Nicotine withdrawal and craving in adolescents: Effects of sex and hormonal contraceptive use

While sex differences in the nicotine withdrawal (NW) symptoms and craving (NC) have been extensively described in adult cigarette smokers, few studies have investigated these phenomena in adolescents. We investigated the effect of gender and hormonal contraception (HC) on NW and NC during the first 14 days of cessation in adolescent smokers using data from a randomized, placebo-controlled, double-blind trial of the transdermal nicotine replacement therapy for smoking cessation. Analyses showed similar levels of NW severity in males and females, regardless of HC use. However, significantly higher NC was observed in females compared to males, (2.22 ± 0.12 vs. 1.65 ± 1.14; p = 0.003). Further, females not using HC reported the highest level of NC (2.38 ± 0.16) followed by females using HC (2.08 ± 0.25) and males (1.71 ± 0.16; p = 0.007). The current findings suggest that adolescent females experience similar NW severity to males, but have stronger NC. Further, the use of hormonal contraceptives may impact the severity of craving. Addressing these different symptoms in adolescents may be useful in increasing smoking cessation rates in this special population of smokers.