Bupropion SR Research Articles

Smoking cessation interventions in nurses and other health care workers

Introduction: Tobacco smoking can be considered an old and a new challenge for public health. The aim of this review was to analyse different smoking cessation interventions aiming at health care workers.Methods: A literature search of electronic journal databases for studies on smoking cessation interventions among health care workers was performed according to PRISMA criteria, using the MEDLINE and Scopus databases.Results: Smoking restriction policies shouldn’t be considered as actual interventions, being ineffective, unpopular and reducing willingness to quit smoking in many subjects. Even though pharmacological therapies based on bupropion SR and transdermal nicotine patches grant significant results on the short-term (weeks and months), smoking recurrence rates are high and individualised interventions should be preferred or integrated since they seem to grant better results on the longterm (years).Conclusions: There is evidence that smoking cessation interventions among health care workers can be effective. This is of particular interest both for reducing tobacco smoking prevalence among this type of workers and for helping them to be useful model for the general population.

Weight Loss With Naltrexone SR/Bupropion SR Combination Therapy as an Adjunct to Behavior Modification: The COR‐BMOD Trial

This 56-week, randomized, placebo-controlled trial examined the efficacy and safety of naltrexone plus bupropion as an adjunct to intensive behavior modification (BMOD). A total of 793 participants (BMI = 36.5 ± 4.2 kg/m²) was randomly assigned in a 1:3 ratio to: (i) placebo + BMOD (N = 202); or (ii) naltrexone sustained-release (SR, 32 mg/day), combined with bupropion SR (360 mg/day) plus BMOD (i.e., NB32 + BMOD; N = 591). Both groups were prescribed an energy-reduced diet and 28 group BMOD sessions. Co-primary end points were percentage change in weight and the proportion of participants who lost ≥5% weight at week 56. Efficacy analyses were performed on a modified intent-to-treat population (ITT; i.e., participants with ≥1 postbaseline weight while taking study drug (placebo + BMOD, N = 193; NB32 + BMOD, N = 482)). Missing data were replaced with the last observation obtained on study drug. At week 56, weight loss was 5.1 ± 0.6% with placebo + BMOD vs. 9.3 ± 0.4% with NB32 + BMOD (P < 0.001). A completers analysis revealed weight losses of 7.3 ± 0.9% (N = 106) vs. 11.5 ± 0.6% (N = 301), respectively (P < 0.001). A third analysis, which included all randomized participants, yielded losses of 4.9 ± 0.6 vs. 7.8 ± 0.4%, respectively (P < 0.001). Significantly more NB32 + BMOD- vs. placebo + BMOD-treated participants lost ≥5 and ≥10% of initial weight, and the former had significantly greater improvements in markers of cardiometabolic disease risk. NB32 + BMOD was generally well tolerated, although associated with more reports of nausea than placebo + BMOD. The present findings support the efficacy of combined naltrexone/bupropion therapy as an adjunct to intensive BMOD for obesity.

Smoking history and motivation to quit in smokers with schizophrenia in a smoking cessation program

Objective The present study sought to better understand the relationships among smoking history, motivation to change, and smoking cessation outcomes in people with schizophrenia who smoke. Method We examined smoking and quit history, negative consequences due to smoking, readiness to change, smoking temptation, and confidence to quit in a sample of people diagnosed with schizophrenia or schizoaffective disorder according to DSM-IV criteria who were participating in a larger randomized trial of bupropion SR and a psychoeducational intervention for smoking cessation. Data were collected from June 2003 to May 2005. Results At baseline, participants reported high levels of nicotine dependence and daily smoking, as well as multiple recent and lifetime quit attempts that were generally brief in nature. Participants were most concerned about the health effects of smoking and endorsed reasons for smoking related to coping with negative affect and boredom. Most participants reported wanting to quit smoking, but the sample generally reported low levels of confidence in their ability to quit. During the course of participation in the intervention, self-efficacy to quit increased while temptation to smoke decreased; however readiness to quit remained unchanged. Conclusion Smoking cessation programs for people with schizophrenia should focus on teaching coping skills for negative affect, boredom, and specific “high risk situations” for smoking in addition to education, medication, or nicotine replacement therapy. Further, cessation efforts may benefit from directly addressing low self-efficacy for quitting, rather than readiness for change alone, among people with schizophrenia.

