PEAPACK, N.J., March 5 /PRNewswire-FirstCall/ -- The idea that men are from Mars and women are from Venus has received another boost, as researchers have discovered that sex differences may play a role in trying to quit smoking.

A new report on smoking cessation and gender suggests that women smokers have a higher behavioral dependence on cigarettes and a lower nicotine dependence than men. The authors recommend that nicotine replacement therapy (NRT) and behavioral treatment be specifically tailored to women to increase their chances of quitting for good. Women smokers using NRT to quit may receive an added benefit from the use of the Nicotrol(R) Inhaler (nicotine inhalation system) because of its potential to replace some of the oral, handling and sensory reinforcements of smoking, the report notes. The importance of such an effect in smoking cessation is yet unknown. "Our study showed that women appear to have higher behavioral and lower nicotine dependence than men," said study lead author Abraham Bohadana, MD, Research Director, French National Institute of Health. "The nicotine inhaler may be a good tool for women as it not only provides nicotine craving relief but also seems to satisfy the 'hand-to-mouth' habit smokers are used to." The French study, published in the February 2003 issue of Nicotine & Tobacco Research, also demonstrated that men trying to quit smoking had a higher success rate than women regardless of which method of NRT they used. This study was investigational; combination nicotine replacement therapy has not been approved by the U.S. Food and Drug Administration. "These findings tell us that men and women may require different tools to help them meet the challenge of quitting cigarettes," said Gregory S. McCormick, Vice President of Marketing, Pharmacia Consumer Healthcare, the makers of Nicotrol tobacco dependence therapies. "Knowing that counsel and support can further increase a smoker's chances of quitting, we hope that people wanting to quit will also utilize behavior modification and support programs, such as Pathways to Change, the American Cancer Society's Break Away from the Pack and the Nicotrol Helping Hand program." Study Design and Findings The study is derived from a smoking cessation trial sponsored by Pharmacia Consumer Healthcare that followed, over a one-year period, 400 adult smokers (196 men and 204 women) who wanted to quit. The double-blind, randomized, placebo-controlled trial was conducted between March 1996 and February 1998 in Nancy, France. The subjects were randomly and evenly divided between those receiving both a nicotine inhaler (NI) and nicotine patches (NP) for six weeks, then nicotine inhaler and placebo patches for six weeks, and those receiving the nicotine inhaler with placebo patches (PP) for 12 weeks. Both groups then received only the inhalers for another 14 weeks. The subjects had the following abstinence rates at six months (an expired carbon monoxide level of 10 parts per million (ppm) or lower): * Men with combination therapy (nicotine inhaler plus nicotine patch): 33 percent * Women with combination therapy (nicotine inhaler plus nicotine patch): 17 percent * Gender difference: 16 percent * Men with monotherapy (nicotine inhaler plus placebo patch): 27 percent * Women with monotherapy (nicotine inhaler plus placebo patch): 18 percent * Gender difference: 9 percent The study also showed a gender difference between men and women trying to quit smoking. When men and women were divided by treatment, gender differences appeared to be more prominent in the group that received combination therapy (both the nicotine inhaler and the nicotine patch), ranging from 20 percent at six weeks to 16 percent at six months to 13 percent at one year. Further, at the-six month mark, men who received more nicotine (combination therapy) achieved a significantly higher quit rate than men who did not, while women in either group demonstrated nearly equal quit rates, indicating that men may require higher levels of nicotine replacement than women. The study examined these gender-related differences in the trial's cessation outcome measures, and focused on how these differences, if any, were influenced by objectively assessed baseline smoking behavior. The day before quit day, the study subjects were given questionnaires that assessed their reasons for stopping smoking, the degree of nicotine dependence (Fagerstrom Test for Nicotine Dependence, FTND) and baseline smoking behavior (Glover-Nilsson Smoking Behavioral Questionnaire, GN-SBQ). The GN-SBQ comparison showed significant male to female differences, with females showing higher scores than males for gesture, cognitive factors, anti-panic and social coping components of smoking behavior at baseline. Overall, women had significantly higher GN-SBQ scores than men, indicating a more pronounced behavioral component. In contrast, baseline FTND score was significantly higher among men than among women (6.44 vs. 5.99; p=0.018), indicating somewhat greater nicotine dependence among men. This difference observed at the beginning of the study remained statistically significant from week 2 to 12 months (males 6.13 vs. females 5.5; p=0.032). Patients included adults, aged 18 to 70 years old, who smoked 10 or more cigarettes per day for three or more years, had an expired carbon monoxide level of 10 parts per million (ppm) or greater, had made at least one previous attempt to quit, and were personally motivated to stop smoking. The study was co-authored by Yves Martinet, MD, PhD, Chief, Department of Pulmonary Disease, University Hospital of Nancy, France; and by Fredrik Nilsson, MSc, and Thomas Rasmussen, MSc, of Pharmacia Corporation in Helsingborg, Sweden. It was supported by a grant from the Consumer Healthcare division of Pharmacia Corporation.

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