***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The goals of this study were ( 1 ) to examine the feasibility of administering progesterone to women during the early follicular phase when the endogenous estradiol and progesterone levels are low , and ( 2 ) to investigate the effects of oral progesterone treatment on smoking behavior in female smokers . Twelve subjects had two experimental sessions , within 3 - 9 days after the beginning of their menses . In each experimental session , subjects received a single 200-mg dose of progesterone or placebo , orally . Two and a half hours after the medication treatment , subjects were assessed for subjective response to two puffs of a cigarette and then started the self-administration period in which they had the option to exchange their token for two puffs of cigarette , 15 min apart . Subjects had low levels of estradiol and progesterone before the first and second sessions . Plasma progesterone levels peaked in 2 h following progesterone treatment . Progesterone treatment attenuated the craving for and subjective effects from smoking . Under progesterone treatment , there was a trend for decreased smoking behavior . These preliminary results suggest that the early follicular phase of the menstrual cycle may be a useful interval to investigate the effects of exogenous progesterone in female smokers . The effects of progesterone on nicotine dependence need to be studied further A 2-way factorial repeated measures design examined the effects of menstrual cycle phase and smoking on : 1 ) smoking behavior , 2 ) mood state , 3 ) nicotine withdrawal symptomatology , and 4 ) menstrual symptomatology .  Female smokers , aged 20 - 39 , were followed for two consecutive menstrual cycles with two data collection sessions per cycle , which were conducted in the University 's General Clinical Research Center ( GCRC ) . Participants were r and omly assigned to order of smoking condition , which included : 1 ) smoking ad libitum , and 2 ) 24-hour abstinence prior to data collection . Data were collected in the mid-to-late follicular ( MLF ) phase ( between days 6 through to 11 ) and the four days prior to menses in late luteal ( LL ) phase . Participants completed the Profile of Mood States and Menstrual Symptom Severity List and recorded daily cigarette smoking rate in the natural environment during MLF and LL phases .  Nicotine boost and carbon monoxide ( CO ) boost  were measured and the Shiffman-Jarvick Tobacco Withdrawal Question naire was administered during GCRC data collection sessions . Results indicated that subjects smoked more cigarettes per day during the LL phase and CO boost was greater during MLF . No difference was noted in nicotine boost by condition or phase . No difference in mood state was noted by either condition or phase . Withdrawal symptomatology and craving for cigarettes were increased after 24 hours of abstinence . No difference was noted in menstrual symptoms by condition or phase . Further investigations are still needed to characterize the importance of cycle phase in the design of smoking cessation interventions for women of reproductive age BACKGROUND Health promotion efforts encourage smokers to quit and to use effective cessation treatments . R and omized controlled trials demonstrate that medications and behavioral treatments improve cessation rates , but retrospective surveys have been inconsistent . This study assessed frequency of quit attempts , use of treatments for cessation , and abstinence rates among treatment users and non-users . METHODS Data were analyzed from the 2003 Tobacco Use Special Cessation Supplement to the Current Population Survey . Participants included 29,537 U.S. smokers aged > or = 18 years who smoked daily 12 months before the survey . Outcome measures included past-year quit attempts ; use of behavioral , pharmacologic , and alternative treatments ; receipt of social support ; and abstinence for > or = 4 weeks at time of survey . RESULTS Approximately 43.5 % of smokers reported a quit attempt in the preceding year : 64.2 % of attempters used no cessation treatments ; 8.8 % used behavioral treatment ; 32.2 % used medication ; and 14.1 % used more than one treatment .  