Anxiety diagnoses in smokers seeking cessation treatment: relations with tobacco dependence, withdrawal, outcome and response to treatment

To understand the relations among anxiety disorders and tobacco dependence, withdrawal symptoms, response to smoking cessation pharmacotherapy and ability to quit smoking. Randomized placebo-controlled clinical trial. Participants received six 10-minute individual counseling sessions and either: placebo, bupropion SR, nicotine patch, nicotine lozenge, bupropion SR + nicotine lozenge or nicotine patch + nicotine lozenge. Two urban research sites. Data were collected from 1504 daily smokers (>9 cigarettes per day) who were motivated to quit smoking and did not report current diagnoses of schizophrenia or psychosis or bupropion use. Participants completed baseline assessments, the Composite International Diagnostic Interview and ecological momentary assessments for 2 weeks. A structured clinical interview identified participants who ever met criteria for a panic attack (n = 455), social anxiety (n = 199) or generalized anxiety disorder (n = 99), and those who qualified for no anxiety diagnosis (n = 891). Smokers with anxiety disorders reported higher levels of nicotine dependence and pre-quit withdrawal symptoms. Those ever meeting criteria for panic attacks or social anxiety disorder showed greater quit-day negative affect. Smokers ever meeting criteria for anxiety disorders were less likely to be abstinent at 8 weeks and 6 months post-quit and showed no benefit from single-agent or combination-agent pharmacotherapies. Anxiety diagnoses were common among treatment-seeking smokers and were related to increased motivation to smoke, elevated withdrawal, lack of response to pharmacotherapy and impaired ability to quit smoking. These findings could guide treatment assignment algorithms and treatment development for smokers with anxiety diagnoses.

A multi‐level analysis of non‐significant counseling effects in a randomized smoking cessation trial

To determine, in the context of a trial in which counseling did not improve smoking cessation outcomes, whether this was due to a failure of the conceptual theory identifying treatment targets or the action theory specifying interventions. Data from a randomized clinical trial of smoking cessation counseling and bupropion SR were submitted to multi-level modeling to test whether counseling influenced real-time reports of cognitions, emotions and behaviors, and whether these targets predicted abstinence. Center for Tobacco Research and Intervention, Madison, WI. A total of 403 adult, daily smokers without contraindications to bupropion SR use. Participants were assigned randomly to receive individual counseling or no counseling and a 9-week course of bupropion SR or placebo pill. Cessation counseling was delivered in eight 10-minute sessions focused on bolstering social support, motivation, problem-solving and coping skills. Pre- and post-quit ecological momentary assessments of smoking behavior, smoking triggers, active prevention and coping strategies, motivation to quit, difficulty quitting and reactions to initial lapses. Counseling prompted avoidance of access to cigarettes, improved quitting self-efficacy, reduced perceived difficulty of quitting over time and protected against guilt and demoralization following lapses. Results also supported the importance of limiting cigarette access, receiving social support, strong motivation and confidence and easing withdrawal distress during cessation efforts. Quitting self-efficacy and perceived difficulty quitting may partially mediate counseling effects on abstinence. Smoking cessation counseling may work by supporting confidence about quitting and reducing perceived difficulty quitting. Counseling did not affect other targets that protect against relapse.

Immediate versus delayed quitting and rates of relapse among smokers treated successfully with varenicline, bupropion SR or placebo

