Smoking: Differences between Men and Women
Guest: Dr. Karen Hartwell - Psychiatry & Behavioral Sciences, MUSC
Host: Dr. Linda Austin – Psychiatry, MUSC
Dr. Linda Austin: Dr. Karen Hartwell is Assistant Professor in the Department of Psychiatry at the Medical University of South Carolina, and works in the Clinical Science program at MUSC, as well as the VA hospital in Charleston. Dr. Hartwell, you’re very active in research these days. I know you have a couple different protocols. We already talked about one. Tell us about the second protocol that you’re recruiting subjects for.
Dr. Karen Hartwell: The second study is looking at differences in smoking between men and women. Currently, about 22 percent of South Carolinians smoke. Generally, men smoke at higher rates than women, although, of some concern, teenagers; boys and girls, are starting at the same rate. But, we know there are some differences between men and women in how they smoke, and how much they smoke.
Women tend to not smoke as much, so they consume less nicotine, but they have a harder time quitting. Women seem to really like the act of smoking, more so than men. They like the feel of the cigarette. They like the sensations of the smoke going down their throat. Men don’t care so much about how they get their nicotine, as long as they get it. So, what we’re seeing is that with nicotine replacement therapies; things like the nicotine patch and nicotine gum, and the lozenges, women don’t get as much relief from withdrawal symptoms from those products, and it’s less effective.
So, in this particular study, we’re going to, again, use neuroimaging to explore some of the differences between men and women, and smoking. So, similar to the last study, we’re recruiting healthy adult smokers over the age of 21. We’ll have people get a baseline scan looking at the areas of their brain that respond to smoking cues. And then, after we’ve gotten that kind of baseline scan of people smoking as usual, we’re going to put everyone on the nicotine patch. And then, after three days on the patch, we’re going to bring people back for a second scanning session looking at the differences between men and women and their brain responses on the patch. And then, everyone is going to be given denicotinized cigarettes. These are cigarettes that don’t contain nicotine. People can smoke as many, or as few, of them as they want over the next four days. And then we’ll bring them back for a third scanning session. This study is much shorter in duration. It’s about a week, although we’ll want to see you everyday during that week, and there will be scanning sessions.
Dr. Linda Austin: Do you have a hypothesis about what you will find in this study? Have there been any previous studies looking at something similar, or is this a brand new field of investigation?
Dr. Karen Hartwell: Well, this is an expansion of some previous work. But our hypothesis is that we will find that men have a greater response to the nicotine patch than women, and women will have a greater response to the denicotinized cigarettes.
Dr. Linda Austin: So this could actually help guide treatment decisions for people, in the future, who want to quite smoking?
Dr. Karen Hartwell: Absolutely.
Dr. Linda Austin: Now, tell us who is eligible for this.
Dr. Karen Hartwell: You need to be in good general health. You need to be over the age of 21. And, there are differences in the brain between lefties and righties, so we’re only using right-handed people. Also, you have to be able to undergo an MRI. The MRI, many of us recall, or may know, we use magnetic fields, as opposed to radiation, to look at the brain. And if people have metal in their body, they may not be eligible, because that metal could either heat up or move in the magnetic field. And, of course, we wouldn’t anyone to be harmed. And, of course, we wouldn’t take anyone who is pregnant or nursing into this study either. And, there are certain types of medications, and neurological problems, and medical problems that might keep you from being able to participate.
Dr. Linda Austin: What are the potential benefits to the patients who are participating?
Dr. Karen Hartwell: You, certainly, will be getting counseling every day, when you’re coming in for the study. And, also, we may find that, after a week of not smoking, with a combination of the patch and denicotinized cigarettes, you may be able to go ahead and successfully quit.
Dr. Linda Austin: Which would be something to rejoice over.
Dr. Karen Hartwell: Absolutely.
Dr. Linda Austin: Do you have a telephone number that interested people could call to learn more about this study?
Dr. Karen Hartwell: Absolutely. Anyone who’s interested can call our study office and ask to speak to Harvey. Her phone number is 792-8938. We welcome your questions. And, if you’d like to participate, we’d love to have you.
Dr. Linda Austin: Dr. Hartwell, thank you so much, and good luck with this study.
Dr. Karen Hartwell: Thank you so much.