Women who want to quit smoking may find it easier if they time their efforts just right. A new study finds hormone fluctuations that occur over the course of a woman’s menstrual cycle may impact her ability to kick the cigarette habit.
According to small study conducted by researchers at the University of Montreal, women are more likely to crave cigarettes and have trouble quitting when in the follicular phase of their monthly cycle. This is the time right after her period and before ovulation.
“While overall more men than women smoke cigarettes, women and girls take less time to become dependent after initial use and have more difficulties quitting the habit,” the researchers write in their study. “One of the factors contributing to these differences may be that women crave cigarettes more than men and that their desire to smoke is influenced by hormonal fluctuations across the menstrual cycle.”
The study, which was published in Psychiatry Journal, involved 19 women and 15 men who were all chronic smokers but otherwise healthy. None of the study participants were enrolled in a smoking cessation program or were trying to quit.
Researchers asked each participant to smoke one cigarette 30 to 40 minutes before undergoing an fMRI, or brain scan. They were asked to view photos both related and unrelated to smoking. After undergoing the brain scans they viewed the photos a second time and reported on a scale from zero to 100 if the pictures triggered cigarette cravings.
The researchers tested 13 of the female participants twice to assess how their response changed at a different point in their menstrual cycle.
The brain scans showed that during the follicular stage, cigarette imagery activated five areas of the brain which the researchers say are linked to higher-level cravings. However during the luteal phase — after a woman ovulates and before her period — only one area of the brain was activated by images of cigarettes and smoking.
During the luteal phase, estrogen and progesterone levels are at their highest, which may help a woman keep addictive cravings at bay and reduce feelings of cigarette withdrawal.
Previous studies have found women’s monthly hormone fluctuations can affect everything from food cravings and digestive problems to joint pain and a whole host of other health issues.
“This result emphasizes the need for gender-specific programs to quit smoking, as well as taking into consideration a menstrual cycle phase during addiction treatment in women,” the researchers conclude. They called for more studies to help understand all the factors that contribute to sex and gender differences in smoking.
The story’s headline and lead paragraph promise news about the best time of the month for women to quit smoking. But the study being reported on can tell us almost nothing about that intriguing topic. The study involved just 13 female smokers who were looking at smoking-related images, and the researchers found that brain scans differed between women who were at different phases in the menstrual cycle when they viewed the images. These subjects weren’t trying to quit smoking, and there’s no way to know, based on this research, whether the menstrual cycle plays any role in the success of attempts to quit. So the main gist of this story is irresponsible speculation.
Anyone who’s trying to quit smoking has a difficult path ahead of them, and they won’t be helped by stories like this one that don’t contain evidence-based information. There’s a huge stretch here between the study’s findings — that brain activity related to smoking cravings varies during the menstrual cycle — and the assertion that timing attempts to quit according to the cycle phase increases their effectiveness. It’s a small exploratory study on neurophysiologic mechanisms of smoking desire, and cannot be generalized to guide women on how to approach quitting smoking.
Since the story let the researchers get away with saying, “This result emphasizes the need for gender-specific programs to quit smoking…”, we might have dinged it for not projecting what the costs of such programs might be. But we’re going to rule this Not Applicable because it would be difficult at this point to think about all that might be involved in costs of such an approach, even if this research was close to true real-world application, which it is not.
In the original study that’s being reported on, the authors state that they “only observed subtle differences in brain activations between the follicular and luteal phases.” But the article does not make clear that the findings were “subtle.” In fact, there was no discussion about the strengths of the relationships observed. In addition, the story states that other areas of the brain showed activity during certain phases of menstrual cycle. Do these areas of the brain also show activity for other responses? Are there other parts of the brain that are also associated with cravings that were not activated? The story could have done a lot more to describe what the researchers actually found in the study and why it might be relevant to readers.
No harms were mentioned, but it’s also difficult for us to envision what they might be in this case, so we’ll call it not applicable.
The story raises a lot of questions that we wish were answered but were not. Is fMRI — the brain scan used by the researchers — a valid tool for detecting smoking cravings? Are cravings associated with visual cues strong predictors of smoking behavior? How would the concepts discussed in the story be applied in a real-world smoking cessation setting?
The story overstates the findings of a very small exploratory study on the neurophysiology of smoking cravings related to the menstrual cycle. It implies that there is a practical clinical application of the study’s findings when in fact there is no evidence that this is the case.
The story did not consult with independent sources. A brief talk or email exchange with any qualified expert would’ve shot down most of the inflated claims made in this story. Any journalist who doesn’t know where to turn for independent sources could access our List of Industry-Independent Experts.
The story did not mention other approaches to smoking cessation that have strong evidence to support them. Even though the value of timing smoking cessation efforts with a woman’s menstrual cycle is unknown, the story could have done a service to readers by informing them of methods that have been rigorously tested. This could have been done with just an additional sentence or two.
The story ends with a call for emphasis on “gender-specific programs to quit smoking.” Are such programs available? The headline and the first sentence might suggest to some readers that the proof is in and that women can already get help with this. Accordingly, we’ll rate this as unsatisfactory.
While the story established that “Previous studies have found women’s monthly hormone fluctuations can affect everything from food cravings and digestive problems to joint pain and a whole host of other health issues,” it never really addresses whether this is groundbreaking research about hormone flux and smoking. It may well be important and novel research, but the story doesn’t establish that context.
The spin that’s prevalent in this story probably originated with this press release headlined, “Women, quitting smoking for New Years? Time it with your period!” However, the story includes quotes from the original study, so it appears that the press release was not the only source of information used for the story. We’ll call this satisfactory.
Systematic, Criteria-Driven
Excelente conversación entre @garyschwitzer de @HealthNewsRevu y @marynmck sobre exageración y #COVID19 en el excelente MOOC de @utknightcenter. Vale la pena verlo. https://www.youtube.com/watch?v=SkgXiPojtg4&feature=youtu.be
Words of real wisdom, as usual @garyschwitzer
And: “There were no details, charts, graphs, numbers, nothing published in a journal."
#Pharma chairman:“If you don’t put out data people will say why are you withholding the data?”
Well, yes, that is exactly what people are asking. https://twitter.com/garyschwitzer/status/1264572399523180548
Comments (1)
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Liz Seegert
January 12, 2015 at 10:27 amIt seems that CBS didn’t bother to interview the lead author. I did and was told that some of the quotes and information in the release were taken out of context. The researcher was only laying groundwork for a future study involving a much larger sample of people with schizophrenia. The published study [required reading] did point out several of the limitations noted above. This is another case study of why reporters (even on deadline) cannot rely only on press releases — or even just a study in isolation. It’s vital to speak with the author(s) and independent experts to put it all in context.
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