Gender differences in craving and cue reactivity to smoking and negative affect/stress cues.

There is evidence that women may be less successful when attempting to quit smoking than men. One potential contributory cause of this gender difference is differential craving and stress reactivity to smoking- and negative affect/stress-related cues. The present human laboratory study investigated the effects of gender on reactivity to smoking and negative affect/stress cues by exposing nicotine dependent women (n = 37) and men (n = 53) smokers to two active cue types, each with an associated control cue: (1) in vivo smoking cues and in vivo neutral control cues, and (2) imagery-based negative affect/stress script and a neutral/relaxing control script. Both before and after each cue/script, participants provided subjective reports of smoking-related craving and affective reactions. Heart rate (HR) and skin conductance (SC) responses were also measured. Results indicated that participants reported greater craving and SC in response to smoking versus neutral cues and greater subjective stress in response to the negative affect/stress versus neutral/relaxing script. With respect to gender differences, women evidenced greater craving, stress and arousal ratings and lower valence ratings (greater negative emotion) in response to the negative affect/stressful script. While there were no gender differences in responses to smoking cues, women trended towards higher arousal ratings. Implications of the findings for treatment and tobacco-related morbidity and mortality are discussed.

[1]  Stephen T. Tiffany,et al.  Production of smoking urges through imagery: The impact of affect and smoking abstinence. , 1996 .

[2]  G A Miller,et al.  Emotional imagery: conceptual structure and pattern of somato-visceral response. , 1980, Psychophysiology.

[3]  M. Litt,et al.  Reactivity to alcohol cues and induced moods in alcoholics. , 1990, Addictive behaviors.

[4]  Dustin C. Lee,et al.  Prolonged duration of craving, mood, and autonomic responses elicited by cues and imagery in smokers: Effects of tobacco deprivation and sex. , 2010, Experimental and clinical psychopharmacology.

[5]  D. Wetter,et al.  Gender differences in response to nicotine replacement therapy: objective and subjective indexes of tobacco withdrawal. , 1999, Experimental and clinical psychopharmacology.

[6]  D. Abrams,et al.  Response to social stress, urge to smoke, and smoking cessation. , 2002, Addictive behaviors.

[7]  C. Husten,et al.  Cigarette smoking and smoking cessation among older adults: United States, 1965-94. , 1997, Tobacco control.

[8]  E. Wynder,et al.  Cumulative tar exposure. A new index for estimating lung cancer risk among cigarette smokers , 1992, Cancer.

[9]  M. Carroll,et al.  Biological basis of sex differences in drug abuse: preclinical and clinical studies , 2002, Psychopharmacology.

[10]  D. Wetter,et al.  Gender Differences in Smoking Cessation , 1998 .

[11]  S. Tiffany,et al.  The effect of alcohol consumption on craving to smoke. , 1997, Addiction.

[12]  S. Fortmann,et al.  Evaluation of a treatment approach combining nicotine gum with self-guided behavioral treatments for smoking relapse prevention. , 1990, Journal of consulting and clinical psychology.

[13]  Gregory A. Miller,et al.  Individual differences in imagery and the psychophysiology of emotion , 1987 .

[14]  R. Ehrman,et al.  Effect of smoking cues and cigarette availability on craving and smoking behavior. , 1995, Addictive behaviors.

[15]  D. Abrams,et al.  Individual differences in cue reactivity among smokers trying to quit: effects of gender and cue type. , 1998, Addictive behaviors.

[16]  S. Shiffman,et al.  Are there gender differences in smoking cessation, with and without bupropion? Pooled- and meta-analyses of clinical trials of Bupropion SR. , 2004, Addiction.

[17]  M. Litt,et al.  Alcohol cue reactivity, negative-mood reactivity, and relapse in treated alcoholic men. , 1997, Journal of abnormal psychology.

[18]  Rachel Kozink,et al.  Individual Differences in Nicotine Dependence, Withdrawal Symptoms, and Sex Predict Transient fMRI-BOLD Responses to Smoking Cues , 2008, Neuropsychopharmacology.

[19]  O. Parsons,et al.  Cardiovascular differentiation of emotions. , 1992, Psychosomatic medicine.

[20]  William D S Killgore,et al.  Sex-specific developmental changes in amygdala responses to affective faces , 2001, Neuroreport.

[21]  S. Fortmann,et al.  Who shall quit? Comparison of volunteer and population-based recruitment in two minimal-contact smoking cessation studies. , 1994, American journal of epidemiology.

