Data from a pilot randomized trial published in Nicotine & Tobacco Research showed that administering exogenous progesterone may potentially prevent postpartum smoking relapse. 

There has been increasing evidence suggesting sex hormones may play a role in drug abuse behavior. The significant reduction of sex hormones seen at delivery may affect postpartum smoking relapse. Researchers from the University of Minnesota conducted a 12-week, double-blind, placebo-controlled, randomized pilot trial (n=46) that assigned abstinent postpartum women to active progesterone 200mg twice daily or placebo for 4 weeks. Study patients were followed for relapse for 12 weeks. The main outcomes included abstinence, feasibility, and self-reported acceptability. Also, depressive symptom scores, adverse events, and breastfeeding was assessed for safety outcomes.  

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The data indicated an overall retention rate of 87% at Week 12. At Week 4, the progesterone group showed 75% abstinence rate compared with 68.2% in the placebo group (P=0.75). The study authors found the medication adherence rate was 68% and clinic visit attendance was at 80% with no differences by randomization. Depressive symptom scores, adverse events, and breastfeeding also did not vary by randomization.

Overall, a higher rate of abstinence at Week 4 was seen in the progesterone group. Exogenous progesterone was well tolerated with no adverse impact on depressive symptoms or breastfeeding. The study’s findings support additional research of progesterone as a postpartum relapse prevention treatment. 

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