Menstrual Phase and Depression Symptoms in Acute Smoking Abstinence

描述（由申请人提供）： 女性比男性更难戒烟，并且面临吸烟带来的更严重的特定性别健康后果。有几个因素可能会破坏女性戒烟，包括抑郁症状和月经期。研究探讨了重度抑郁症对戒烟的影响，但很少有人研究过较轻抑郁症状的影响，这些症状是相当一部分女性吸烟者所经历的，她们可能需要有针对性的干预措施。与抑郁症相关的戒烟困难是终生荷尔蒙波动，也影响情绪，即月经期性激素。这项为期4年的竞争性更新申请是一项针对女性吸烟者（N=200）的广泛系统性实验研究，旨在确定抑郁症状单独和与卵巢激素（月经期-卵泡/黄体中期）联合对急性戒烟期间戒断症状、尼古丁渴求、吸烟欲望、经前症状和皮质醇水平（应激反应）的影响。第二个目的是确定急性戒烟后抑郁症状和月经期是否对公认的反应系统（生理、主观、行为、药代动力学和神经内分泌）产生中度尼古丁反应。研究将包括受试者内因素（卵泡期与黄体中期）和受试者间因素（非抑郁和亚临床抑郁女性吸烟者），其中要求受试者在交替周期阶段自由吸烟2天后戒烟4天。在戒烟第4天，将使用定量尼古丁鼻喷雾剂测量尼古丁反应。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。这些信息将指导定制治疗的发展，并为临床医生提供循证指南，最终长期目标是减少女性吸烟相关的危害。

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.