Gender differences in acute tobacco withdrawal: effects on subjective, cognitive, and physiological measures

Abstract

Gender differences in tobacco withdrawal are of considerable clinical importance, but research findings on this topic have been mixed. Methodological variation in samples sizes, experimental design, and measures across studies may explain the inconsistent results. The current study examined whether male (n = 101) and female (n = 102) smokers (> or =15 cigarettes/day) differed in abstinence-induced changes on a battery of self-report measures (withdrawal, affect, craving), cognitive performance tasks (attention, psychomotor performance), and physiological responses (heart rate, blood pressure, brain electroencephalogram). Participants attended 2 counterbalanced laboratory sessions, 1 following 12 hr of abstinence and the other following ad libitum smoking. Results showed that women reported greater abstinence-induced increases in negative affect, withdrawal-related distress, and urge to smoke to relieve withdrawal distress. In contrast, both genders reported similar abstinence-induced changes in positive affect and urge to smoke for pleasure. Men and women exhibited generally similar abstinence-induced changes in physiological and cognitive performance measures. In addition, gender did not moderate the association between withdrawal symptoms and baseline measures of smoking behavior and dependence. Abstinence-induced changes in withdrawal distress mediated the effect of gender on latency until the 1st cigarette of the day at trend levels ( p < .10). These findings suggest that there are qualitative gender differences in the acute tobacco withdrawal syndrome that may underlie gender-specific smoking patterns.

Figure 1

Effects of gender on QSU ratings. Mean scores per item (±SEM) by state and gender are displayed. This graph illustrates a trend-level Gender × State (abstinent vs. nonabstinent) × Subscale (Factor 1 vs. Factor 2) interaction, F(1, 200) = 3.18, p = .08. Women reported greater abstinence-induced increases in urge to relieve negative affect by smoking (Factor 2) than men; however, there were no gender differences in abstinence-induced changes in urge to attain positive effects of smoking (Factor 1). QSU = Brief Questionnaire of Smoking Urges. ^*p < .01, Gender × State interaction.

Figure 2

Effects of gender on TCQ ratings. Mean scores per item (±SEM) by state and gender are displayed. This graph illustrates a significant Gender × State (abstinent vs. nonabstinent) × Subscale (emotionality vs. expectancy vs. compulsivity vs. purposefulness) interaction, F(3, 597) = 2.89, p = .04. Women reported greater abstinence-induced increases in anticipation of relief from withdrawal and negative mood by smoking (TCQ Emotionality) than men; however, there were no gender differences in abstinence-induced changes in the other domains of craving. TCQ = Tobacco Craving Questionnaire. ^*p < .01, Gender × State interaction.

Figure 3

Effects of gender on PANAS ratings. Mean scores per item (±SEM) by state and gender are displayed. This graph illustrates a significant Gender × State (abstinent vs. nonabstinent) × Affect Type (positive vs. negative) interaction, F(1, 201) = 4.94, p = .03. Women reported greater abstinence-induced increases in negative affect than men; however, there were no gender differences in abstinence-induced changes in positive affect. PANAS = Positive and Negative Affect Schedule. ^***p < .0001, Gender × State interaction.