Addictive Behaviors

Finding Out Why it is Harder for Women to Quit Smoking

Sherry McKee, Ph.D., Associate Professor of Psychiatry

Tobacco use is the most preventable cause of mortality, yet illness and death associated with smoking continues to rise, particularly among women.  Dr. McKee studied the mood and memory processes that contribute to why women have more difficulty quitting smoking and maintaining smoking cessation.

Highlighted Study Findings

In her research, Dr. McKee examined the impact of gender and mood on smoking behavior in a laboratory setting. In this study, daily smokers engaged in a task designed to increase negative or positive emotion, followed by a 30-minute smoking period. For both women and men, negative mood was strongly related to smoking behavior. However, this relationship was stronger in women than in men. Specifically, participants high in negative mood, compared to those with a more positive mood, started smoking more quickly, smoked more cigarettes, inhaled the smoke more deeply, inhaled for a longer duration, and inhaled a larger volume of smoke over the entire 30 minutes. Additionally, if negative mood was high and individuals believed that smoking would help them to feel better, they smoked more cigarettes, smoked more deeply, and inhaled a larger volume of smoke over the entire 30 minutes. The study found that these effects were more pronounced in women. The results of this project advanced our understanding of how mood and specific ways of thinking influence smoking behavior. These findings suggest that when designing more effective ways to quit smoking, it is crucial, especially for women, to include methods for reducing negative emotion as well as for challenging beliefs that smoking is a good means to improve mood.

Determining How Estrogen Affects the Brain

Julie K. Staley, Ph.D.

Julie K. Staley, Ph.D., Associate Professor of Psychiatry and Diagnostic Radiology

Understanding the effects of sex and hormones on brain chemistry is becoming increasingly important as evidence emerges of sex differences in behavioral symptoms and treatment response in neuropsychiatric disorders. However, the mechanisms underlying these differences have not been well understood. Through its action at brain estrogen receptors, the female sex steroid estradiol is a primary neurochemical responsible for sex-specific brain development and plays an important role in numerous brain disorders that plague women in particular, including depression. Dr. Staley’s work focused on imaging estrogen receptors in the brain using single photon emission computed tomography (SPECT) to begin to understand the unique neurobiological role of sex hormones as they relate to behavior, cognition and emotion.

Highlighted Study Findings

Dr. Staley’s Ethel F. Donaghue Women’s Health Investigator Program-funded pilot research demonstrated that a new radioactive tracer, a chemical compound called [123]MIE2 held promise for use in imaging estrogen receptors in the brain by an imaging technology called single photon emission computed tomography (SPECT). Her findings have had far-reaching impact. Dr. Staley’s work enhanced the study of SPECT radiotracers in humans, thus allowing advancement of nicotinic receptor imaging which is now being used in the studies of nicotine dependence, alcoholism, Alzheimer’s disease, depression and schizophrenia.

Pilot Project Study funded in 2003, Dr. Staley †

Improving Smoking Cessation Interventions for Women

Benjamin Toll, Ph.D., Assistant Professor of Psychiatry.

Dr. Benjamin Toll will determine which aspects of a smoking cessation "quitline" might be particularly effective for women. A "quitline" is a toll-free telephone "call center" commonly used by smokers for help in quitting. While more men than women smoke, this gender gap has been narrowing, and women find it more difficult to quit compared to men. As quitlines can reach millions of smokers, gender-based knowledge could bring a substantial benefit in reducing smoking and related diseases among women.

More Good News!

Dr. Toll’s study was to be co-funded by WHRY and the Transdisciplinary Tobacco Use Research Center at Yale. However, the quality of Dr. Toll’s study was recognized by the National Institutes of Health and his research now will be funded by the National Institute on Drug Abuse.

Establishing a Gender-Sensitive Smoking Cessation Intervention

Andrea Weinberger, Ph.D.

Andrea Weinberger, Ph.D., Assistant Professor of Psychiatry 

Smoking remains the leading preventable cause of death in the United States. Annual smoking quit rates continue to demonstrate that women are less likely to quit smoking than men; and first-line treatments, such as the nicotine patch, are less effective in smoking cessation for women than men. In earlier work conducted by Drs. Weinberger and Sherry McKee, it was found that women have different perceived risks associated with quitting than men. In particular, women are more likely to be concerned about weight gain, mood regulation, stress management, and negative mood than are men. Because of the strong relationship for women between these concerns and smoking cessation outcomes, a promising area for the development of a behavioral treatment is to target sex-specific perceived risks associated with quitting.

Highlighted Study Findings

Dr. Weinberger’s study is developing the foundation for smoking cessation interventions in which behavioral treatments are tailored to individual female smokers’ perceived risks of quitting smoking. She is creating the basis for a standardized approach that can be tailored to particular needs, and will allow the treatment to address a wide range of individual smokers. In addition, Dr. Weinberger envisions adapting the tailored treatments to formats, such as web-based information, that would allow for economical and widespread dissemination, thus making a substantial impact on improving quit rates for women and men, and reducing the damaging health consequences of smoking. Dr. Weinberger has completed development of a 50-page treatment manual of cognitive-behavioral counseling sessions related to perceived risks of smoking. The manual will be used in a pilot study, which is currently initiating recruitment, involving female smokers receiving tailored treatment as compared to a control group, to assess the feasibility, acceptability and efficacy of the tailored approach.