AimsWe assessed to what degree smokers who fail to quit on the target quit date (TQD) or lapse following TQD eventually achieve success with continued treatment.DesignA secondary analysis of pooled data of successful quitters treated with varenicline (306 of 696), bupropion (199 of 671) and placebo (121 of 685) from two identically-designed clinical trials of varenicline versus bupropion sustained-release and placebo.SettingMultiple research centers in the US.ParticipantsAdult smokers (n = 2052) randomized to 12 weeks drug treatment plus 40 weeks follow-up.MeasurementThe primary end-point for the trials was continuous abstinence for weeks 9–12. TQD was day 8. Two patterns of successful quitting were identified. Immediate quitters (IQs) were continuously abstinent for weeks 2–12. Delayed quitters (DQs) smoked during 1 or more weeks for weeks 2–8.FindingsCumulative continuous abstinence (IQs + DQs) increased for all treatments during weeks 3–8. Overall IQs and DQs for varenicline were (24%; 20%) versus bupropion (18.0%, P =0.007; 11.6%, P <0.001) or placebo (10.2%, P <0.001; 7.5%, P <0.001). However, DQs as a proportion of successful quitters was similar for all treatments (varenicline 45%; bupropion 39%; placebo 42%) and accounted for approximately one-third of those remaining continuously abstinent for weeks 9–52. No gender differences were observed by quit pattern. Post-treatment relapse was similar across groups.ConclusionsOur data support continuing cessation treatments without interruption for smokers motivated to remain in the quitting process despite lack of success early in the treatment.

A Targeted Review of Smoking Cessation Aids and Their Pharmacology for the Pharmacy Technician

Objective: To review the pharmacologic treatment options available for smoking cessation. Data Synthesis: Nicotine replacement therapy (NRT) has a less rapid onset than that of nicotine received from smoking; therefore, it does not cause the same pleasurable response but helps to decrease the cravings. NRT is available over the counter as a gum, lozenge, and patch. NRT is also available by prescription as a nasal spray and inhaler. Information is also provided on the dosing and adverse effect profiles of 2 non-NRT prescription products used for smoking cessation including bupropion SR and varenicline. Conclusions: It is important for pharmacy technicians to be aware of the NRT and non-NRT products available both over the counter and by prescription so that they can better work with the pharmacist to aid patients in the smoking cessation process. Current guidelines do not specify any of the medications as first line. Patients should be educated on all of the options available so that they can decide which option they think will help them succeed.

Smoking Cessation Intervention: An Evidence-Based Approach

Cigarette smoking represents the most important source of preventable morbidity and premature mortality worldwide. Approximately 100 million deaths were caused by tobacco use in the 20th century. There are > 1 billion smokers worldwide, and globally the use of tobacco products is increasing, with the epidemic shifting to the developing world. Tobacco dependence is a chronic condition that often requires repeated intervention for success. Just informing a patient about health risks, although necessary, is usually not sufficient for a decision to change. Smokers should be provided with counseling when attempting to quit. Pharmacologic smoking cessation aids are recommended for all smokers who are trying to quit, unless contraindicated. Evidence-based guidelines recommend nicotine replacement therapy, bupropion SR, and varenicline as effective alternatives for smoking cessation therapy, especially when combined with behavioral interventions. Combination pharmacotherapy is indicated for highly nicotine-dependent smokers, patients who have failed with monotherapy, and patients with breakthrough cravings. An additional form of nicotine replacement therapy or an addition of a non-nicotine replacement therapy oral medication (bupropion or varenicline) may be helpful. The rate of successful smoking cessation at 1 year is 3% to 5% when the patient simply tries to stop, 7% to 16% if the smoker undergoes behavioral intervention, and up to 24% when receiving pharmacological treatment and behavioral support.

Current approaches to pharmacotherapy for smoking cessation

It is well established that smoking is the primary preventable cause of disease and death in the United States and that it is responsible for a wide range of negative health consequences, including but not limited to respiratory disease. According to the US Public Health Service, all patients attempting to quit smoking should be encouraged to use one or more effective pharmacotherapy agents for cessation except in the presence of special circumstances or in populations for which there is insufficient evidence of effectiveness (pregnant women, smokeless tobacco users, light smokers and adolescents). These medications are most effective when coupled with behavioral counseling interventions. This review article provides an overview of comprehensive (the 5 A's framework: Ask, Advise, Assess, Assist, Arrange) and brief (Ask, Advise, Refer) interventions for assisting patients with quitting, and a more detailed review of the seven first-line pharmacological agents for smoking cessation (nicotine replacement therapy formulations, bupropion SR and varenicline) and combination therapy regimens. This information will facilitate respiratory therapists in addressing the most important risk factor for pulmonary disease in the patient population that they serve.

