Is the Effect of Anhedonia on Smoking Cessation Greater for Women Versus Men?
Anhedonia has been recognized as a major risk factor for smoking persistence. Potential gender differences in the effect of anhedonia on smoking cessation have not been studied. Using data from a completed clinical trial of maintenance nicotine patch therapy, we hypothesized that gender would moderate the effect of anhedonia on short-term abstinence, such that anhedonic women would be less likely to achieve abstinence.



Participants (N = 525; 50% female, 48.2% Black/African American, average age: 46 years) received 21mg/day nicotine patch and four brief behavior counseling sessions over 8 weeks. Participants were classified at baseline using the Snaith-Hamilton Pleasure Scale as anhedonic (scores > 2) or hedonic (scores ≤ 2). Bioverified 7-day point prevalence abstinence was measured at week 8. Using logistic regression analysis, we tested the interaction of anhedonia by gender predicting abstinence, adjusting for age, race, nicotine dependence, and baseline depressive symptomatology.



Seventy participants (13%) were classified as anhedonic. Men were more likely to be anhedonic than women (16.6% vs. 10.2%, p = .03). Contrary to our hypothesis, the interaction of anhedonic status (hedonic vs. anhedonic) by gender was nonsignificant (p = .18). There was a main effect of hedonic capacity, such that anhedonia predicted abstinence, odds ratio = 3.24, 95% confidence interval = 1.39-7.51, p = .006.



Both male and female anhedonic smokers were more likely to be abstinent, which contrasts with prior research indicating that anhedonia is a risk factor for difficulty quitting. This unexpected finding may be explained by a possible selective benefit of nicotine patch therapy, which has been observed in some studies to have antidepressant effects.



This is the first study to examine whether the association between pretreatment anhedonia and smoking cessation differs by gender. For both women and men, anhedonia was associated with a greater likelihood of abstinence after 8 weeks of treatment with 21mg/day nicotine patch and behavior counseling. Our findings indicate that the association between anhedonia and smoking cessation is not as clear as has been assumed and may depend in part on the type of treatment delivered.
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Jessica M
JM
Powers
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Allison J
AJ
Carroll
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Anna K
AK
Veluz-Wilkins
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Sonja
S
Blazekovic
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Peter
P
Gariti
Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Presbyterian Medical Center, Philadelphia, PA.
Frank T
FT
Leone
Department of Psychiatry and Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Robert A
RA
Schnoll
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; b-hitsman@northwestern.edu.
Brian
B
Hitsman
D000328:Adult; D001741:Black or African American / Q000523:psychology; D059445:Anhedonia; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000627:therapeutic use; D016017:Odds Ratio; D010349:Patient Compliance / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000208:ethnology / Q000523:psychology / Q000628:therapy; D016540:Smoking Cessation / Q000208:ethnology / Q000379:methods / Q000523:psychology*; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000188:drug therapy / Q000208:ethnology / Q000523:psychology; D055815:Young Adult
D009538:Nicotine