Nicotine patches and gum less effective for women than men

With studies showing smoking could be on the rise despite the fact that the self-destructive habit is projected to kill nearly a third all cigarette smokers, research at Texas A&M University reveals that one of the most widely used forms of treatment - nicotine replacement therapy (NRT), or nicotine chewing gum and 'the patch' - may be less effective for women than men.

Antonio Cepeda-Benito, an associate professor of psychology at Texas A&M who studies drug addiction and nicotine dependency and treatment, says women using NRT generally find it harder than men to quit smoking. Cepeda-Benito, along with colleagues Jose T. Reynoso and Stephen Erath, conducted an analysis of several major smoking studies and found NRT was equally helpful to men and women in the short term, but in the long term, women were less likely than men to remain smoke-free. Their research appears in the August issue of the Journal of Consulting and Clinical Psychology, published by the American Psychological Association.

"We found that NRT given with low-adjunct support was efficacious across all follow-up periods for men only," he says. "At midterm follow-up, NRT was efficacious for women if the treatment was given only in conjunction with an intensive treatment approach. At long-term follow up, men benefited and women did not benefit from NRT regardless of whether or not they received the treatment in conjunction with high or low levels of support."

Cepeda-Benito says data from the U.S. Department of Health and Human Services indicates about 75 percent of women daily smokers are interested in quitting, but the odds are stacked against them, with less than 10 percent of those who quit remaining abstinent in a given year. Further complicating matters is the lack of assistance in quitting smoking provided to women because, as some studies suggest, physicians are less likely to ascertain women's smoking status and advise to quit smoking, he notes.

Cepeda-Benito and his colleagues say their results suggest that women looking to kick the habit use a combination of NRT and comprehensive smoking cessation programs.

Such a program, he explains, would need to address the many variables that influence smoking behavior in women, Cepeda-Benito notes. He says studies have shown that in comparison with men, women are more craving-reactive to smoking related cues, they enjoy the olfactory - taste and hand-to-mouth sensations associated with smoking and the have greater expectations that smoking will enhance or facilitate social interactions, reduce negative moods and prevent weight gain.

For these reasons, Cepeda-Benito says women may need a truly comprehensive psychological intervention that addresses these variables.

In addition, women's fast return to smoking in the low-intensity NRT group could also lead to a recommendation to prolong the prescription of NRT, he says.

"These two recommendations are not incompatible because at some point NRT needs to be discontinued, and at that point smokers still need and benefit from learned skills and increased motivation to prevent smoking relapse," he explains.