Alicia Marie Allen

Interests

Research

Addiction, Tobacco, Opioids, Marijuana,Women's Health, Sex Hormones, Menstrual Cycle, Postpartum,Mood, Depression, Anxiety,Clinical Trials, Epidemiology, Online and Remote Methods

Teaching

Epidemiology, Study Design, Causality, Error/Bias, Manuscript Writing,Residents, Graduate Students, Undergraduate Students

Courses

Scholarly Contributions

Journals/Publications

• Allen, A. M., Friedichsen, S., Petersen, N., & Allen, S. S. (2019). Subjective response to intranasal nicotine administration in oral contraceptive users and naturally cycling women. Addictive Behaviors.
• Allen, A. M., Muramoto, M. L., Campbell, J., Connolly, T., McGuffin, B., & Bernstein, A. D. (2018). Multi-Method Formative Research to Improve the Training and Delivery of Tobacco Cessation Interventions in Behavioral Health Settings. Journal of Addiction Medicine, 6, 470-475.
• Allen, A. M., Muramoto, M. L., Campbell, J., Conolly, T., McGuffin, B., & Bernstein, A. (2019). Multi-method formative research to improve the training and delivery of tobacco cessation interventions in behavioral health settings. Journal of Addiction Medicine, 6, 470-475.
• Bell, M. L., Allen, A. M., Reikowsky, R. C., & Nair, U. S. (2019). Quitline Program Utilization and Cessation Outcomes: A Comparison of Provider-referred Clients by Healthcare Settings. Preventive Medicine Reports.
• Blaes, A., Nagler, R. H., Allen, A. M., Mason, S., Teoh, D., Talley, K., Raymond, N., Vogel, R., & Wyman, J. (2019). Breast Cancer Screening Practices with High-Risk Women: A Cross-Sectional Survey of Primary Care. Journal of Women's Health.
• Harrison, K., Petersen, A., Tosun, N., Crist, K., Allen, A. M., & Allen, S. (2018). Associations between exogenous progesterone administration, endogenous sex hormones, and smoking-related symptomology in oral contraceptive users who smoke. Addictive Behaviors.
• Harrison, K., Petersen, A., Tosun, N., Crist, K., Allen, A. M., & Allene, S. (2020). Effect of exogenous progesterone administration on cigarette smoking-related symptomology in oral contraceptive users who smoke. Addictive behaviors, 102, 106148.
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  Cigarette smoking-related symptomatology (e.g., craving; SRS) is linked to relapse after a quit attempt. SRS varies by menstrual phase, possibly due to variations in sex hormones (e.g., progesterone), though much of the research to-date has relied on observations from the menstrual cycle acting as a proxy for hormone levels. The goal of this study was to examine the effect of exogenous progesterone on SRS during ad libitum smoking and following overnight abstinence. Oral contraceptive users who smoked completed two 9-day crossover testing periods (7 days of ad libitum smoking and 2 days following overnight abstinence) while taking double-blind active/placebo exogenous progesterone. Participants completed questionnaires to measure SRS. The effect of exogenous progesterone and endogenous hormones (progesterone, estradiol, and progesterone-to-estradiol [P/E] ratio) on SRS was assessed with paired t-tests and linear mixed effect models. Participants (n = 53) were, on average, 24 years old and smoked 11 cigarettes per day. During ad libitum smoking, a doubling of the P/E ratio was associated with 0.09 points lower anticipated relief from negative affect (95% confidence interval [CI]: 0.03-0.15 points lower; p = 0.008) and 0.11 points lower psychological reward (95% CI: 0.03-0.18 points lower; p = 0.006). After correction for multiple testing, these associations were not statistically significant: anticipated relief from negative effect (p = 0.10) and psychological reward (p = 0.09). No other significant associations were observed. Although substantial previous literature indicates that progesterone influences SRS, exogenous progesterone administration did not alter SRS here. Additional research is needed to elucidate alternative mechanisms involved in menstrual phase effects on SRS.
• Martin, K., Vogel, R. I., Nagler, R. H., Wyman, J. F., Raymond, N., Teoh, D., Allen, A. M., Talley, K. M., Mason, S., & Blaes, A. H. (2020). Mammography Screening Practices in Average-Risk Women Aged 40-49 Years in Primary Care: A Comparison of Physician and Nonphysician Providers in Minnesota. Journal of women's health, 29(1), 91-99.
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  Breast cancer screening practices and the influence of clinical guidelines or recommendations are well documented for physicians, but little is known about the screening practices of nonphysician providers (physician assistants and advanced practice registered nurses). The seven breast cancer screening guidelines or recommendations on the use of mammography have the most variation for screening average-risk women 40-49 years of age. Therefore, to better understand the practices of nonphysicians, this study will compare the practices of physicians with nonphysician providers for women 40-49 years of age. Minnesota physicians and nonphysicians were e-mailed an anonymous cross-sectional survey, which asked primary care providers about their mammography screening practices for average-risk women 40-44 and 45-49 years of age and to rate the influence of seven breast cancer screening recommendations on the use of mammography in their practice. Comparisons across providers' demographic and professional characteristics were conducted using chi-squared and Fisher's exact tests, as appropriate, and multivariate logistic regression analyses. Of the respondents who practiced primary care (193 physicians, 50 physician assistants, and 197 advanced practice registered nurses), 66.7% reported recommending mammography for women at ages 40-44 and 77.2% recommended mammography for women at ages 45-49. Nonphysician providers were more likely to recommend screening in both these age groups ( 
• Martin, K., Vogel, R., Nagler, R., Wyman, J., Raymond, N., Teoh, D., Allen, A. M., Talley, K., Mason, S., & Blaes, A. (2020). Mammography Screening Practices in Average-Risk Women in Primary Care: A Comparison of Physician and Non-physician Providers in Minnesota. Journal of Women's Health, 91-99.
• Martinez, A., & Allen, A. M. (2020). Journal of Addiction Medicine Nonpharmacological Adjunct Treatment for Postpartum Women with Opioid Use Disorder: A Review of the Literature. Addictive Behaviors.
• Nair, U. S., Reikowsky, R. C., Allen, A. M., & Bell, M. L. (2018). Quitline Program Utilization and Cessation Outcomes: A Comparison of Provider-referred Clients by Healthcare Settings. Pending.
• Nair, U. S., Reikowsky, R. C., Allen, A. M., & Bell, M. L. (2018). Quitline Program Utilization and Cessation Outcomes: A Comparison of Provider-referred Clients by Healthcare Settings. Preventive Medicine Reports.
• Oncken, C., Allen, S., Kenny, A., Lando, H., Allen, A. M., & Dornelas, E. (2019). Exercise for Smoking Cessation in Post-Menopausal Women: A Randomized, Controlled Trial.. Nicotine and Tobacco Research. doi:10.1093/ntr/ntz176
