of greater increases in craving and negative affect.Scientific Significance and Future DirectionsFindings suggest a mechanism that may contribute to greater cessation failure among female smokers. (Am J Addict 2014;23:211–217)American Journal on Addictions 05/2014; 23(3). · 1.74 Impact Factor