Torres Oscar V, O'Dell Laura E
Molecular Neuropsychiatry Research Branch, DHHS/NIH/NIDA Intramural Research Program National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD 21224.
Department of Psychology, The University of Texas at El Paso, El Paso, TX 79902, USA.
Prog Neuropsychopharmacol Biol Psychiatry. 2016 Feb 4;65:260-8. doi: 10.1016/j.pnpbp.2015.04.005. Epub 2015 Apr 22.
Tobacco use is a major economic and health problem. It is particularly concerning that women consume more tobacco products, have a more difficult time quitting smoking, and are less likely to benefit from smoking cessation therapy than men. As a result, women are at higher risk of developing tobacco-related diseases. Clinical evidence suggests that women are more susceptible to anxiety disorders, and are more likely to smoke in order to cope with stress than men. During smoking abstinence, women experience more intense anxiety than men and report that the anxiety-reducing effects of smoking are the main reason for their continued tobacco use and relapse. Consistent with this, pre-clinical studies using rodent models suggest that females display more intense stress during nicotine withdrawal than males. This review posits that in women, stress is a principal factor that promotes the initiation of tobacco use and relapse behavior during abstinence. Studies are reviewed at both the clinical and pre-clinical levels to provide support for our hypothesis that stress plays a central role in promoting tobacco use vulnerability in females. The clinical implications of this work are also considered with regard to treatment approaches and the need for more research to help reduce health disparities produced by tobacco use in women.
烟草使用是一个重大的经济和健康问题。尤其令人担忧的是，与男性相比，女性消费更多的烟草产品，戒烟难度更大，且从戒烟治疗中获益的可能性更小。因此，女性患烟草相关疾病的风险更高。临床证据表明，女性更容易患焦虑症，且比男性更有可能为应对压力而吸烟。在戒烟期间，女性比男性经历更强烈的焦虑，并表示吸烟的抗焦虑作用是她们继续使用烟草和复吸的主要原因。与此一致的是，使用啮齿动物模型的临床前研究表明，雌性在尼古丁戒断期间比雄性表现出更强烈的应激反应。本综述认为，在女性中，压力是促进烟草使用起始及戒烟期间复吸行为的主要因素。本文对临床和临床前水平的研究进行了综述，以支持我们的假设，即压力在促进女性烟草使用易感性方面起着核心作用。本文还考虑了这项工作在治疗方法方面的临床意义，以及开展更多研究以帮助减少女性烟草使用造成的健康差距的必要性。