• Smith, T. T., Donny, E. C., Luo, X., Allen, A. M., Carroll, D. M., Denlinger-Apte, R. L., Dermody, S. S., Koopmeiners, J. S., McClernon, F. J., Pacek, L. R., Vandrey, R., & Hatsukami, D. K. (2019). The Impact of Gradual and Immediate Nicotine Reduction on Subjective Cigarette Ratings. Nicotine & tobacco research, 21(Supplement_1), S73-S80.
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  A recent clinical trial showed that an immediate transition to very low nicotine content (VLNC) cigarettes, compared with a gradual transition, produced greater reductions in smoking behavior, smoke exposure, and dependence. However, there was less compliance with the instruction to smoke only VLNC cigarettes in the immediate versus gradual reduction condition. The goal of this study was to test whether nicotine reduction method alters subjective ratings of VLNC cigarettes, and whether subjective ratings mediate effects of nicotine reduction method on smoking behavior, smoke exposure, dependence, and compliance.
• Tosun, N. L., Fieberg, A. M., Eberly, L. E., Harrison, K. A., Tipp, A. R., Allen, A. M., & Allen, S. S. (2019). Exogenous progesterone for smoking cessation in men and women: a pilot double-blind, placebo-controlled randomized clinical trial. Addiction (Abingdon, England), 114(10), 1800-1813.
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  In some clinical studies men and women have been found to differ in their ability to quit smoking, perhaps as a result of progesterone. The primary aim of this study was to provide a preliminary test of whether progesterone (PRO), compared with placebo (PBO), was more effective for smoking cessation in men and women.
• Allen, A. M., Carlson, S. C., Bosch, T. A., Eberly, L. E., Okuyemi, K., Nair, U., & Gordon, J. S. (2018). High Intensity Interval Training and Continuous Aerobic Exercise Interventions to Promote Self-Initiated Quit Attempts in Young Adults Who Smoke: Feasibility, Acceptability, and Lessons Learned from a Randomized Pilot Trial. Journal of Addiction Medicine.
• Allen, A. M., Jung, A. M., Lemieux, A., Alexander, A., Allen, S. S., Ward, K. D., & al'Absi, M. (2019). Stressful life events are associated with perinatal cigarette smoking. Preventive Medicine, 118, 264-271.
• Allen, A. M., Lundeen, K., Murphy, S., Spector, L., & Harlow, B. (2018). Web-Delivered Multimedia Training Materials for the Self-Collection of Dried Blood Spots: A Formative Project. JMIR Formative Research.
• Allen, A. M., Yuan, N. P., Wertheim, B. C., Krupski, L. A., Bell, M. L., & Nair, U. S. (2018). Gender Differences in Utilization of Services and Smoking Cessation Outcomes at a State Quitline. Translational Behavioral Medicine.
• Gordon, J. S., Nair, U. S., Okuyemi, K., Eberly, L., Bosch, T., Carlson, S., & Allen, A. M. (2018). High Intensity Interval Training and Continuous Aerobic Exercise Interventions to Promote Self-Initiated Quit Attempts in Smokers: Feasibility, Acceptability, and Lessons Learned from a Randomized Pilot Trial. Journal of Addiction Medicine.
• Nair, U. S., Bell, M. L., Krupski, L. A., Wertheim, B. C., Yuan, N. P., & Allen, A. M. (2018). Gender Differences in Utilization of Services and Smoking Cessation Outcomes at a State Quitline. Translational Behavioral Medicine.
• Purani, H., Carlson, S., & Allen, A. M. (2018). Exercise, Sleep Quality and Smoking Behavior in Young Adult Smokers. Addictive Behaviors.
• Allen, A. M., Abdelwahab, N. M., Carlson, S., Bosch, T. A., Eberly, L. E., & Okuyemi, K. (2018). Effect of brief exercise on urges to smoke in men and women smokers. Addictive behaviors, 77, 34-37.
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  Although smoking urges have been demonstrated to vary by gender and also be influenced by exercise, it is unknown if exercise has a differential effect on smoking urges by gender. This study aimed to explore gender-specific effects of an acute bout of exercise on cessation-related symptoms in men and women smokers during acute abstinence.
• Allen, A. M., Carlson, S., Eberly, L. E., Hatsukami, D., & Piper, M. E. (2018). Use of hormonal contraceptives and smoking cessation: A preliminary report. Addictive behaviors, 76, 236-242.
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  Although endogenous sex hormones influence smoking-related outcomes, little is known about the effect of exogenous sex hormones. Therefore, the goal of this preliminary study was to examine differences in withdrawal symptoms and cessation between women using hormonal contraceptives (HC), women not using hormonal contraceptives (no-HC) and men. Utilizing data from two recently completed smoking cessation randomized clinical trials, we selected participants who were between the ages of 18-35years old. Participants were classified based on use of hormonal contraceptives and gender, then matched based on pharmacotherapy randomization assignment and baseline cigarettes per day. Participants provided self-reported assessments on withdrawal, craving and negative affect, and smoking status was assessed for 52weeks after quit date. Participants (N=130) were 28.7±0.4years old and smoked 16.8±0.6 cigarettes/day. Compared to both no-HC and men, the HC group had significantly greater withdrawal one week prior to the quit date, on the quit date and one week after the quit date. During the first week of attempted abstinence, craving declined in HC and in men, but increased in no-HC. At end of treatment, the HC group was at 3.73 times higher odds of being abstinent compared to men (95% confidence interval: 1.12-12.40). There were no group differences in abstinence rates at Week 26 or 52. These data suggest that HC users may experience more adverse levels of withdrawal, though may be more likely to achieve short-term abstinence. Future research is needed to replicate our observations and explore mechanisms of action.
• Allen, A. M., Lundeen, K., Eberly, L. E., Allen, S. S., al'Absi, M., Muramoto, M., & Hatsukami, D. (2018). Hormonal contraceptive use in smokers: Prevalence of use and associations with smoking motives. Addictive behaviors, 77, 187-192.
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  While endogenous sex hormones influence smoking-related outcomes, little is known about the role of hormonal contraceptives (HCs). This is despite dated estimates suggesting that HC use is prevalent among female smokers. Therefore, we sought to update estimates of the prevalence of HC use among female smokers and explore the association of HC use with various smoking motives (SMs).
• Allen, A. M., Weinberger, A. H., Wetherill, R. R., Howe, C. L., & McKee, S. A. (2019). Oral Contraceptives and Cigarette Smoking: A Review of the Literature and Future Directions. Nicotine and Tobacco Research, 592-601.
