more susceptible to stressful life events
that can cause a relapse
Women are affected more than men by certain stressful life events, a factor that can contribute to their inability to quit smoking or their decision to resume smoking, according to a new study by Yale researchers.
Health problems and financial setbacks are particular risk factors when it comes to women and smoking, the study says.
The study -- "Sex differences in the effects of stressful life events on changes in smoking status," published in this month's issue of Addiction, the journal of the Society for the Study of Addiction to Alcohol and Other Drugs -- says that health care providers and smoking cessation programs should consider this information as they deal with women smokers, particularly those who have quit or are trying to quit.
"Stressful life events do have an impact. It's important to outline these stressful events, so women know to be prepared for them," says Sherry A. McKee, assistant professor in the Department of Psychiatry at the School of Medicine and the lead author of the study.
According to the study, women are more likely than men to take up smoking again when faced by a negative financial event. Negative financial events also made it harder for women to quit, according to the study. "Women respond differently to financial stressors than men," says McKee. "Also, women were more likely to experience personal financial problems than men."
Women were also less likely than men to quit in response to an adverse health event, perhaps due to gender bias in health care referral patterns. McKee says, "In some cases, women are less likely to be referred on for additional testing or treatment after experiencing a major health event, like a heart attack. Some studies also have shown that doctors are less likely to provide smoking cessation advice to women," she says.
McKee says the new study reinforces past research that has shown women have a harder time quitting than men and that men and women may respond to different cessation techniques and advice. "Not only is the percentage of quitting higher with men, women have a harder time staying abstinent once they quit," McKee says. "It's important to factor in gender when it comes to tobacco studies."
"These investigations ultimately will yield new practical applications for treating female smokers," McKee says. "Health care providers should consider focusing on techniques for coping with stressful life events and preventing relapse in the face of such events. Also, health care providers may want to ask female patients who are former smokers about recent stressful events and provide advice to them to help them maintain their abstinence."
McKee is an investigator for the Transdisciplinary Tobacco Use Research Center at Yale (TTURC), part of the Center for Nicotine and Tobacco Use Research at Yale (CENTURY). She also is affiliated with Women's Health Research at Yale, an interdisciplinary program designed to advance health research on women. The program is the largest of its kind in the country.
The study's co-authors are Carolyn M. Mazure, director of CENTURY's sex-specific factors core, director of Women's Health Research at Yale and professor of psychiatry; Tracy Falba, associate research scientist with the Department of Epidemiology and Public Health; and Paul Maciejewski, associate research scientist in psychiatry and director of the statistical core for Women's Health Research at Yale.
The study was a pilot project for TTURC. Funding for TTURC and CENTURY comes from the National Institute on Drug Abuse, the National Cancer Institute and the Robert Wood Johnson Foundation. The mission of CENTURY and TTURC is to conduct research to understand better why some tobacco users have difficulty quitting and how to help them quit.
-- By Jacqueline Weaver
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