Background: A high percentage of adult smokers try to quit, but most of these attempts fail. The ability to predict the success or failure of smoking cessation efforts will be useful for clinical practice. Stress response is regulated by two primary neuroendocrine systems. Salivary cortisol has been used as a marker for the hypothalamus-pituitary-adrenocortical axis and salivary α-amylase as a marker for the sympathetic adrenomedullary system.
Methods: We studied 62 chronic smokers (34 women and 28 men with an average age of 45.2±12.9 years). The levels of salivary cortisol and α-amylase (SAA) were measured during the period of active smoking, and 6 weeks and 24 weeks after quitting. The local Ethics Committee approved the study.
Results: The men who were unsuccessful in cessation showed significantly higher levels of salivary α-amylase over the entire course of the cessation attempt. Before stopping smoking, salivary cortisol levels were higher among the men who were unsuccessful in smoking cessation. After quitting, there were no differences between this group and the men who were successful in cessation. In women we found no differences between groups of successful and unsuccessful ex-smokers during cessation. In both groups of men, there was a significant and acute decrease in salivary cortisol levels after smoking cessation. The women, on the other hand, showed only a slight but insignificant decrease in salivary cortisol after smoking cessation. Neither the men nor the women showed any change in sAA concentrations over the course of cessation.
Conclusion: Increased levels of salivary α-amylase before and during smoking cessation may predict failure to quit in men. On the other hand, no advantage was found in predicting the failure to quit in women. The results of our study support previously described gender differences in smoking cessation.
The study was supported by grant 10215-3 IGA MZCR.
Prague, Czech Republic
24 - 28 Apr 2010
European Society of Endocrinology