Menstrual Phase and Depression Symptoms in Acute Smoking Abstinence

描述(由申请人提供)： 与男性相比，女性戒烟的难度更大，而且面临着吸烟带来的与性别相关的更具体的健康后果。有几个因素可能会影响女性戒烟，包括抑郁症状和月经期。研究探索了严重抑郁对戒烟的影响，但很少有人研究较轻抑郁症状的影响，很大一部分女性吸烟者可能需要有针对性的干预。终生的荷尔蒙波动也会影响情绪，即月经期的性激素，这加剧了戒烟过程中与抑郁相关的困难。这项为期4年的竞争性更新应用是一项针对女性吸烟者(N=200)的广泛和系统的实验研究，以确定抑郁症状单独以及与卵巢激素(月经期-卵泡/黄体中期)一起对急性戒烟期间的戒断症状、尼古丁渴望、吸烟冲动、经前症状和皮质醇水平(压力反应)的影响。第二个目的是确定抑郁症状和月经期是否在急性戒烟后对公认的反应系统(生理、主观、行为、药代动力学和神经内分泌)产生适度的尼古丁反应。这项研究将包括受试者内部因素(卵泡期与黄体中期)和受试者之间因素(非抑郁和亚临床抑郁女性吸烟者)，其中受试者将被要求在交替周期阶段中临时吸烟2天后戒烟4天。在戒烟的第四天，将使用计量剂量的尼古丁鼻腔喷雾来测量尼古丁的反应。这项研究的结果将是非常宝贵的，以进一步了解抑郁症状和周期阶段是否以及如何影响戒烟尝试。这些信息将指导量身定做的治疗方法的开发，并为临床医生提供循证指南，最终达到减少女性吸烟相关危害的长期目标。

DESCRIPTION (provided by applicant): Women have a more difficult time quitting smoking than men and face more significant specific gender-related health consequences from smoking. Several factors could undermine smoking cessation in women, including depressive symptoms and menstrual phase. Studies have explored the impact of major depression on smoking cessation, but few have examined the effects of lesser depressive symptoms which are experienced by a significant portion of female smokers who may require targeted interventions. Compounding the depression-related difficulty in quitting smoking are the lifetime hormonal fluctuations that also affect mood, i.e. menstrual phase sex hormones. This 4-year competing renewal application is an extensive and systematic experimental study of women smokers (N=200) to determine the effect of depressive symptoms, alone and in concert with ovarian hormones (menstrual phase - follicular/mid-luteal), on withdrawal symptoms, nicotine craving, smoking urges, premenstrual symptoms and cortisol levels (stress response) during acute smoking abstinence. The second aim is to determine if depressive symptoms and menstrual phase moderate nicotine response on recognized response systems (physiological, subjective, behavioral, pharmacokinetics and neuroendocrine) following acute smoking abstinence. The study will include a within-subject factor (follicular vs. mid-luteal phase) and a between-subjects factor (nondepressed and subclinical depressed women smokers) where subjects will be asked to abstain from smoking for 4 days following 2 days of ad lib smoking during alternate cycle phases. On the 4th day of abstinence nicotine response will be measured using metered doses of nicotine nasal spray. Results from this study will be invaluable to gain further insight into whether and how depressive symptoms and cycle phase affect smoking cessation attempts. This information will guide the development of tailored treatments and provide evidence-based guidelines for clinicians with the ultimate long term goal of reducing smoking related harms in women.