Transdermal nicotine use in postmenopausal women: Does the treatment efficacy differ in women using and not using hormone replacement therapy?

Abstract

This study of postmenopausal female smokers (N = 94) asked: During short-term smoking abstinence, do the beneficial effects of transdermal nicotine replacement therapy (NRT) on acute symptomatology (i.e., withdrawal, cigarette craving, smoking urges, mood, depressive symptoms, motor speed, and reaction time) differ in women who use and do not use hormone replacement therapy (HRT)? Participants were recruited according to HRT and non-HRT use (self-selecting), then randomized within strata to active nicotine or placebo nicotine patch. After 1 baseline week of smoking, participants quit smoking for 2 weeks. Women received cessation counseling and were monitored for abstinence. Dependent measures were collected during five clinic visits. Two-way analysis of covariance (ANCOVA) were run on change scores for dependent variables, with nicotine patch group (active/placebo) and HRT group (HRT/non-HRT) as independent variables and age as a covariate. No interactions were found between HRT and patch condition, but both showed specific effects. During the first abstinent week, women on active nicotine patch (compared with placebo) experienced less severe withdrawal, greater reductions in cigarette cravings, and lower (more favorable) Factor 1 scores on the Questionnaire of Smoking Urges. During the second abstinent week, women using HRT (compared with the non-HRT group) exhibited better mood (Profile of Mood States scores) and less depression (Beck Depression Inventory scores). These results suggest the following: First, the efficacy of transdermal nicotine replacement is not adversely modified by women's HRT use; second, ovarian hormones might influence women's responses to smoking cessation, and thus should be considered in developing effective strategies for women to quit smoking.

Increased impulsive choice for saccharin during PCP withdrawal in female monkeys: influence of menstrual cycle phase

“…However, self-administration of other drugs of abuse such as alcohol (Freitag and Adesso 1993; Hay et al 1984; Holdstock and de Wit 2000; Nyberg et al 2004; Sutker et al 1987), nicotine (Allen et al 1999, 2004; Snively et al 2000), marijuana (Lex et al 1984), and opioids (e.g., Gear et al 1996) does not vary as consistently with phase of the menstrual cycle in humans as does self administration of stimulants such as cocaine and methamphetamine (see review by Anker and Carroll 2011). Other drug classes may not have been studied extensively enough for a clear pattern of results to emerge, or they are not responsive to hormonal fluctuations over the menstrual cycle.…”

“…Furthermore, clinical work on smoking cessation during specific phases of the menstrual cycle indicated that the follicular phase (low progesterone) may be associated with more favorable outcomes when nicotine replacement therapy is used (Franklin et al 2007; Carpenter et al 2008). In contrast, quit attempts during the follicular phase (vs luteal) result in worse smoking cessation outcomes when behavioral strategies, or when non-nicotine (e.g., buproprion) or no medications are used to treat smoking cessation (Allen et al 1999, 2004, 2008, 2009; Mazure et al 2011). Thus, timing quit attempts to specific phases of the menstrual cycle as a function of the type of abused drug and treatment strategy is potentially important to a successful treatment outcome.…”

The role of progestins in the behavioral effects of cocaine and other drugs of abuse: Human and animal research

“…For example, similar to drug intake, research has been unable to establish a connection between menstrual cycle and self-reported measures of positive affect, intoxication, and craving. Subjective measures were insensitive to menstrual cycle effects following alcohol (Freitag and Adesso, 1993; Hay et al, 1984; Holdstock and de Wit, 2000; Nyberg et al, 2004; Sutker et al, 1987), nicotine (Allen et al, 1999, 2004; Pomerleau et al, 1992, 2000; Snively et al, 2000), marijuana (Lex et al, 1984), and opioid (Gear et al, 1996) administration in women; however, similar to results with cocaine (Evans and Foltin, 2006; Evans et al, 2002; Sofuoglu et al, 1999), women reported decreased positive subjective effects following amphetamine administration during the luteal phase compared to follicular phase of the menstrual cycle (Justice and de Wit, 1999, 2000; White et al, 2002). Overall, these findings indicate a lack of an effect of menstrual cycle phase on behavioral/physiological and subjective measures of alcohol, nicotine, marihuana, and opioid use in humans.…”

Smoking cessation in peri- and postmenopausal women: A review.

“…There is some evidence that HT, particularly when combined with antidepressants, can reduce affective symptoms experienced during the menopausal transition (Parry, 2010; Schneider et al, 1997). When examining the effects of HT on mood changes following smoking cessation, Allen and colleagues (2003, 2004) found conflicting results in their two studies (Allen, Hatsukami, Bade, & Center, 2004; Allen, Hatsukami, & Christianson, 2003). In both studies, HT participants were using 0.1 mg estradiol transdermal system and 2.5 mg of Cycrin daily.…”