title: Changes in circulating leptin levels during the initial stage of cessation are associated with smoking relapse.
abstract: BACKGROUND
  Leptin has been linked to tobacco craving and withdrawal-related symptoms. Very few studies have examined leptin prospectively in both male and female nonsmokers and smokers.
  
  
  OBJECTIVE
  We examine leptin concentrations prospectively in both male and female nonsmokers and smokers to assess the associations of leptin with psychological symptoms and smoking relapse during ad libitum smoking, the first 48 h post quit, and 4 weeks post-cessation.
  
  
  METHODS
  Self-report psychological, anthropomorphic, and biological measures (cotinine, carbon monoxide, and plasma leptin) were collected before and after 48 h of smoking abstinence. Smokers were stratified at 28 days post quit as abstinent or relapsed if they had smoked daily for seven consecutive days at any point in the 28 days.
  
  
  RESULTS
  Leptin concentration (square root transformed ng/ml) increased over the 48-h abstinence, but only in female abstainers. In contrast, leptin was very stable across time for nonsmokers, relapsers, and males. Cox regression supported that increased leptin was associated with decreased risk of relapse. Leptin was correlated negatively with withdrawal symptoms for abstainers only. Females produce more leptin than males and this level increases from ad libitum smoking to 48-h post quit.
  
  
  CONCLUSIONS
  The current analysis indicates that a leptin increase early in cessation predicts abstinence. The increase in women, but not men, in response to abstinence provides further evidence of important gender differences. The negative correlation between leptin and withdrawal symptoms indicates a possible protective effect of leptin. Further research is ongoing to elucidate the psychological and biological determinants of this effect.
authors.affiliation: Duluth Medical Research Institute, University of Minnesota Medical School, Duluth, MN, 55812, USA.
authors.forename: Andrine
authors.initials: A
authors.lastname: Lemieux
authors.forename: Motohiro
authors.initials: M
authors.lastname: Nakajima
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
authors.forename: Sharon
authors.initials: S
authors.lastname: Allen
authors.forename: Mustafa
authors.initials: M
authors.lastname: al'Absi
mesh_terms: D000328:Adult; D002248:Carbon Monoxide / Q000032:analysis; D003367:Cotinine / Q000032:analysis; D066249:Craving; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D009538:Nicotine / Q000009:adverse effects; D018722:Nicotinic Agonists / Q000009:adverse effects; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012907:Smoking / Q000097:blood*; D016540:Smoking Cessation; D013375:Substance Withdrawal Syndrome / Q000097:blood* / Q000209:etiology; D014029:Tobacco Use Disorder / Q000097:blood*
chemical_list: D020738:Leptin; D018722:Nicotinic Agonists; D009538:Nicotine; D002248:Carbon Monoxide; D003367:Cotinine