Men cite nicotine, women say social intangibles are behind urge to smoke

Nicotine clearly drives a man'sdesire to smoke, but it may be less of a catalyst for women, according to research by psychologist Kenneth Perkins, PhD.

That's not to say that nicotine isn't important for women, he says. Rather, he has found that the external pleasures of smoking, such as holding and smelling a cigarette, seem to be more important to them. In contrast, nicotine, more so than external factors, seems to influence men's smoking the most.

These findings may have implications for smoking-cessation programs that hope to help women. Several studies find that female smokers have a harder time quitting than men do, particularly with nicotine replacement therapies, indicating that other techniques may be needed.

'Women appear to be less sensitive to different doses of nicotine than men,' says Perkins, professor of psychiatry at the University of Pittsburgh. For example, if he asks smokers to use a nasal spray with varying doses of nicotine or a placebo, women can't tell the difference-even between nicotine and no nicotine. Men, in contrast, can tell the difference even between different doses of nicotine, says Perkins.

This phenomenon, he says, may result from a general inability of women to per-ceive their own physiological activity, as found in several studies by psychologist James Pennebaker, PhD, of the University of Texas at Austin. In a laboratory environment women are less able than men to perceive physiological changes such as increased blood pressure, heart rate or blood glucose levels, finds Pennebaker.

However, women are just as good as men if asked to observe the same physiological functions in context. For example, if women are exercising or watching a scary movie, they are just as sensitive as men to heart rate fluctuations.

Women appear to be more perceptive to contextual and social cues than to internal cues, says Perkins. So, in terms of smoking, women likely pay more attention to the sight and smell of a cigarette than to the dose of nicotine they're receiving from the cigarette.

In his studies with the nicotine nasal spray, he's stripped the experience of nicotine from the context of smoking. For men, it doesn't matter as much. They feel as comfortable and relaxed in response to nicotine they sprayed into their noses as they do when they're smoking. But for women, these positive effects only occurred when they smoked cigarettes, not when they used the nicotine nasal spray.

'It can't only be the nicotine that women are responding to,' says Perkins. 'Women to some extent are reacting positively to the way they take nicotine in through smoking.'

Perkins isn't saying that women don't become dependent on nicotine, he emphasizes. Both nicotine and non-nicotine factors are related to smoking for men and women. But nicotine appears to be less important for women while non-nicotine factors are more important.

Such a finding is significant for treatment. If nicotine replacement therapy is all people are relying on, women will get short-changed, says Perkins.

-B. Azar



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