Researchers wonder why women have harder time quitting smoking

December 08, 1992|By Knight-Ridder Newspapers

Why do female smokers have more trouble quitting than men do?

New theories are emerging that women may have a tougher time because they are more prone to depression and are obsessed with weight gain. At the same time, researchers hope, new insights about women's smoking habits may help more quit.

Women and girls, for example, care more than men about what others think of them. "For women, one of the best motivations to stop is getting praise from others," says Dr. Susan Fiester, a psychiatrist and smoking cessation expert with the National Institutes of Health.

Other big motivators are pregnancy, having children bring home anti-smoking messages from school health programs or losing a parent from a smoking-related illness, says Dr. Susan Stewart, who runs a smoking cessation program for the Morgan Guaranty Trust Co. in New York.

Stewart, Fiester and Jane Gorsline, a research scientist for a company that makes nicotine patches, discussed some of the problems unique to female smokers during the fall conference of the American Medical Women's Association, the nation's largest group of female physicians. The association is mounting an all-out attack on what it sees as an alarming rise in female smoking, particularly among teen-age girls. "We have an epidemic of nicotine addiction among women," Dr. Fiester says.

Every day, more than 1,600 American teen-age girls begin tosmoke, and teen-age girl smokers outnumber teen-age boy smokers.

Currently, 50 million Americans smoke -- 27 percent of all women and 31 percent of men. While women are more apt to try quitting than men are, men are more likely to quit for good, studies show.

At this rate, female smokers may outnumber male smokers by the end of the decade, Dr. Fiester says.

Some states have designed billboards and TV ads to appeal to women smokers to quit.

The gender differences have spurred research to better understand why so many women return to smoking once they've quit.

Studies have shown, for example, that a drug called clonidine, a hypertension medicine also used to curb nicotine withdrawal, works better in women than in men, while nicotine gum works better for men, Dr. Fiester said.

No good studies have been done to determine gender differences with nicotine patches, said Ms. Gorsline, who helped develop the Nicoderm patch for Alza Corp.

Other studies have found that success rates are greater for women who try to quit smoking earlier, rather than later, in their menstrual cycle, Dr. Fiester said.

Women also need counseling about weight gain and depression, she says. "Weight gain is the single most worrisome problem with women," Dr. Fiester says. "They are terrified about gaining 5 10 pounds."

The weight gain problem is key to helping more women stop. Many females, particularly teen-age girls,

start smoking to control weight, Dr. Fiester says. Smokers gain six to eight pounds, on average, when they stop. But women often gain much more, sometimes up to 30 pounds, she says.

Women may need counseling to understand the "temporary necessity" of weight gains to avoid the serious health consequences of smoking, she says.

Depression after smoking cessation also is more common in women than in men. Coupled with premenstrual mood swings and women's greater tendencies to become seriously depressed, depression from nicotine withdrawal can undermine women's attempts to stop smoking, she says. Some women may need anti-depressant medicine for awhile, she says.

This link to depression may explain why widows have such difficulty stopping smoking, Dr. Fiester says. "The husband may have died of lung cancer, but she keeps smoking. It may be she feels 'the cigarette is my best friend.'"

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