Menstrual Cycle Phase at Quit Date Predicts Smoking Status in an NRT Treatment Trial: A Retrospective Analysis

Franklin, Teresa R.; Ehrman, Ronald N.; Lynch, Kevin G.; Harper, Derek; Sciortino, Nathan; O’Brien, Charles P.; Childress, Anna Rose

doi:10.1089/jwh.2007.0423

Cited by 84 publications

(95 citation statements)

References 24 publications

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“…The higher levels of nicotine absorption during follicular phase in women without depressive symptoms may offer additional evidence to explain the seemingly conflicting results of the studies that have assessed smoking cessation outcomes by menstrual phase (Allen et al, 2008;Allen et al, 2009b;Carpenter et al, 2008;Franklin et al, 2008;Mazure et al, 2011). The effectiveness of the nicotine patch may vary by menstrual phase given the differences in nicotine absorption, with higher nicotine levels attained in the follicular phase.…”

Section: Discussionmentioning

confidence: 99%

“…In women who are attempting to quit smoking, menstrual phase, perhaps via sex hormones (specifically progesterone and estradiol), appears to be associated with risk for smoking relapse (Allen, Bade, Center, Finstad, & Hatsukami, 2008;Allen S.S, Allen A.M, Lunos, & Hatsukami, 2009b;Carpenter, Saladin, Leinbach, Larowe, & Upadhyaya, 2008;Franklin et al, 2008;Mazure, Toll, McKee, Wu, & O'Malley, 2011). Women who attempted to quit smoking during the luteal phase (the last 14 days of the menstrual cycle with relatively high levels of progesterone and low levels of estrogen) had improved smoking cessation outcomes compared with those who quit during the early follicular phase (begins after menses with relatively low levels of both progesterone and estrogen) in the absence of nicotine replacement therapy (NRT) (Allen et al, 2008;Allen et al, 2009b;Mazure et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Women who attempted to quit smoking during the luteal phase (the last 14 days of the menstrual cycle with relatively high levels of progesterone and low levels of estrogen) had improved smoking cessation outcomes compared with those who quit during the early follicular phase (begins after menses with relatively low levels of both progesterone and estrogen) in the absence of nicotine replacement therapy (NRT) (Allen et al, 2008;Allen et al, 2009b;Mazure et al, 2011). However, other studies that used NRT observed improved smoking cessation outcomes in the follicular phase compared with the luteal phase (Carpenter et al, 2008;Franklin et al, 2008). Aside from differences in study methodology, one theory to explain these seemingly discordant observations is that among women smokers who did not use NRT, estradiol (which peaks in the late follicular phase) may enhance the reinforcing effects of nicotine and, therefore, favor relapse.…”

Section: Introductionmentioning

confidence: 99%

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Menstrual Phase and Depressive Symptoms Differences in Physiological Response to Nicotine Following Acute Smoking Abstinence

Allen

Kotlyar

et al. 2012

Nicotine & Tobacco Research

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Menstrual Phase and Depressive Symptoms Differences in Physiological Response to Nicotine Following Acute Smoking Abstinence

Allen

Kotlyar

et al. 2012

Nicotine & Tobacco Research

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“…This is strongly supported by preclinical work 14,15 but clinical studies are mixed. [16][17][18][19][20] In pregnancy, progesterone increases by more than 10 fold and certain estrogen levels increase by up to 1000 fold, then within the first few hours postpartum levels drop to near pre pregnancy levels. 21 Sex hormone levels remain low until women begin naturally cycling and sex hormones become more balanced.…”

