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Effectiveness of bupropion sustained release for smoking cessation in a Health care setting: A randomized trial
Journal article   Open access   Peer reviewed

Effectiveness of bupropion sustained release for smoking cessation in a Health care setting: A randomized trial

Gary E Swan, Tim Mcafee, Susan J Curry, Lisa M Jack, Harold Javitz, Sara Dacey and Katherine Bergman
Archives of internal medicine (1960), Vol.163(19), pp.2337-2344
2003
DOI: 10.1001/archinte.163.19.2337
PMID: 14581254
url
https://doi.org/10.1001/archinte.163.19.2337View
Published (Version of record) Open Access

Abstract

Background: The efficacy of bupropion hydrochloride sustained release (SR) (Zyban) for smoking cessation has been evaluated in clinical trials that included frequent in-person behavioral counseling, but not in actual practice settings. Objective: To determine the differential effectiveness of 2 doses of bupropion SR in combination with behavioral interventions of minimal to moderate intensity in an actual practice setting. Design: Open-label randomized trial, with 1 year of follow-up. Setting: A large health system (Group Health Cooperative) based in Seattle. Participants: Adult smokers (N = 1524) interested in quitting smoking. Interventions: Participants were randomly assigned to receive 1 of 4 combinations of bupropion SR (150 or 300 mg) and behavioral counseling (minimal or moderate intensity). Main Outcome Measures: The primary outcome measure was self-reported point-prevalence 7-day nonsmoking status at 3 and 12 months following the target quit date. Secondary outcomes included adverse and abstinence effects reported since beginning treatment with bupropion SR. Results: At 3 months, a significantly higher rate of nonsmoking was observed among those receiving the larger bupropion SR dose (P=.005). At 12 months, moderate intensity counseling was associated significantly with a higher rate of nonsmoking (P=.001). At 3 months, the higher dose was associated with a significantly increased frequency of self-reported symptoms such as difficulty sleeping (P=.02), difficulty concentrating (P=.02), shakiness/tremor (P=.002), and gastrointestinal problems (P=.005)and a decreased frequency of reported desire to smoke (P=.001). Conclusions: In this actual practice setting, the combination of bupropion SR and minimal or moderate counseling was associated with 1-year quit rates of 23.6% to 33.2%. This suggests that existing health care systems can substantially decrease tobacco use rates among their enrollees if they provide these modest interventions.
 Neuropharmacology Biological and medical sciences Medical sciences Miscellaneous Neurotransmitters. Neurotransmission. Receptors Pharmacology. Drug treatments

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