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  Introduction: Evidence continues to mount indicating that endogenous sex hormones (e.g., progesterone and estradiol) play a significant role in smoking-related outcomes. Although approximately 1 out of 4 premenopausal smokers use oral contraceptives (OCs), which significantly alter progesterone and estradiol levels, relatively little is known about how OCs may influence smoking-related outcomes. Thus, the goal of this review paper is to describe the state of the literature and offer recommendations for future directions.Methods: In March 2017, we searched seven databases, with a restriction to articles written in English, using the following keywords: nicotine, smoker(s), smoking, tobacco, cigarettes, abstinence, withdrawal, and craving(s). We did not restrict on the publication date, type or study design.Results: A total of 13 studies were identified. Three studies indicated faster nicotine metabolism in OC users compared to nonusers. Five of six laboratory studies that examined physiological stress response noted heightened response in OC users compared to nonusers. Three studies examined cessation-related symptomatology (e.g., craving) with mixed results. One cross-sectional study observed greater odds of current smoking among OC users, and no studies have explored the relationship between OC use and cessation outcomes. Conclusions: Relatively few studies were identified on the role of OCs in smoking-related outcomes. Future work could explore the relationship between OC use and mood, stress, weight gain and brain function/connectivity, as well as cessation outcomes. Understanding the role of OC use in these areas may lead to the development of novel smoking cessation interventions for premenopausal women.
• Allen, A., Tosun, N., Carlson, S., & Allen, S. (2018). Postpartum Changes in Mood and Smoking-Related Symptomatology: An Ecological Momentary Assessment Investigation. Nicotine & Tobacco Research, 681-689.
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  Postpartum smoking relapse is a highly prevalent public health problem. Mood and breastfeeding are significantly associated with smoking relapse, though less is known about the temporality of these relationships. Therefore, this study utilized ecological momentary assessments (EMA) to prospectively examine changes mood and smoking-related symptomatology in relationship to three events - childbirth, termination of breastfeeding and smoking relapse. We expected all three events to significantly alter mood and smoking-related symptomatology.
• Carlson, S. C., Allen, A. M., Allen, S. S., & al'Absi, M. (2017). Differences in mood and cortisol by menstrual phase during acute smoking abstinence: A within-subject comparison. Experimental and clinical psychopharmacology, 25(5), 338-345.
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  There is evidence that smoking-cessation success differs by menstrual phase and sex hormone levels; however, the biological mechanisms underlying these differences are not clear. One possibility is that variation in cortisol throughout the menstrual cycle and early smoking abstinence may be partly responsible. The goal of this secondary-data analysis was to conduct a within-subject examination of the effects of menstrual phase and smoking abstinence on salivary cortisol and mood. Data are from a controlled crossover trial, in which participants completed 2 testing weeks during their follicular and luteal phases. During each testing week, they smoked ad libitum during the first 2 days and then abstained from smoking during the next 4 days. Salivary cortisol and self-reported mood were collected 5 times on the day before abstinence (D0) and the first (D1) and third (D3) days of abstinence. Participants (n = 125) were, on average (mean ± SE), 29.4 ± 0.6 years old and smoked 12.6 ± 0.5 cigarettes/day. Whereas salivary cortisol varied significantly by time of day (p < .0001) and smoking abstinence (D0 to D1: β = -0.06 ± 0.02 log[ng/ml], p = .0074 and D3: β = -0.05 ± 0.02 log[ng/ml], p = .0117). no significant differences by menstrual phase were observed. Craving increased from D0 to D1 during the follicular phase but decreased in the luteal phase (+0.31 vs. -0.15, β = 0.46 ± 0.19, p = .0162). This work builds on prior observations in demonstrating a decrease in cortisol in acute smoking abstinence and menstrual phase differences in craving. The results provide further evidence that cortisol levels do not vary by menstrual phase in the first few days of abstinence. (PsycINFO Database Record
• Allen, A. M., McRae-Clark, A. L., Carlson, S., Saladin, M. E., Gray, K. M., Wetherington, C. L., McKee, S. A., & Allen, S. S. (2016). Determining menstrual phase in human biobehavioral research: A review with recommendations. Experimental and clinical psychopharmacology, 24(1), 1-11.
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  Given the volume and importance of research focusing on menstrual phase, a review of the strategies being used to identify menstrual phase and recommendations that will promote methodological uniformity in the field is needed. We conducted a literature review via Ovid Medline and PsycINFO. Our goal was to review methods used to identify menstrual phase and subphases in biobehavioral research studies with women who had physiologically natural menstrual cycles. Therefore, we excluded articles that focused on any of the following: use of exogenous hormones, the postpartum period, menstrual-related problems (e.g., polycystic ovarian syndrome, endometriosis), and infertility/anovulation. We also excluded articles on either younger (45 years old) study samples. We initially identified a total of 1,809 articles. After our exclusionary criteria were applied, 146 articles remained, within which our review identified 6 different methods used to identify menstrual phase and subphases. The most common method used was self-report of onset of menses (145/146 articles) followed by urine luteinizing hormone testing (50/146 articles) and measurement of hormones (estradiol and/or progesterone) in blood samples (49/146 articles). Overall, we found a lack of consistency in the methodology used to determine menstrual phase and subphases. We provide several options to improve accuracy of phase identification, as well as to minimize costs and burden. Adoption of these recommendations will decrease misclassification within individual studies, facilitate cross-study comparisons, and enhance the reproducibility of results.
• Allen, A. M., Scheuermann, T. S., Nollen, N., Hatsukami, D., & Ahluwalia, J. S. (2016). Gender Differences in Smoking Behavior and Dependence Motives Among Daily and Nondaily Smokers. Nicotine & Tobacco Research, 18(6), 1408-13.
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  While the overall prevalence of smoking has declined, nondaily smoking is on the rise. Among daily smokers (DS) men tend to smoke more cigarettes per day and have higher dependence. Unfortunately little is known about gender differences in nondaily smokers (NDS).