Section: Introductionmentioning

confidence: 99%

Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial

Allen

Lunos

et al. 2016

NICTOB

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Introduction: Pregnancy is a strong motivator to quit smoking, yet postpartum relapse rates are high. Growing evidence suggests a role of sex hormones in drug abuse behavior and given the precipitous drop in sex hormones at delivery, they may play a role in postpartum relapse. This pilot study evaluates the feasibility and potential role of exogenous progesterone in postpartum smoking relapse. Methods: This 12-week double-blind placebo-controlled randomized pilot trial randomized 46 abstinent postpartum women to active progesterone (PRO; 200 mg twice a day) versus placebo (PBO) for 4 weeks. Participants were followed for relapse for 12 weeks. Main study outcomes include abstinence (point prevalence), feasibility (compliance per number of clinic visits attended, pill counts and Electronic Data Capture [EDC] completed) and self-reported acceptability. Safety was also measured by depressive symptom scores, adverse events, and breastfeeding. Results: Overall retention rate was 87% at week 12. At week 4, abstinence rates were 75% in the PRO group and 68.2% in the PBO group (p = .75). Medication adherence was 68% and clinic visit attendance was 80%, with no differences by randomization. Depressive symptom scores, adverse events, and breastfeeding did not vary by randomization. Conclusions: Although the study was not powered to evaluate abstinence rates, we did observe a higher prevalence of abstinence at week 4 in the PRO group. Further, exogenous progesterone was well tolerated and did not adversely affect depressive symptoms or breastfeeding. Thus, the results of this pilot study indicate further investigation into progesterone as a postpartum relapse prevention strategy is warranted. Implications: This innovative pilot trial determined the feasibility of delivering exogenous progesterone as a potential prevention of postpartum smoking relapse. We observed high retention and moderate adherence rates, as well as high acceptability among participants. Further, though not statistically significant, more women in the treatment group remained abstinent from smoking during follow-up. This project adds to the growing body of literature on the role of sex hormones in smoking relapse and also provides support for a fully powered clinical trial.

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“…5,6 In a smoking cessation intervention, women who quit smoking during the luteal phase were twice as likely to have relapsed at 9 weeks compared with women who quit during the follicular phase. 7 Given that physical inactivity is second only to smoking as a modifiable lifestyle risk factor that causes morbidity and mortality, 8 understanding the influence of menstrual cycle on exercise behavior may provide insight into a crucial area of women's health. Furthermore, evidence has shown that aspects of physiological response to exercise, such as thermoregulation, ventilation, and cardiovascular strain, are influenced by hormonal fluctuations across the cycle.…”

Section: Introductionmentioning

confidence: 99%

Menstrual Cycle Effects on Perceived Exertion and Pain During Exercise Among Sedentary Women

Hooper

Bryan²,

Eaton³

2011

Journal of Women's Health

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Background: Increasing cardiovascular fitness through exercise participation among sedentary people is important for decreasing all-cause mortality. From an intervention perspective, identifying modifiable factors that maximize the successful initiation of exercise is of utmost importance. For women, cyclic hormonal variations can influence aspects of health and health behaviors, from smoking cessation efficacy to physiological responses to exercise. The purpose of this study was to examine the influence of menstrual cycle phase and hormonal contraceptive (HC) use on subjective response to an initial bout of moderate intensity exercise among previously sedentary women (n ¼ 117). Methods: Women completed a treadmill exercise challenge session at 65% of their previously determined maximum oxygen consumption (Vo 2 max) during the early follicular, late follicular, or luteal phase. Participants reported ratings of perceived exertion and pain using Borg's Rating of Perceived Exertion (RPE) and CR10 scales at 10, 20, and 30 minutes during the exercise session.Results: There was a significant menstrual phaseÂbirth control interaction on change in RPE [F(2, 111) ¼ 3.75, p < 0.05] and change in perceived pain [F(2, 110) ¼ 3.31, p < 0.05]. Women in the early follicular phase who were not using HCs had significantly greater increases in RPE and increases in pain compared with women in the late follicular and luteal phases. Conclusions: Our results indicate that the use of HC and cycle phase influence sedentary women's subjective response to exercise. These results have important implications for the timing of exercise interventions aimed at increasing exercise among sedentary women.

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Menstrual Cycle Phase at Quit Date Predicts Smoking Status in an NRT Treatment Trial: A Retrospective Analysis

Abstract: These data support the supposition that better treatment outcomes can be achieved by scheduling quit dates to coincide with the follicular phase of the MC in female smokers.

Cited by 84 publications

References 24 publications

Menstrual Phase and Depressive Symptoms Differences in Physiological Response to Nicotine Following Acute Smoking Abstinence

Menstrual Phase and Depressive Symptoms Differences in Physiological Response to Nicotine Following Acute Smoking Abstinence

Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial

Menstrual Cycle Effects on Perceived Exertion and Pain During Exercise Among Sedentary Women

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