Feasibility of remotely assessing hormonal contraceptive use and smoking-related symptomatology: Evidence from a preliminary prospective cohort study

Background: Half of women who smoke cigarettes also use hormonal contraceptives (HCs). Prior research suggests that variations in ovarian hormones may undermine smoking cessation efforts made by premenopausal women. However, clinical findings of these hormonal effects are inconsistent, potentially due to methodological limitations. The goal of this preliminary prospective cohort study is to determine the feasibility and acceptability of a fully remote protocol to longitudinally examine changes in smoking-related behavior and symptoms in relation to hormone use in women of reproductive age. Methods: Eligible participants (n = 60) were biologically female, current age 18–35 years old, smokes ≥ 5 cigarettes/day, and classified into three groups: naturally-cycling (NC; n = 17), using a monophasic oral contraceptive (OC; n = 21), or using depot medroxyprogesterone acetate (DMPA; n = 22). Participants completed daily surveys and weekly dried blood spot collections. Results: Overall, 92% (55/60) participants completed the study with 90% of daily surveys completed and 87% of participants collecting at least 5 of the 6 dried blood spot samples. Participants were “somewhat” (13%) or “extremely” (87%) likely to participate in the study again. Preliminary observations also suggested differences in self-reported cigarettes/day and premenstrual pain over time by study group. Conclusions: This study outlines a fully remote protocol that may be used to clarify the relationships between hormonal contraceptive use and smoking-related outcomes over time. Preliminary results add to existing evidence that HC use may reduce relapse risk for premenopausal women.