[22]  T J Payne,et al.  Exposure to smoking-relevant cues: effects on desire to smoke and topographical components of smoking behavior. , 1991, Addictive behaviors.

[23]  D. Hatsukami,et al.  Effects of transdermal nicotine on craving, withdrawal and premenstrual symptomatology in short-term smoking abstinence during different phases of the menstrual cycle. , 2000, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[24]  M. Field,et al.  Cue reactivity in smokers: the effects of perceived cigarette availability and gender , 2004, Pharmacology Biochemistry and Behavior.

[25]  O. Miettinen,et al.  Women's susceptibility to tobacco carcinogens and survival after diagnosis of lung cancer. , 2006, JAMA.

[26]  S. Shiffman,et al.  Smoking relapse situations: a preliminary typology. , 1985, The International journal of the addictions.

[27]  K. Perkins,et al.  Sex differences in the subjective and reinforcing effects of cigarette nicotine dose , 2002, Psychopharmacology.

[28]  Dana H Bovbjerg,et al.  Smoking-related videos for use in cue-induced craving paradigms. , 2007, Addictive behaviors.

[29]  K. Perkins,et al.  Sex differences in nicotine effects and self-administration: review of human and animal evidence. , 1999, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[30]  Jason D. Robinson,et al.  Gender differences in affective response to acute nicotine administration and deprivation. , 2007, Addictive behaviors.

[31]  R. Ehrman,et al.  Comparing levels of cocaine cue reactivity in male and female outpatients. , 1999, Drug and alcohol dependence.

[32]  E. Wynder,et al.  Differences in lung cancer risk between men and women: examination of the evidence. , 1996, Journal of the National Cancer Institute.

[33]  V. Knott,et al.  Craving-Induced EEG Reactivity in Smokers: Effects of Mood Induction, Nicotine Dependence and Gender , 2009, Neuropsychobiology.

[34]  Mitchell H. Gail,et al.  Community Intervention Trial for Smoking Cessation (COMMIT): I. cohort results from a four-year community intervention. , 1995, American journal of public health.

[35]  Rajita Sinha,et al.  Gender differences in response to emotional stress: an assessment across subjective, behavioral, and physiological domains and relations to alcohol craving. , 2008, Alcoholism, clinical and experimental research.

[36]  P. Willner,et al.  The Questionnaire of Smoking Urges is sensitive to abstinence and exposure to smoking-related cues. , 1999, Behavioural pharmacology.

[37]  Kenneth I Forster,et al.  DMDX: A Windows display program with millisecond accuracy , 2003, Behavior research methods, instruments, & computers : a journal of the Psychonomic Society, Inc.

[38]  Megan E. Piper,et al.  Addiction motivation reformulated: an affective processing model of negative reinforcement. , 2004, Psychological review.

[39]  T. Baker,et al.  Postcessation cigarette use: the process of relapse. , 1990, Addictive behaviors.

[40]  J. J. Johnston,et al.  Social support for smoking cessation and abstinence: the Lung Health Study. Lung Health Study Research Group. , 1995, Addictive behaviors.

[41]  K. Perkins,et al.  Subjective and reinforcing effects of smoking during negative mood induction. , 2005, Journal of abnormal psychology.

[42]  A. Miller,et al.  Are female smokers at higher risk for lung cancer than male smokers? A case-control analysis by histologic type. , 1993, American journal of epidemiology.

[43]  D J Rohsenow,et al.  Alcohol cue reactivity and mood induction in male and female alcoholics. , 1994, Journal of studies on alcohol.

[44]  L. Kozlowski,et al.  The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. , 1991, British journal of addiction.

[45]  G. Kaplan,et al.  High-dose transdermal nicotine and naltrexone: effects on nicotine withdrawal, urges, smoking, and effects of smoking. , 2007, Experimental and clinical psychopharmacology.

[46]  Dana H Bovbjerg,et al.  Stress- and cue-induced cigarette craving: effects of a family history of smoking. , 2007, Drug and alcohol dependence.

[47]  A. Garvey,et al.  Gender differences in the outcome of an unaided smoking cessation attempt. , 1997, Addictive behaviors.

[48]  D. Hatsukami,et al.  Withdrawal and pre-menstrual symptomatology during the menstrual cycle in short-term smoking abstinence: effects of menstrual cycle on smoking abstinence. , 1999, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[49]  S. Morchón,et al.  Effects of partner smoking status and gender on long term abstinence rates of patients receiving smoking cessation treatment. , 2007, Addictive behaviors.