• Allen, A. M., Vogel, R., Meier, E., Anderson, A., Jensen, J., Severson, H. H., & Hatsukami, D. (2016). Gender differences in snus versus nicotine gum for cigarette avoidance among a sample of US smokers. Drug and alcohol dependence, 168, 8-12. doi:10.1016/j.drugalcdep.2016.08.624
• Allen, S. S., Allen, A. M., Lunos, S., & Tosun, N. (2016). Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial. Nicotine & Tobacco Research, 18(11), 2145-2153.
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  Pregnancy is a strong motivator to quit smoking, yet postpartum relapse rates are high. Growing evidence suggests a role of sex hormones in drug abuse behavior and given the precipitous drop in sex hormones at delivery, they may play a role in postpartum relapse. This pilot study evaluates the feasibility and potential role of exogenous progesterone in postpartum smoking relapse.
• Allen, A. M., Lunos, S., Heishman, S. J., al'Absi, M., Hatsukami, D., & Allen, S. S. (2015). Subjective response to nicotine by menstrual phase. Addictive behaviors, 43, 50-3.
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  The luteal menstrual phase might be a favorable time for smoking cessation when non-nicotine interventions (e.g. counseling, bupropion) are used, whereas the follicular menstrual phase appears favorable when nicotine interventions are used. Thus, there may be an interaction between menstrual phase and response to nicotine. We sought to examine the role of menstrual phase on response to nicotine during acute smoking abstinence.
• Allen, A. M., al'Absi, M., Lando, H., & Allen, S. S. (2015). Allopregnanolone association with psychophysiological and cognitive functions during acute smoking abstinence in premenopausal women. Experimental and clinical psychopharmacology, 23(1), 22-8.
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  Nicotine response may predict susceptibility to smoking relapse. Allopregnanolone, a neuroactive steroid metabolized from progesterone, has been shown to be associated with several symptoms of nicotine response. We sought to explore the association between allopregnanolone and response to nicotine during acute smoking abstinence in premenopausal women. Participants completed 2 nicotine-response laboratory sessions, 1 in their follicular (low allopregnanolone) and 1 in their luteal (high allopregnanolone) menstrual phase, on the fourth day of biochemically confirmed smoking abstinence. During the laboratory sessions, participants self-administered a nicotine nasal spray and completed a timed series of cardiovascular, cognitive, and subjective assessments of response to nicotine. The relationships of allopregnanolone with baseline values and change scores of outcome measures were assessed using covariance pattern modeling. Study participants (N = 77) had a mean age of 29.9 (SD = 6.8) years and smoked an average of 12.2 (SD = 4.9) cigarettes per day. Allopregnanolone concentration measured before nicotine administration was positively associated with systolic (β = 0.85, p = .04) and diastolic blood pressure (β = 1.19, p < .001) and self-report of physical symptoms (β = 0.58, p < .001), dizziness (β = 0.88, p < .01), jitteriness (β = 0.90, p = .04), and pleasantness (β = 2.05, p = .04). Allopregnanolone also had significant positive associations with change in cognition following nicotine nasal spray administration, specifically discriminability as a measure of attention (β = 1.15, p = .05) and response bias as a measure of impulsivity (β = 0.13, p = .02). These data suggest that allopregnanolone may be related to cardiovascular and subjective physical state during acute smoking abstinence, as well as cognitive response to nicotine.
• Hinderaker, K., Allen, A. M., Tosun, N., al'Absi, M., Hatsukami, D., & Allen, S. S. (2016). The effect of combination oral contraceptives on smoking-related symptomatology during short-term smoking abstinence. Addictive behaviors, 41, 148-51.
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  Although an estimated 25% of premenopausal smokers report using oral contraceptives (OC), little is known about how OC use may influence smoking cessation. The purpose of this study was to examine the difference in smoking-related symptomatology during acute smoking abstinence between women on a standardized combination OC (Tri-Sprintec(™)) compared to women not on OCs (no-OC). Participants were women aged 18-40 who smoked ≥5 cigarettes/day and reported regular menstrual cycles. Using a controlled cross-over design, participants completed two six-day testing weeks: Low Progesterone Week (LPW; Follicular (F) phase in no-OC or 1st week of pills in OC) and High Progesterone Week (HPW; Luteal (L) phase in no-OC or 3rd week of pills in OC). Each testing week included daily assessment of symptomatology and biochemical confirmation of smoking status. During smoking abstinence, the OC group (n=14) reported significantly lower levels of positive affect (21.56±7.12 vs. 24.57±6.46; β=3.63, p=0.0323) than the no-OC group (n=28). Further significant interactions between group and testing week were observed as follows: Smoking satisfaction was higher during LPW in the OC group (LPW: 4.29±1.30 vs. HPW: 4.10±1.37) but higher during HPW in the no-OC group (LPW: 3.91±1.30 vs. HPW: 4.23±1.30; β=-0.5499, p
• Huttlin, E. A., Allen, A. M., Tosun, N. L., Allen, S. S., & al'Absi, M. (2015). Associations between adrenocortical activity and nicotine response in female smokers by menstrual phase. Addictive behaviors, 50, 135-9.
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  Previous research suggests that menstrual phase may influence smoking-related symptomatology. The present study analyzes the relationship between menstrual phase and salivary cortisol with subjective responses to nicotine among female smokers during ad libitum smoking. We hypothesize higher cortisol levels would be associated with increased positive and decreased negative subjective responses to nicotine. We also expected that these associations would vary by menstrual phase. Females aged 18-40 who smoke at least five cigarettes/day, reported regular menstrual cycles and did not use exogenous hormones or psychotropic medications were enrolled into a controlled cross-over trial. Participants completed identical data collection procedures during follicular (F) and luteal (L) phases; including self-collected salivary cortisol samples and completion of a nicotine response lab session involving administration of nicotine nasal spray and monitoring of subjective response to nicotine via the Subjective State Scale and Visual Analog Scale. Participants (n = 116) were 29.1 ± 6.9 years old and smoked an average of 12.3 ± 5.5 cigarettes daily. During F phase, higher morning cortisol was associated with decreased negative affect (r = -0.21, p = 0.03), withdrawal (r = -0.30, p < 0.01) and increased relaxation (r = 0.24, p = 0.02) after administration of nicotine nasal spray. Conversely, during L phase, higher morning cortisol was associated with a decrease in head rush (r = -0.26, p = 0.01) and urge to smoke (r = -0.21, p = 0.04) after administration of nicotine nasal spray. Similar associations between greater diurnal cortisol variation and response to nicotine were seen. These observations indicate that cortisol may have a phase-specific association with some subjective responses to nicotine in female smokers. Additional research should explore how these relationships may influence smoking cessation efforts.
