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

• Published in: Psychopharmacology Vol. 237; no. 6; pp. 1737 - 1744
• Main Authors: Chai, Stephanie H., Leventhal, Adam M., Kirkpatrick, Matthew G., Eisenlohr-Moul, Tory A., Rapkin, Andrea J., D’Orazio, Lina, Pang, Raina D.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2020; Springer Nature B.V
• Subjects: Administration, Cutaneous; Adult; Affect (Psychology); Affect - drug effects; Affect - physiology; Biomedical and Life Sciences; Biomedicine; Cigarette smoking; Cigarette Smoking - drug therapy; Cigarette Smoking - psychology; Cigarettes; Drug addiction; Emotions; Female; Females; Humans; Menstrual cycle; Neurosciences; Nicotine; Nicotine - administration & dosage; Original Investigation; Pain; Pharmacology/Toxicology; Premenopause - drug effects; Premenopause - physiology; Premenopause - psychology; Psychiatry; Reinstatement; Smokers - psychology; Smoking; Smoking Cessation - methods; Smoking Cessation - psychology; Tobacco; Tobacco Use Cessation Devices; Transdermal medication; Treatment Outcome; Sex differences; Female smokers; Transdermal nicotine patch; Pain; Smoking; Negative affect
• ISSN: 0033-3158; 1432-2072; 1432-2072
• DOI: 10.1007/s00213-020-05494-z

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.