Progesterone for smoking relapse prevention following delivery: A pilot, randomized, double-blind study

Forray, Ariadna; Gilstad‐Hayden, Kathryn; Suppies, Cristine; Bogen, Debra L.; Sofuoglu, Mehmet; Yonkers, Kimberly A.

doi:10.1016/j.psyneuen.2017.09.012

Cited by 27 publications

(16 citation statements)

References 49 publications

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“…Results of this study support our and others’ prior findings that women who attempt to quit smoking in the luteal phase of the menstrual cycle (high progesterone) may have better smoking cessation outcomes . Results of this study also complement previous findings that exogenous progesterone may be helpful in preventing postpartum smoking relapse . However, the lack of an association between endogenous progesterone levels and study outcomes suggests that the progesterone itself may not be the direct cause of improved cessation outcomes in women.…”

Section: Discussionsupporting

confidence: 85%

“…In a recent 12‐week double‐blind, placebo‐controlled randomized pilot trial ( n = 46), we observed that at 4 weeks postpartum, 7‐day point prevalence abstinence (PPA) rates were higher in the progesterone‐treated group versus the placebo group (75.0 versus 68.2%; P = 0.75) . A similar study by Forray and colleagues (2017; n = 41) found that postpartum women taking progesterone were 1.8 times more likely to be abstinent during week 8 of treatment .…”

Section: Introductionmentioning

confidence: 79%

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Exogenous progesterone for smoking cessation in men and women: a pilot double‐blind, placebo‐controlled randomized clinical trial

Tosun

Fieberg

Eberly³

et al. 2019

Addiction

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Background and Aims In some clinical studies men and women have been found to differ in their ability to quit smoking, perhaps as a result of progesterone. The primary aim of this study was to provide a preliminary test of whether progesterone (PRO), compared with placebo (PBO), was more effective for smoking cessation in men and women. Design Pilot double‐blind, placebo‐controlled randomized clinical trial. Setting Minneapolis/St Paul metro area, Minnesota, USA. Participants A total of 216 participants were randomized, including 113 men (18–60 years; PRO = 56, PBO = 57) and 103 women (18–50 years, pre‐menopausal with self‐reported regular menstrual cycles; PRO = 51, PBO = 52). Intervention Participants were randomized (1 : 1 within sex group) to either PRO (200 mg twice daily) or PBO. Participants were assigned a quit date approximately 7 days after starting medication (luteal phase for women) and were followed for 12 weeks to assess relapse. Measurements The primary outcome was self‐reported 7‐day point prevalence abstinence (PPA) at week 4. Secondary outcomes included 7‐day PPA at weeks 8 and 12, prolonged abstinence, continuous abstinence, urine cotinine < 50 ng/ml, expired carbon monoxide ≤ 5 parts per million (p.p.m.) and days to relapse. Findings There was a significant difference in 7‐day PPA at week 4 among women [PRO: 18 (35.3%) versus PBO: 9 (17.3%), odds ratio (OR) = 2.61, 95% confidence interval (CI) = 1.04, 6.54, P = 0.041], but not among men [PRO: 13 (23.2%) versus PBO: 12 (21.1%), 1.13 (0.47, 2.76), P = 0.782]. There was some evidence that PRO delayed relapse in women (days to relapse; PRO: 20.5 ± 29.6 versus PBO: 14.3 ± 26.8, P = 0.03) but not in men (PRO: 13.4 ± 25.9 versus PBO: 13.3 ± 23.8, P = 0.69). Conclusions Oral micronized progesterone may aid smoking cessation in women.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 79%

Exogenous progesterone for smoking cessation in men and women: a pilot double‐blind, placebo‐controlled randomized clinical trial

Tosun

Fieberg

Eberly³

et al. 2019

Addiction

View full text Add to dashboard Cite

show abstract

“…For instance, high endogenous progesterone is associated with better efficacy of transdermal nicotine patch replacement therapy for relief of smoking urges [115], and administration of exogenous progesterone reduces positive subjective effects of smoking cigarettes [116] and cocaine [117]. Smoking cessation therapies may potentially be able to leverage menstrual cycle phase to reduce relapse by identifying the optimal cycle window in which to initiate abstinence; however, findings to date have been mixed, with some studies showing no effect of cycle phase on cessation [118–120], others showing better outcomes when cessation is initiated in the low progesterone follicular phase [121,122], and still others showing better outcomes when cessation is initiated in the luteal phase [123–125] or when progesterone levels are high [126,127]. Expert recommendations to clarify these findings have been made [128], and can be adapted from the smoking literature to inform evaluations of ovarian hormone effects in other substance use disorders.…”

Section: Implications Future Directions and Conclusionmentioning

confidence: 99%

Addiction and dopamine: sex differences and insights from studies of smoking

Petersen

London

2018

Current Opinion in Behavioral Sciences

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Mesolimbic dopaminergic function influences addiction through effects on reinforcement learning, decision-making, and impulsivity. This review covers sex differences in dopaminergic neurochemistry, their hormonal and genetic determinants, and how differences in dopaminergic tone interact with sex and/or ovarian hormone status to affect cognitive functions. Findings from research on cigarette smoking reveal sex differences in striatal and midbrain dopamine D2-type receptor availability and striatal dopamine release that suggest mechanisms of nicotine dependence, and stronger subjective responses to nicotine and efficacy of nicotine replacement therapies in male smokers than in their female counterparts. Opportunities exist to extend such efforts in studies of how sex and hormone status influence other addictions.

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“…Twice-daily exogenous administration of 200 mg oral micronized progesterone increased rates of abstinence at 1 month after the initiation of treatment and delayed relapse in women, but not men [1]. These results add to a growing literature identifying that the administration of exogenous progesterone may serve as a novel intervention for substance use disorders, including tobacco use [2][3][4]. However, the mechanism underlying beneficial treatment effects is unclear.…”

mentioning

confidence: 72%

Hormonal contraceptive use in smokers: Prevalence of use and associations with smoking motives

Allen

Lundeen

Eberly

et al. 2018

Addictive Behaviors

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Progesterone for smoking relapse prevention following delivery: A pilot, randomized, double-blind study

Cited by 27 publications

References 49 publications

Exogenous progesterone for smoking cessation in men and women: a pilot double‐blind, placebo‐controlled randomized clinical trial

Exogenous progesterone for smoking cessation in men and women: a pilot double‐blind, placebo‐controlled randomized clinical trial

Addiction and dopamine: sex differences and insights from studies of smoking

Hormonal contraceptive use in smokers: Prevalence of use and associations with smoking motives

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