• Allen, A. M., Oncken, C., & Hatsukami, D. (2014). Women and Smoking: The Effect of Gender on the Epidemiology, Health Effects, and Cessation of Smoking. Current addiction reports, 1(1), 53-60.
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  Smoking is still the leading cause of premature morbidity and mortality. This paper examines new research on gender differences and the epidemiology of smoking, smoking-related morbidity and mortality, and factors that affect smoking cessation. The rate of decline in the prevalence of smoking has been slowing, especially among adolescent girls. New research suggests that, compared with men, women may be more susceptible to smoking-related morbidity and mortality. Gender-related barriers to smoking cessation include weight gain, sex hormones, and mood. Furthermore, the sensory aspects of smoking may have more of an effect on smoking treatment for women than for men. We discuss new studies that examine smoking-cessation interventions that may be particularly beneficial for women, including exercise (as an adjunct intervention), very low nicotine content cigarettes, and a variety of pharmacotherapy. Further research is needed to identify and target the gender-specific needs of smokers.
• Allen, S. S., Allen, A. M., Tosun, N., Lunos, S., al'Absi, M., & Hatsukami, D. (2014). Smoking- and menstrual-related symptomatology during short-term smoking abstinence by menstrual phase and depressive symptoms. Addictive behaviors, 39(5), 901-6.
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  Menstrual phase and depressive symptoms are known to minimize quit attempts in women. Therefore, the influence of these factors on smoking- and menstrual-related symptomatology during acute smoking cessation was investigated in a controlled cross-over lab-study. Participants (n=147) completed two six-day testing weeks during their menstrual cycle with testing order randomly assigned (follicular vs. luteal). The testing week consisted of two days of ad libitum smoking followed by four days of biochemically verified smoking abstinence. Daily symptomatology measures were collected. Out of the 11 total symptoms investigated, six were significantly associated with menstrual phase and nine were significantly associated with level of depressive symptoms. Two significant interactions were noted indicating that there may be a stronger association between depressive symptoms with negative affect and premenstrual pain during the follicular phase compared to the luteal phase. Overall, these observations suggest that during acute smoking abstinence in premenopausal smokers, there is an association between depressive symptoms and symptomatology whereas menstrual phase appears to have less of an effect. Further study is needed to determine the effect of these observations on smoking cessation outcomes, as well as to define the mechanism of menstrual phase and depressive symptoms on smoking-related symptomatology.
• Allen, A. M., Kleppinger, A., Lando, H., & Oncken, C. (2013). Effect of nicotine patch on energy intake and weight gain in postmenopausal women during smoking cessation. Eating behaviors, 14(4), 420-3.
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  Post-cessation weight gain is a commonly cited barrier to smoking cessation. Some evidence suggests that nicotine replacement therapy may limit post-cessation weight gain by reducing energy intake. This project aims to assess differential changes in energy intake and body weight during smoking cessation in a sample of postmenopausal women randomized to receive 21 mg nicotine or placebo patch for 12 weeks.
• Allen, A. M., al'Absi, M., Lando, H., Hatsukami, D., & Allen, S. S. (2013). Menstrual phase, depressive symptoms, and allopregnanolone during short-term smoking cessation. Experimental and clinical psychopharmacology, 21(6), 427-33.
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  Preclinical literature indicates that allopregnanolone (ALLO), a neuroactive steroid metabolized from progesterone, may protect against drug abuse behaviors. It is important to understand how ALLO varies during smoking changes in clinical samples 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 samples 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.
• Allen, S. S., Allen, A. M., Kotlyar, M., Lunos, S., Al'absi, M., & Hatsukami, D. (2013). Menstrual phase and depressive symptoms differences in physiological response to nicotine following acute smoking abstinence. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 15(6), 1091-8.
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  Accumulating evidence has linked depressive symptoms and sex hormones to risk for relapse; however, the specific mechanisms involved in these associations remain unknown. This randomized crossover study assessed physiological response to nicotine by menstrual phase in female smokers with and without depressive symptoms following acute smoking abstinence.
• Allen, A. M., Allen, S. S., Lunos, S., & Pomerleau, C. S. (2010). Severity of withdrawal symptomatology in follicular versus luteal quitters: The combined effects of menstrual phase and withdrawal on smoking cessation outcome. Addictive behaviors, 35(6), 549-52.
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  Women are at an increased risk of relapse after a smoking cessation attempt. While the reasons for this phenomenon are not fully understood, recent research indicates that both the menstrual cycle and negative symptomatology may play a role. The goal of this study was to describe the association between withdrawal symptoms during attempted smoking cessation, and to investigate the impact of these symptoms on smoking cessation outcomes as defined by 7-day point prevalence at 14 and 30 days. Negative symptoms associated with the premenstrual period were also assessed. Participants (n = 202) were 29.8 (SD +/- 6.6) years old and smoked 16.6 (SD +/- 5.6) cigarettes per day. They were randomly assigned to quit smoking in the follicular (n = 106) or luteal (n = 96) menstrual phase. We observed several significantly more severe premenstrual and withdrawal symptoms in the luteal phase. Regardless of quit phase, most withdrawal symptoms were associated with an increased risk of relapse at 14 and 30 days post quit date. Participants attempting to quit smoking in the follicular phase who had higher levels of Anger and Craving were more likely to relapse to smoking at 14-days (OR = 2.00, p-value = 0.026; OR = 2.63, p-value = 0.006; respectively). These data suggest that the menstrual cycle may play a role in smoking cessation outcome, as well as in the symptomatology experienced during a cessation attempt.
