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Effectiveness of transdermal nicotine patch in premenopausal female smokers is moderated by within-subject severity of negative affect and physical symptoms

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Abstract

Rationale

Nicotine patches may be less effective in female compared with male smokers. However, it is unknown if negative affect and physical symptoms influence transdermal nicotine patch–related effects on smoking behaviors.

Methods

Eighty-one acutely tobacco-abstinent premenopausal female smokers attended three counter-balanced experimental sessions across the menstrual cycle (early follicular, late follicular, and mid-luteal) and were randomized to patch condition (nicotine [21 mg] vs. placebo [0 mg] transdermal patch). Negative affect and physical symptoms were assessed prior to patch administration. The patch was removed 5 h post-administration, and participants completed a smoking reinstatement task. Multilevel linear models tested associations of patch condition, negative affect and physical symptoms, and their interaction on smoking behavior.

Results

There was a significant patch condition × Negative Affect and Pain symptoms interaction on the number of cigarettes smoked (p < 0.05). When Negative Affect and Pain were lower-than-usual, females administered a nicotine patch smoked significantly fewer cigarettes than females administered a placebo patch (p < .05), but there were no significant patch differences when Negative Affect and Pain were higher-than-usual. There was also a significant patch condition × Negative Affect interaction on time delay. The effects of patch condition on time delay to smoking were greater during sessions in which Negative Affect was higher-than-usual.

Conclusions

Results suggest that among female smokers transdermal nicotine patch effectiveness may interact with negative affect and pain. Understanding and considering female-specific factors that may impact the efficacy of one of the most commonly used cessation medications is important for improving smoking cessation in female smokers.

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Funding

This study was funded by NIDA K01 DA040043 and R21 DA034768.

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Authors and Affiliations

  1. Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N Soto Street, 312E, Los Angeles, CA, 90032, USA

    Stephanie H. Chai, Adam M. Leventhal, Matthew G. Kirkpatrick & Raina D. Pang

  2. Department of Psychology, University of Southern California, Los Angeles, CA, USA

    Adam M. Leventhal

  3. Department of Psychiatry, University of Illinois Chicago, Chicago, IL, USA

    Tory A. Eisenlohr-Moul

  4. Department of Obstetrics and Gynecology, Center for the Health Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA

    Andrea J. Rapkin

  5. Department of Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    Lina D’Orazio

Authors
  1. Stephanie H. Chai
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  2. Adam M. Leventhal
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  3. Matthew G. Kirkpatrick
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  4. Tory A. Eisenlohr-Moul
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  6. Lina D’Orazio
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  7. Raina D. Pang
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Correspondence to Raina D. Pang.

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Chai, S.H., Leventhal, A.M., Kirkpatrick, M.G. et al. Effectiveness of transdermal nicotine patch in premenopausal female smokers is moderated by within-subject severity of negative affect and physical symptoms. Psychopharmacology 237, 1737–1744 (2020). https://doi.org/10.1007/s00213-020-05494-z

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  • DOI: https://doi.org/10.1007/s00213-020-05494-z

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