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Menstrual Cycle Influences Smoking-Cessation Success: Presented at SFN

By Glynn Wilson

NEW ORLEANS, LA -- November 13, 2003 -- For women in treatment to quit smoking, success may depend on taking into account the influence of their menstrual cycle, according to a study presented here November 11^th at the Society for Neuroscience 33^rd Annual Meeting.

Previous studies have shown that females have a harder time quitting smoking, and less success with a nicotine replacement therapy (NRT), such as the patch, than males, said lead author Teresa R Franklin, PhD, Department of Psychiatry, University of Pennsylvania, Philadelphia, United States.

Previous research found that women in the luteal phase, which corresponds to the 2 weeks prior to menstruation, had more cravings for cigarettes than women in the follicular phase, which is equivalent to the 2 weeks prior to ovulation.

"We reasoned that women who attempted to quit smoking in the luteal phase of their cycle would have more difficulty stopping than women in the follicular phase," Dr. Franklin said.

This study tested that hypothesis in a group of women who had completed an NRT (patch) study for smoking cessation at the University of Pennsylvania Addiction Treatment Research Center. Women were grouped according to cycle phase -- 16 in the follicular phase and 21 in the luteal phase -- and measured at their quit date, for the first 3 days of nicotine replacement, after 8 weeks of treatment, at 6 months and at 1 year following treatment.

The researchers found that at 3 days into treatment, luteal females were twice as likely to report smoking), in comparison to follicular females (52 versus 19%, P < .04).

"This is meaningful, [since] previous research has shown that lapse (having one cigarette) is predictive of relapse (reverting to pre-treatment smoking behavior)," Dr. Franklin said.

Smoking prevalence was examined at the end of treatment. The effect of cycle phase was even more pronounced by the end of treatment (69% luteal versus 25% follicular females were smoking, P < .02).

The result was verified by examining subjects' urine for levels of cotinine (the major metabolite of nicotine, absent in nonsmokers).

"The results of this study suggest that earlier inconsistencies in the literature may indeed be partially related to uneven numbers of women beginning treatment in the luteal versus follicular phase," Dr. Franklin said. "Menstrual cycle phase at quit date is a strong predictor of treatment outcome, and future smoking-cessation treatments should monitor phase and time accordingly."

The study may also have implications for other medical treatments of women.

"This study suggests that it may be critically important to monitor cycle phase, not only for smoking cessation, but for many types of treatment-outcome studies that involve women," Dr. Franklin concluded.


[Study title: Menstrual Cycle Phase at Onset of Smoking Cessation Predicts Treatment Outcome. Abstract 559.4]

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