• Allen, A. M., Allen, S. S., Widenmier, J., & Al'absi, M. (2009). Patterns of cortisol and craving by menstrual phase in women attempting to quit smoking. Addictive behaviors, 34(8), 632-5.
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  Research indicates stress, craving and menstrual phase may play a role in relapse to smoking. It remains unknown how these factors may interact during cessation. This study describes the relationship between craving and cortisol concentrations by menstrual phase during ad libitum smoking and investigates the impact of this relationship on time to relapse. Five assessments of cortisol concentrations and craving levels were collected the day before smoking cessation in female smokers (n=38) during either the follicular (n=21; F) or luteal (n=17; L) phase. Craving at wake-up was significantly greater in the F phase than the L phase (2.5+/-1.9 vs. 1.1+/-1.4; p=0.018; respectively). Decreased levels of morning cortisol concentrations and a greater decline from morning to the nadir levels in cortisol were associated with increased craving at bedtime in the L (r=-0.68, p=0.002; r=-0.67, p=0.003; respectively), but not in the F phase. Craving at wake-up was a significant predictor of time to relapse (p=0.008). Our results indicate that menstrual phase may play a role in the relationship among craving, cortisol concentrations, and risk for relapse.
• Allen, A. M., Mooney, M., Chakraborty, R., & Allen, S. S. (2009). Circadian patterns of ad libitum smoking by menstrual phase. Human psychopharmacology, 24(6), 503-6.
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  Recent research suggests nicotine metabolism may be influenced by sex hormones. Thus, we hypothesized that circadian smoking patterns would vary by menstrual phase.
• Allen, A. M., Prince, C. B., & Dietz, P. M. (2009). Postpartum depressive symptoms and smoking relapse. American journal of preventive medicine, 36(1), 9-12.
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  Smokers with depressive symptoms are more likely to relapse after attempting to quit than those without depressive symptoms. Little is known about the relationship between depressive symptoms and relapse during the postpartum period; thus the aim of the present study is to assess the relationship between postpartum smoking relapse and depressive symptoms.
• Allen, S. S., Allen, A. M., & Pomerleau, C. S. (2009). Influence of phase-related variability in premenstrual symptomatology, mood, smoking withdrawal, and smoking behavior during ad libitum smoking, on smoking cessation outcome. Addictive behaviors, 34(1), 107-11.
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  Emerging evidence suggests that women have a more difficult time quitting smoking than men-possibly due, in part, to sex hormones. The present study characterized mood, premenstrual symptomatology, and smoking withdrawal, as well as smoking behavior, in the follicular and luteal phases during ad libitum smoking in 25 women intending to quit. We also investigated the possible influence of phase-related variability in these measures on likelihood of study adherence and smoking cessation. We found that premenstrual symptomatology, as well as some measures of mood and smoking withdrawal, were significantly higher during the luteal phase than in the follicular phase. Cigarettes/day did not vary by menstrual cycle phase. Phase-related variability in premenstrual symptomatology [F(3, 20)=2.82, p=0.0650)] and urge to smoke [F(2, 21)=4.85, p=0.0186)] were associated with relapse. These data support the inference that sex hormones influence smoking cessation outcome. This knowledge may contribute to the development of more rational and effective smoking cessation interventions for women.
• Allen, S. S., Allen, A. M., Lunos, S., & Hatsukami, D. K. (2009). Patterns of self-selected smoking cessation attempts and relapse by menstrual phase. Addictive behaviors, 34(11), 928-31.
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  Clinical studies are emerging which suggest that sex hormones may play a role in quit attempts and relapse. The present study aim is to determine if menstrual phase plays a role on a second self-selected quit attempt and subsequent relapse during a twenty-six week follow-up. Participants (n=138) were 29.7+/-6.5 years old and smoked 16.1+/-4.8 cigarettes per day. Participants were more likely to self-select a second quit date during the Follicular (F) phase (59.4%) than Luteal (L) phase (40.6%, p=0.033) and were also more likely to relapse during the F phase than the L phase (59.7% vs. 40.3%, p=0.043, respectively). Those who self-selected to quit in the L phase experienced a significantly longer time to relapse than those who chose the F phase (median of 3 days vs. 2 days, respectively; Hazard Ratio=1.599, p-value=0.014). This confirms previous work suggesting quit dates in the F phase are associated with worse smoking cessation outcomes. Additional research is needed to investigate how this relationship may vary with the use of pharmacotherapy.
• Allen, S. S., Allen, A. M., Mooney, M., & Bade, T. (2009). Short-term weight gain by menstrual phase following smoking cessation in women. Eating behaviors, 10(1), 52-5.
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  Prevention of early weight gain may be critical to avoid relapse among women with a fear of weight gain. Menstrual phase has physiological fluctuation of fluid resulting in short-term weight gain, suggesting menstrual phase of smoking cessation may impact short-term weight gain. This study examined the effect of smoking abstinence and menstrual cycle on short-term weight gain. Women were randomized to quit smoking during the follicular or luteal phase of their cycle and followed for four weeks. Weight, among other measures, was recorded at five post-quit date visits (days 2, 5, 9, 12 and week 4). Participants (n=152) were grouped based on randomized quit phase and smoking status after assigned quit date: 1) follicular (F), quit < 24 h, 2) F, quit > or = five days, 3) luteal (L), quit < 24 h, and 4) L, quit > or = five days. Participants who quit smoking experienced significantly more weight gain than those who quit for less than 24 h. There were no significant increases in short-term weight gain based on menstrual cycle phase during attempted smoking cessation.
• Allen, A. M., Dietz, P. M., Tong, V. T., England, L., & Prince, C. B. (2008). Prenatal smoking prevalence ascertained from two population-based data sources: birth certificates and PRAMS questionnaires, 2004. Public health reports (Washington, D.C. : 1974), 123(5), 586-92.
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  This study provided a population-based estimate of the prevalence of smoking during pregnancy by combining information from two data sources: birth certificates (BCs) and a self-administered questionnaire.

