Sex Differences in Nicotine Reinforcement and Reward: Influences on the Persistence of Tobacco Smoking
The factors that acutely reinforce tobacco smoking behavior can be divided into nicotine and non-nicotine contributions. Substantial laboratory-based research suggests that the smoking behavior of women, relative to that of men, is less sensitive to manipulations of nicotine and more sensitive to manipulations of non-nicotine factors, such as smoking-associated environmental stimuli (e.g., cues). This chapter examines controlled human research on sex differences in acute nicotine reinforcement (i.e., self-administration behavior) and reward (self-reported ratings of the hedonic characteristics of a substance). Compared to men, women self-administer nicotine to a lesser degree, and nicotine pre-treatment alters their subsequent smoking or nicotine self-administration to a lesser extent. On the other hand, smoking reinforcement and reward in women are influenced more by non-nicotine factors, such as the presence of smoking cues, accurate verbal information about the nicotine content of cigarettes, and controllability over smoking pattern. These differences in responsiveness to nicotine versus non-nicotine factors may help explain why women have greater difficulty quitting in general, and with nicotine patch in particular, compared to men. Clinical research may be able to take advantage of these differences to develop improved interventions for smoking cessation in women, a change with important public health implications.
The preparation of this chapter was supported by Grants DA12655, DA16483, and DA19478, and by University of Pennsylvania Transdisciplinary Tobacco Research Center (TTURC) Grant P50 DA/CA84718.
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