Alicia Armeli

This year I’ll quit smoking. How many times have you said that before? With the arrival of the New Year, many of us make resolutions to change for the better. But according to the Statistic Brain Research Institute, approximately 1 in every 10 people makes resolutions and actually feels successful in kicking bad habits to the curb—leaving the other nine of us thinking better luck next year.¹

But what if the key to being smoke-free was understanding your menstrual cycle? Researchers at the University of Southern California Keck School of Medicine found that women who suffer from premenstrual syndrome (PMS) have a harder time quitting and that special clinical help during this time of the month may be necessary in order to control tobacco cravings.²

Published in Experimental and Clinical Psychopharmacology, the study analyzed data from two laboratory studies that focused on how the menstrual cycle affects smoking.²  Researchers collected information from self-reported surveys of 157 premenopausal women daily smokers tracking two main factors: tobacco dependence/smoking cessation history and three domains of PMS: affective, water retention, and pain.

Results showed that women who experience PMS had greater daytime tobacco dependence as well as withdrawal symptoms when attempting to quit, and they relied more on smoking cessation aids in the past.²  These findings suggest that PMS may play an even bigger role than we thought for women who are trying to quit.

And researchers found another interesting outcome. It wasn’t PMS in general that was making it hard for women to quit. It was a type of PMS called affective PMS that might be to blame.²

What exactly is affective PMS? According to the journal American Family Physician, PMS can be broken down into physical symptoms and affective symptoms.³ Physical symptoms include bloating, headache, sore breasts, joint and muscle pain, and weight gain. On the other hand, affective PMS symptoms can show up as feelings of depression, social withdrawal, anxiety, irritability, angry outbursts, and confusion. Women who suffer from affective PMS report it getting in the way of their social interaction along with their academic and work performance.

One way affective PMS is diagnosed is if one of the aforementioned affective symptoms is experienced during the luteal phase—which is the time after ovulation and before your period starts—for three consecutive cycles. In other words, PMS-related affective symptoms would occur during the five days before your period but end within four days of the start of your period and not return until at least day 13 of your cycle.³

Got that? It can be confusing. To avoid mixing up days in your cycle, it helps to pull out your calendar and track what’s happening with your body. Keeping track of your symptoms not only helps you understand your body better and prepares you to discuss any menstrual problems with your doctor, but it may also help you time when to quit.

Studies have found that tobacco withdrawal is greatest during the luteal phase and that the number of cigarettes a woman smokes positively correlates with times during the month when PMS increases—but not with phases when PMS is typically minimal.^2,4,5

What can this mean for you?

It means that quitting is tough and potentially an even bigger challenge if you suffer from affective PMS, but you don’t have to quit alone. More research needs to be done to further understand the connection between PMS and smoking cessation. But in the meantime, discuss your symptoms with your doctor and how your cycle may influence your ability to quit. And most of all remember, if you suffer from affective PMS and are trying to quit, give yourself permission to rely on help from medical professionals who specialize in smoking cessation, family, friends, support groups, and all the tools you may need to keep this year’s resolution for good.

REFERENCES

1. Statistic Brain Research Institute. (2017, Jan 1). New Years Resolution Statistics. Retrieved from https://www.statisticbrain.com/new-years-resolution-statistics/
2. Pang, R. D., Andrabi, N., & Leventhal, A. M. (2017). Premenstrual symptoms and factors implicated in smoking cessation among women smokers. Exp Clin Psychopharmacol, Aug; 25(4):235-241.
3. Hofmeister, S., & Bodden, S. (2016). Premenstrual syndrome and premenstrual dysphoric disorder. Am Fam Physician, Aug 1;94(3):236-240.
4. Sakai, H., & Ohashi, K. (2013). Association of menstrual phase with smoking behavior, mood and menstrual phase-associated symptoms among young Japanese women smokers. BMC Women’s Health, Mar 2;13:10.
5. Weinberger, A. H., Smith, P. H., Allen, S. S., et al. (2015). Systematic and meta analytic review of research examining the impact of menstrual cycle phase and ovarian hormones on smoking and cessation. Nicotine & Tobacco Research, 17, 407–421.