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A hand holding a lit cigarette.

According to large population studies, about 48 percent of smokers pick up a cigarette within the first week of quitting.

Predicting a smoker's relapse

From eNews, June 10, 2004

University of Minnesota researchers have found that after someone quits smoking, the intensity of withdrawal symptoms and changes in certain hormone levels could predict his or her potential for relapse. They also found that men and women are affected by these factors differently. "We have found that stress affects men and women differently when it comes to nicotine addiction and relapse," says lead researcher Mustafa al'Absi of the University's School of Medicine, Duluth and a member of the U's Cancer Center. "During abstinence, women have more difficulties with the emotional side effects, while men have difficulties with the biological changes they experience." The researchers examined 72 smokers (38 men and 34 women), all of whom had a long smoking history but were otherwise healthy. Their levels of the hormone cortisol were assessed while they were smoking and again during their first 24 hours of abstinence. Their stress responses were also measured after the first day of abstinence before and after a public-speaking test and a mental-performance challenge. About 48 percent of the smokers relapsed within the first week of quitting-a statistic comparable to large population studies, says al'Absi. Participants who relapsed reported greater distress and withdrawal symptoms during the initial 24 hours of abstinence. They also exhibited a steeper decline of cortisol concentrations compared with a previous day when they were smoking at their usual rate. Men who exhibited lower hormonal responses to stress relapsed sooner than men who showed a higher response. Hormonal responses did not relate to relapse risk in women. Women experienced greater cravings for cigarettes and more intense withdrawal symptoms during the mental-performance challenges. Women with intense withdrawal symptoms were also more likely to relapse sooner than women who with less intense symptoms. Withdrawal symptoms did not relate to relapse risk in men. "In future studies, we hope to discover the mechanisms responsible for these gender differences so that we can develop more effective intervention strategies to help men and women overcome this addiction," says al'Absi. Al'Absi presented the findings at the American Association for the Advancement of Science's annual meeting in Seattle on February 13.

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