Presentations

• Allen, A. M. (2019, Fall). Hormones in Substance Use Disorders: A Novel Approach to Breaking the Abstinence-Relapse Cycle?. Innovations & Interventions.
• Allen, A. M. (2019, Spring). A Pack of Pills and A Puff of Smoke: Could Hormonal Contraceptives be Influencing Cigarette Smoking?. UPenn Seminar.
• Allen, A. M., & Pettit, J. M. (2019, November 14). Marijuana Use in Pregnant and Breastfeeding Women. DFCM Grand Rounds.
• Allen, A. M., Grisham, L., & Bader, M. (2019, Summer). EAT-SLEEP-CONSOLE AS A TREATMENT FOR BABIES WITH NEONATAL ABSTINENCE SYNDROME. College of Problems on Drug Dependence.
• Tosun, N., Fieberg, A., Eberly, L., Harrison, K., Tipp, A., Allen, A. M., & Allen, S. (2019, Spring). Exogenous progesterone for smoking cessation in men and women: a double-blind, placebo-controlled randomized trial. Society for Research on Nicotine and Tobacco.
• Tosun, N., Tosun, N., Fieberg, A., Fieberg, A., Eberly, L., Eberly, L., Harrison, K., Harrison, K., Tipp, A., Tipp, A., Allen, A. M., Allen, A. M., Allen, S., & Allen, S. (2019, Spring). Exogenous progesterone for smoking cessation in men and women: a double-blind, placebo-controlled randomized clinical trial. Society for Research on Nicotine and Tobacco.
• Allen, A. M. (2018, Summer). Smoking Cessation in Women of Reproductive Age. National Reproductive Health Conference.
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  I was invited to give two seminars at this national conference.
• Allen, A. M., Yuan, N. P., Wetheim, B., Krupski, L. A., Nair, U. S., & Bell, M. L. (2018, Spring). Gender Differences in Smoking Cessation outcomes Among Callers at a State Quitline. College on Problems of Drug Dependence. San Diego, CA.
• Bell, M. L., Nair, U. S., Krupski, L. A., Wetheim, B., Yuan, N. P., & Allen, A. M. (2018, Spring). Gender Differences in Smoking Cessation outcomes Among Callers at a State Quitline. College on Problems of Drug Dependence. San Diego, CA.
• Nair, U. S., Nair, U. S., Bell, M. L., Bell, M. L., Krupski, L. A., Krupski, L. A., Wertheim, B., Wertheim, B., Yuan, N. P., Yuan, N. P., Allen, A. M., & Allen, A. M. (2018, June). Gender differences in utilization of quitline services and tobacco cessation among callers at a state quitline. College of Problems on Drug Dependence. San Diego, CA.
• Allen, A. M. (2017, July). A pack of pills and a puff of smoke. American Academy of Pediatrics, Tobacco Consortium. Elk Grove Village, IL.
• Allen, A. M., Tosun, N., Carlson, S., & Allen, S. (2017, March). Postpartum changes in mood and smoking-related symptomatology: An investigation using ecological momentary assessment. Society for Research on Nicotine and Tobacco. Florence, Italy.
• Allen, A. M. (2016, December). Hormones and Addiction. American Academy of Pediatrics, Tobacco Consortium. Virtual.
• Bell, M. L., Allen, A. M., Nair, U. S., Yuan, N. P., Wetheim, B., Krupski, L. A., Wetheim, B., Krupski, L. A., Yuan, N. P., Nair, U. S., Allen, A. M., & Bell, M. L. (2018, Spring). Gender Differences in Smoking Cessation outcomes Among Callers at a State Quitline. College on Problems of Drug Dependence. San Diego, CA.