Social support was reported to have been received by 24.1 % . More nicotine-dependent smokers were more likely to use medications ( OR=3.58 ; 95 % CI=3.04 - 4.20 ) . At the time of the survey , 19.3 % of attempters were abstinent > or = 4 weeks . Smokers who sought treatment were less likely to be abstinent ( OR=0.75 ; 95 % CI=0.67 - 0.84 ) , and those who sought multiple treatments were even less likely to be abstinent . CONCLUSIONS Many U.S. smokers make quit attempts , but most do not use behavioral or pharmacologic treatments . More nicotine-dependent smokers were more likely to seek treatment . Smokers who sought treatment were less likely to report abstinence , probably due to biased self- selection and recall . Retrospective survey data are not well-suited to assess the effectiveness of treatment Gender differences in tobacco withdrawal are of considerable clinical importance , but research findings on this topic have been mixed . Method ological variation in sample s sizes , experimental design , and measures across studies may explain the inconsistent results . The current study examined whether male ( n = 101 ) and female ( n = 102 ) smokers ( > or = 15 cigarettes/day ) differed in abstinence-induced changes on a battery of self-report measures ( withdrawal , affect , craving ) , cognitive performance tasks ( attention , psychomotor performance ) , and physiological responses ( heart rate , blood pressure , brain electroencephalogram ) . Participants attended 2 counterbalanced laboratory sessions , 1 following 12 hr of abstinence and the other following ad libitum smoking . Results showed that women reported greater  abstinence-induced increases in negative affect , withdrawal-related distress , and urge to smoke to relieve withdrawal distress . In contrast , both genders reported similar abstinence-induced changes in positive affect and urge to smoke for pleasure .  Men and women exhibited generally similar abstinence-induced changes in physiological and cognitive performance measures . In addition , gender did not moderate the association between withdrawal symptoms and baseline measures of smoking behavior and dependence . Abstinence-induced changes in withdrawal distress mediated the effect of gender on latency until the 1st cigarette of the day at trend levels ( p < .10 ) . These findings suggest that there are qualitative gender differences in the acute tobacco withdrawal syndrome that may underlie gender-specific smoking patterns Gender differences in smoking quit rates are frequently reported and are the subject of much speculation . This study examined the generalizability of gender differences in abstinence across study sites , treatments , and time of relapse , as well as potential mediators and moderators of gender effects . Participants were smokers who participated in 3 r and omized clinical trials of the nicotine patch ( N = 632 ) . Men had higher cessation rates than women at all follow-ups . The impact of gender on abstinence was unaffected by controlling for study site , treatment , or time of relapse . There was little evidence for mediation or moderation of this relation by any of a host of predictor variables . The magnitude and consistency of the gender differential , coupled with an inability to account for it , highlights a compelling need for additional research specifically aim ed at elucidating the relation between gender and abstinence Five parameters of postcessation smoking withdrawal variability derived from clinical data ( T. M. Piasecki , D. E. Jorenby , S. S. Smith , M. C. Fiore , & T. B. Baker , 2003a , 2003b ) were predicted from baseline measures and pharmacotherapy assignment . Smokers who were more dependent , older , and high in negative affect reported more severe withdrawal .  Women , heavier smokers , and those with a history of depression reported more variable symptoms .  Smokers treated with nicotine patch , bupropion , or both reported less severe withdrawal than did those given placebo , but medication did not affect the slope of symptoms over time , day-to-day variability of symptoms , or the size of acute changes in symptoms associated with lapses to smoking . Prior research has shown that these symptom facets predict later relapse : thus , current pharmacotherapies may aid cessation by diminishing withdrawal severity , but they do not affect all clinical ly important aspects of withdrawal In a series of exploratory analyses , we examined the roles of gender , reproductive status and negative affect on  smoking abstinence in subjects participating in a large ( n=385 ) 6-week r and omized clinical trial ( RCT ) of nicotine patch therapy  , with varying doses of oral naltrexone ( 0 mg , 25 mg , 50 mg , 100 mg ) treatment . Negative affect was assessed daily during the first post-quit week via telephone interactive voice response ( IVR )  . Weight and adverse events were recorded