[50]  M. Bradley,et al.  Measuring emotion: the Self-Assessment Manikin and the Semantic Differential. , 1994, Journal of behavior therapy and experimental psychiatry.

[51]  R. Hurt,et al.  Self-administered Nicotine-Dependence Scale (SANDS): item selection, reliability estimation, and initial validation. , 1994, Journal of clinical psychology.

[52]  Jie Shi,et al.  Gender and stimulus difference in cue-induced responses in abstinent heroin users , 2007, Pharmacology Biochemistry and Behavior.

[53]  P. Lang,et al.  Individual differences in autonomic response: conditioned association or conditioned fear? , 1985, Psychophysiology.

[54]  K. Cosgrove,et al.  Sex differences in the vulnerability to drug abuse: a review of preclinical studies , 2004, Neuroscience & Biobehavioral Reviews.

[55]  A. Buist,et al.  Gender differences in smoking cessation after 3 years in the Lung Health Study. , 1995, American journal of public health.

[56]  B. Carter,et al.  Meta-analysis of cue-reactivity in addiction research. , 1999, Addiction.

[57]  L. Cox,et al.  Evaluation of the brief questionnaire of smoking urges (QSU-brief) in laboratory and clinical settings. , 2001, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[58]  S. Shiffman,et al.  A cluster-analytic classification of smoking relapse episodes. , 1986, Addictive behaviors.

[59]  S. Tiffany,et al.  Induction of smoking urge through imaginal and in vivo procedures: physiological and self-report manifestations. , 1997, Journal of abnormal psychology.

[60]  C. Kilts,et al.  The neural correlates of cue-induced craving in cocaine-dependent women. , 2004, The American journal of psychiatry.

[61]  M. Saladin,et al.  Menstrual cycle and cue reactivity in women smokers. , 2010, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[62]  D. Abrams,et al.  Cue elicited urge to drink and salivation in alcoholics: Relationship to individual differences , 1992 .

[63]  D. Abrams,et al.  A content analysis of smoking craving. , 2001, Journal of clinical psychology.

[64]  J. McKay,et al.  Gender differences in the relapse experiences of cocaine patients. , 1996, The Journal of nervous and mental disease.

[65]  L. Cahill Why sex matters for neuroscience , 2006, Nature Reviews Neuroscience.

[66]  B. Carter,et al.  The cue-availability paradigm: the effects of cigarette availability on cue reactivity in smokers. , 2001, Experimental and clinical psychopharmacology.

[67]  Verner Knott,et al.  EEG correlates of imagery-induced cigarette craving in male and female smokers. , 2008, Addictive behaviors.

[68]  K. Hutchison,et al.  Smoking cues decrease prepulse inhibition of the startle response and increase subjective craving in humans. , 1999, Experimental and clinical psychopharmacology.

[69]  S. Tiffany,et al.  Imagery and smoking urges: the manipulation of affective content. , 1990, Addictive behaviors.

[70]  D. Kavanagh,et al.  Addition of cue exposure to cognitive-behaviour therapy for alcohol misuse: a randomized trial with dysphoric drinkers. , 2006, Addiction.

[71]  K. Brady,et al.  Menstrual cycle phase effects on nicotine withdrawal and cigarette craving: a review. , 2006, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[72]  K. Perkins Sex differences in nicotine versus nonnicotine reinforcement as determinants of tobacco smoking. , 1996 .

[73]  S. Shiffman,et al.  Does heightened affect make smoking cues more salient? , 2008, Journal of abnormal psychology.

[74]  Andrew J Waters,et al.  Cue-provoked craving and nicotine replacement therapy in smoking cessation. , 2004, Journal of consulting and clinical psychology.

[75]  G. Giovino Epidemiology of tobacco use in the United States , 2002, Oncogene.

[76]  William D S Killgore,et al.  Sex differences in amygdala activation during the perception of facial affect , 2001, Neuroreport.

[77]  M. Saladin,et al.  Reactivity to nicotine cues over repeated cue reactivity sessions. , 2007, Addictive behaviors.

[78]  S. Zakowski,et al.  Gender and stress: differential psychophysiological reactivity to stress reexposure in the laboratory. , 2008, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[79]  John Scott,et al.  Sex differences in long-term smoking cessation rates due to nicotine patch. , 2008, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[80]  G. Marlatt,et al.  Addictive behaviour: Cue exposure theory and practice. , 1995 .