Perceived stress and smoking-related behaviors and symptomatology in male and female smokers

Introduction: Stress has been found to be a significant risk factor for cigarette smoking. Stress affects males and females differently, as does the use of smoking for stress reduction. Few studies have examined gender differences with the interrelation of perceived stress and smoking behaviors and nicotine related symptomatology. Our study investigates this association, as well as the influence of sociodemographic variables. Methods: This is a retrospective analysis of 62 smokers (41 males, 21 females) enrolled in a smoking cessation study. At the screening visit sociodemographic information, smoking behaviors and survey measures were completed. These included the Perceived Stress Scale (PSS), Minnesota Nicotine Withdrawal Scale (MNWS), and others. Analyses were conducted using multiple linear regression models. Results: PSS score was found to have a negative association with number of cigarettes smoked in males (slope -0.29 ± 0.08; p = 0.0009) and females (slope -0.20. ± 0.18; p = 0.26) with no difference in effect between genders (p = 0.64). Linear regression of MNWS on PSS revealed a positive association for both males (slope 0.41 ± 0.068; p < 0.0001) and females (slope 0.73 ± 0.14; p < 0.0001). There was a significant difference in effect between genders (p = 0.04). Conclusions: A strong positive association was observed between perceived stress and nicotine withdrawal symptomatology in smokers of both sexes, with a larger effect seen in women. These findings emphasize the importance of stress reduction in smokers, which may lead to fewer withdrawal symptoms and more effective smoking cessation.