People trying to quit smoking often fail because of stress. As this ScienCentral News video reports, now physiologists have found that the reason for this is different in men and women.
Coping with Quitting
If you're having trouble quitting smoking, the culprit may be that constant enemy, stress.
"I have a really busy, active schedule right now, so there's a lot of stress," says Troy Carson, recent quitter and member of the Stop Smoking Program at Bellevue Hospital Center. "It's an excuse to smoke, the stress, because I say to myself, 'Oh my God, I'm having such a bad time right now, just gimme a cigarette! I can smoke because I'm having a bad time.' You know, 'I'll smoke a cigarette now and everything will be fine tomorrow and I won't smoke again.'"
"Stress is a potent trigger for relapse," agrees Mustafa al'Absi, physiologist at the University of Minnesota School of Medicine. "We hear it a lot. Every smoker will tell you that they smoke when they are stressed out. That is out there. But we don't know why. And since science is about advancement, about coming up with new things that we can then tackle and achieve, we wanted to look at the mechanisms for why stress causes people to smoke and to relapse."
So al'Absi and his team asked 72 smokers— 38 men and 34 women— to report their level of stress during a particularly tough time— the first 24 hours of a quit attempt. "We measured various mood changes, various smoking-related withdrawal symptoms, and we also measured an important biological index of stress, and that is a hormone called cortisol," says al'Absi.
And what he found is that "those who have quick drop in cortisol on the first day of their quit attempt, a very steep drop, these individuals were more likely to relapse within the first few days, 5 to 7 days, than those who had minimal or not much perturbation or changes from a previous time when they were still smoking."
But this wasn't true of both men and women. Al'Absi found that this change in cortisol levels was only able to predict who would eventually start smoking again among male smokers. Not for females.
"In women, hormonal measures did not seem to be sensitive in terms of telling us who's going to relapse. Rather, it was the withdrawal symptoms, how they felt, the mood changes that occurred during the first 24 hours," says al'Absi. "Studies have indicated that women report that they smoke to feel more relaxed. Men tend to smoke to cope with the craving or the absence of the substance of nicotine."
The Stop Smoking Support Group.
Al'Absi thinks this might explain why men tend to respond better to nicotine replacement therapies, while women respond better to psychosocial therapies like support groups. "It's definitely important to have the support," says Luz Santiago, also a member of the Stop Smoking Program at Bellevue. "I think that people can't do it without the support. It's nice to have the support of other people who can say, 'If I sit at my computer, I'm studying, I'm stressed, maybe that causes stress, and I'm starting to smoke.'"
Al'Absi believes these gender differences should be reflected in the treatment people seek. "I think the process of tailoring an intervention to the individual is so critical if one is to make an effort successful," he says. "So, for a woman is struggling with smoking and wants to quit, it might help a great deal to learn about the stress in her life, how she deals with stress, teaching her tools to deal with various stressors that might have triggered her smoking in the past, and that might trigger urges in the future, after cessation."