IntroductionMost quit attempts end in relapse, 1 and there is evidence that female smokers have more difficulty quitting smoking than male smokers. [2][3][4] This gender difference has often been observed in clinical trials, 5,6 but population-based evidence for gender differences in quit success has been mixed. 7,8 An appeal for research identifying mechanisms related to these disparate cessation outcomes has been made in the smoking literature. 9 Craving, stress, and negative affect (NA) have been hypothesized as potential factors underlying gender differences in quit rates.
10Previous research has demonstrated gender differences in reactivity to cues presented in the laboratory setting. Saladin et al.
11conducted a laboratory-based study examining gender differences in response to smoking cues (holding and viewing a cigarette), stress cues (listening to a description of a recent life event that the participant identified as stressful), and neutral cues (holding and viewing a pack of pencils and an eraser while listening to a description
Original investigation
Gender Differences in Responses to
AbstractIntroduction: Although the evidence is mixed, female smokers appear to have more difficulty quitting smoking than male smokers. Craving, stress, and negative affect have been hypothesized as potential factors underlying gender differences in quit rates. Methods: In the current study, the cue-reactivity paradigm was used to assess craving, stress, and negative affect in response to cues presented in the natural environment of cigarette smokers using ecological momentary assessment. Seventy-six daily smokers (42% female) responded to photographs (smoking, stress, and neutral) presented 4 times per day on an iPhone over the course of 2 weeks. Results: Both smoking and stress cues elicited stronger cigarette craving and stress responses compared to neutral cues. Compared with males, females reported higher levels of post-stress cue craving, stress, and negative affect, but response to smoking cues did not differ by gender. Discussion: Findings from this project were largely consistent with results from laboratory-based research and extend previous work by measuring response to cues in the natural environment of cigarette smokers. This study extends previous cue reactivity ecological momentary assessment research by using a new platform and by measuring response to stress cues outside of the laboratory. Findings from this project highlight the importance of addressing coping in response to stress cues in clinical settings, especially when working with female smokers.