weekly . In the intent to treat sample , the effects of dose on continuous abstinence were non-significant in the overall model for men and women . In the 295 study completers , there was a significant effect of dose on continuous abstinence in women only ( F=8.53 , p=0.04 ) . In the 100 mg group , 71 % of women were continuously abstinent compared to 41 % in the placebo group ( p<0.05 ) . Women in the active naltrexone groups gained less weight ( F=2.91 , df=3 , p=0.04 ) . Women in the 100 mg vs. placebo group were less adherent with medication ( F=3.19 , p<0.05 ) . These effects were not significant in men . Naltrexone treatment condition ( 100 mg vs. placebo , p=0.02 , odds ratio (OR)=0.28 ) , gender ( OR=0.55 p=0.09 ) , and IVR ratings of negative affect ( OR 1.02 , p=0.04 ) predicted abstinence at Week 1 in study completers . Menstrual cycle status on quit day had a modest affect on abstinence . These data suggest that naltrexone dose , gender , and negative affect play a role in smoking abstinence , particularly in the early stages of treatment . When used in conjunction with nicotine replacement therapy , naltrexone dose may be important in women Previous studies suggest possible modulatory effects of progesterone on nicotine addiction . The goal of this study was to determine the effects of progesterone , on acute physiological and subjective responses to intravenous ( IV ) nicotine in overnight abstinent male and female smokers Pre clinical literature indicates that allopregnanolone ( ALLO ) , a neuroactive steroid metabolized from progesterone , may protect against drug abuse behaviors . It is important to underst and how ALLO varies during smoking changes in clinical sample s with depressive symptoms ( DS ) given they are at high risk of smoking relapse . The purpose of this article is to characterize changes in ALLO by menstrual phase during short-term smoking cessation among women with and without DS . At screening , study participants ( n = 84 ) were classified as either having past or current DS ( n = 48 ) or not ( n = 36 ) . In a controlled crossover trial design , participants completed 2 testing weeks in the follicular ( F ; low ALLO ) and luteal ( L ; high ALLO ) menstrual phases . During each testing week , blood sample s were collected during ad libitum smoking and on the fourth day of biochemically verified smoking abstinence . Participants were , on average , 30.1 ± 6.7 years old , smoked 12.6 ± 5.7 cigarettes per day , and most ( 73 % ) were White . The change in ALLO during short-term smoking cessation varied significantly by menstrual phase such that it decreased by 10 % in the follicular phase and increased by 31 % in the luteal phase . There were no significant differences in ALLO levels by DS group . In premenopausal women  , ALLO levels varied by menstrual phase and smoking status , but not DS . Given that other research has indicated L phase is associated with improved smoking cessation outcomes , an increase in ALLO during short-term cessation in the L phase may protect against relapse whereas a decrease in ALLO , as observed in the F phase , may increase risk for relapse INTRODUCTION Accumulating evidence has linked depressive symptoms and sex hormones to risk for relapse ; however , the specific mechanisms involved in these associations remain unknown . This r and omized crossover study assessed physiological response to  nicotine by menstrual phase in female smokers with and without depressive symptoms following acute smoking abstinence . METHODS Females , ages 18 - 40 years with regular menstrual cycles , not on exogenous hormones or psychotropic medications , who reported smoking ≥ 5 cigarettes/day were enrolled . Participants were stratified into 2 groups : no depressive symptoms ( NDS ; n = 23 ) and depressive symptoms ( DS ; n = 24 ) . After 4 days of biochemically verified smoking abstinence , participants completed 2 laboratory sessions in the follicular ( F ) and luteal ( L ) phases . Participants used nicotine nasal spray at Time 0 , and blood pressure , heart rate , and serum nicotine were measured at Time -1 , 5 , 10 , 20 , 30 , 45 , 60 , and 90 min . RESULTS Participants ( n = 47 ) were 29.1 ± 6.8 years old and smoked an average of 12.5 ± 5.1 cigare 
    Output:
    
Women reported greater withdrawal during the luteal phase than during the follicular phase , and there was a nonsignificant trend for greater tonic craving in the luteal phase .
Progesterone administration was associated with decreased positive and increased negative subjective effects of nicotine .