Poster Presentations

• Allen, A. M., & Martinez, A. (2019, Summer). Nonpharmacological Adjunct Treatment for Postpartum Women with Opioid Use Disorder: A Review of the Literature beyond Pharmacology Treatment. College on Problems of Drug Dependence. San Antonio, TX.
• Allen, A. M., Cao, Q., Stayer, L., Donny, E., & Hatsukami, D. (2019, Spring). Smoking-Related Symptoms and Biomarkers by Hormonal Contraceptive Use. Society for Research on Nicotine and Tobacco.
• Allen, A. M., Chen, Y., & Bell, M. L. (2019, Spring). PREVALENCE OF CIGARETTE AND E-CIGARETTE USE AMONG WOMEN WHO USED OPIOIDS DURING PREGNANCY. Society for Research on Nicotine and Tobacco.
• Allen, A. M., Lundeen, K., Eberly, L., Allen, S. S., al'Absi, M., Muramoto, M. L., & Hatsukami, D. (2018, Spring). Hormonal Contraceptive Use is Associated with Smoking Motives. Society for Research on Nicotine and Tobacco. Baltimore, MD.
• Allen, A. M., Lundeen, K., Eberly, L., Allen, S., al'Absi, M., Muramoto, M. L., & Hatsukami, D. (2018, February). Hormonal contraceptive use is associated with smoking motives. Society for Research on Nicotine and Tobacco. Baltimore, MD.
• Allen, A. M., Nair, U. S., Yuan, N. P., Bell, M. L., Wertheim, B., Krupski, L. A., Wertheim, B., Krupski, L. A., Bell, M. L., Yuan, N. P., Nair, U. S., & Allen, A. M. (2018, Febraury). Gender differences in smoking cessation outcomes among callers at a state quitline. Society for Research on Nicotine and Tobacco. Baltimore, MD.
• Allen, A. M., Weinberger, A. H., Wetherill, R. R., Howe, C. L., & McKee, S. A. (2018, Spring). Oral Contraceptive Use and Cigarette Smoking: A Review of the Literature. Society for Research on Nicotine and Tobacco. Baltimore, MD.
• Allen, A. M., Weinberger, A., Wetherill, R., Howe, C. L., & McKee, S. (2018, February). Oral contraceptive use and cigarette smoking: A review of the literature. Society for Research on Nicotine and Tobacco. Baltimore, MD.
• Allen, A. M., Yuan, N. P., Wetheim, B., Krupski, L. A., Nair, U. S., & Bell, M. L. (2018, Spring). Gender Differences in Smoking Cessation outcomes Among Callers at a State Quitline. Society for Research on Nicotine and Tobacco. Baltimore, MD.
• Casper, K., Tosun, N., Carlson, S., Allen, A. M., Harrison, K., Lewis, B., & Allen, S. (2018, February). Exercise and smoking-related symptomatology in pregnant women. Society for Research on Nicotine and Tobacco. Baltimore, MD.
• Crist, K., Tosun, N., Harrison, K., Lammert, S., Allen, A. M., & Allen, S. S. (2018, Spring). Differences in smoking-related symptomatology between pregnant and non-pregnant smokers during ad libitum smoking and following overnight abstinence. Society for Research on Nicotine and Tobacco. Baltimore, MD.
• McKee, S. A., Allen, A. M., Weinberger, A. H., Howe, C. L., Wetherill, R. R., Wetherill, R. R., Weinberger, A. H., Howe, C. L., McKee, S. A., & Allen, A. M. (2018, Spring). Oral Contraceptive Use and Cigarette Smoking: A Review of the Literature. Society for Research on Nicotine and Tobacco Annual Meeting. Baltimore, MD: Society for Research on Nicotine and Tobacco.
• Allen, A. M. (2017, March). A pack of pills and a puff of smoke: Could hormonal contraceptives be influencing smoking behavior?. Society for Research on Nicotine and Tobacco. Florence, Italy.
• Allen, A. M., Abdelwahab, N., Carlson, S., Bosch, T., Eberly, L., & Okuyemi, K. (2017, March). The effect of exercise on craving and withdrawal: Does it vary by gender?. Society for Research on Nicotine and Tobacco. Society for Research on Nicotine and Tobacco.
• Allen, A. M., Carlson, S., Bosch, T., Eberly, L., & Okuyemi, K. (2017, March). Effect of exercise on self-initiated quit attempts?. Society for Research on Nicotine and Tobacco. Society for Research on Nicotine and Tobacco.
• Allen, A. M., Eberly, L., Allen, S., al'Absi, M., & Hatsukami, D. (2017, November). Cigarette Craving Differs by Use of Hormonal Contraceptives. Junior Investigator Poster Forum. Tucson, Arizona: University of Arizona.
• Allen, A. M., Eberly, L., Allen, S., al'Absi, M., & Hatsukami, D. (2017, October). Cigarette Craving Differs by Use of Hormonal Contraceptives. Building Interdisciplinary Research Careers in Women's Health. Washington, DC: National Institutes of Health.
• Blaes, A. H., Vogel, R. I., Raymond, N., Allen, A. M., Nagler, R., & Wyman, J. (2017, May). Breast cancer screening practices with high-risk women: A cross-sectional survey. American Society of Clinical Oncology.
• Teoh, D. G., Vogel, R. I., Allen, A. M., Blaes, A. H., Mason, S., Nagler, R., Raymond, N., & Wyman, J. (2017, May). Minnesota healthcare providers’ breast cancer screening practices at the extremes of age.. American Society of Clinical Oncology.
• Allen, A. M., Weinberger, A. H., Wetherill, R. R., Howe, C. L., & McKee, S. A. (2018, Spring). Oral Contraceptive Use and Cigarette Smoking: A Review of the Literature. Society for Research on Nicotine and Tobacco Annual Meeting. Baltimore, MD: Society for Research on Nicotine and Tobacco.
• McKee, S. A., Howe, C. L., Wetherill, R. R., Weinberger, A. H., & Allen, A. M. (2018, Spring). Oral Contraceptive Use and Cigarette Smoking: A Review of the Literature. Society for Research on Nicotine and Tobacco Annual Meeting. Baltimore, MD: Society for Research on Nicotine and Tobacco.

Others

• Allen, A. M. (2019, Nov). Preventing the Use of Marijuana: Focus on Women and Pregnancy. SAMHSA.
  More info

  https://store.samhsa.gov/system/files/pep19-pl-guide-2.pdf