Sustain Released Bupropion in the Treatment of Tricotillomania: Outpatient Follow Up Survey

Objectives. Tricotillomania (TTM) is more common than expected. SSRI's are the treatment of choice in TTM. However, response rates are lower with SSRI's. The aim of our study is to explore other pharmacological interventions. Materials and Methods. Nine female TTM patients with SSRI treatment failure were included. Sample was treated with bupropion SR up to 450 mg/day. Results. Six out of nine patients responded well to bupropion SR. Massachusetts General Hospital Hair Pulling Scale (MGH) demonstrated a significant improvement at the twelve week point (f: 32.3, power: 1, lambda: 97.1, P .0001 ) and the response rates remained stable at sixteen-month follow up visit. Conclusions. Bupropion SR could be an alternative pharmacological treatment for TTM. Larger samples with double blind placebo controlled design are needed to confirm our preliminary report.

Assessment of the effectiveness of sustained release Bupropion and intensive physician advice in smoking cessation

Background:Tobacco use is the cause of immense burden on our nation in terms of mortality and morbidity, being the single leading cause of preventable illnesses and death. Smoking cessation interventions in our country will be the most cost effective of all interventions considering that the cost incurred on the three main tobacco related illnesses (COPD, CAD, and Cancer) being around Rs 27,761 crore in the year 1999.Matrials and MethodsA double blind placebo controlled trial was conducted to see the efficacy of Bupropion in smoking cessation. Smokers with current depression were excluded. The subjects (n = 30) were randomly assigned to receive Bupropion SR 300 mg/day or placebo for seven weeks. Target quit date was preferentially 8th day of starting the treatment. Intensive counseling was provided by the physician at the baseline and brief counseling at every visit weekly during the treatment phase and at weeks 12 and 16. Self reported abstinence was confirmed by a carbon monoxide concentration in expired air of less than 10 ppm.Results:The seven-day point prevalence abstinence rate at the end of week 2 and week 16 in the drug group was 46.67% and 53.33 % respectively and in the placebo group was 13.33% and 20% respectively with the ‘P’ value of 0.04 and 0.05 respectively. Rates of continuous abstinence at weeks 4, 7 and 16 were 46.67%, 40% and 33.33% in the drug group and 13.33%, 13.33% and 13.33% in the placebo group respectively. The rates were significantly higher in the drug group till week 4 starting from week 2 of the treatment phase. The mean weight gain in drug group was found to be significant less as compared to the placebo at week 16 (P = 0.025) The mean change of depression scores from the baseline was not significantly different between the two groups at any point of time. The withdrawal symptom score increase from the baseline was not significantly higher at any point of time in the drug group but in the placebo group the increase was significantly higher for seven days after target quit date and at weeks 3 and 4 (P < 0.05). The most common adverse events in the drug group were insomnia, which was seen in 6 (40%) patients and dry mouth and/or altered taste in 4 (26.67%) patients, which was significantly higher as compared to placebo. Predictors of Outcome:The univariate predictors of a successful outcome were the point prevalence abstinence at week 16 were older age (>40 years), (P = 0.044) and quitter status at week 2 (P = 0.001). Multivariate predictors in order of importance were Quit status at 2nd week (P = 0.002) and Age >40 years (P = 0.031). The combined predictive value of these two variables was found to be 86.3%.Conclusions:Bupropion helps in smoking cessation. This has been proved by three large multicenter randomized controlled trials. This study has also reflected the same result in the form of significantly high seven-day point prevalence abstinence at week 16 in the Bupropion group as compared to placebo. Bupropion has a beneficial effect on weight gain and withdrawal symptoms and the benign adverse effects of insomnia and dry mouth or altered taste make it a very effective and cheap treatment for nicotine addiction in smokers.

Comparative Effectiveness of 5 Smoking Cessation Pharmacotherapies in Primary Care Clinics

Randomized efficacy clinical trials conducted in research settings may not accurately reflect the benefits of tobacco dependence treatments when used in real-world clinical settings. Effectiveness trials (eg, in primary care settings) are needed to estimate the benefits of cessation treatments in real-world use. A total of 1346 primary care patients attending routine appointments were recruited by medical assistants in 12 primary care clinics. Patients were randomly assigned to 5 active pharmacotherapies: 3 monotherapies (nicotine patch, nicotine lozenge, and bupropion hydrochloride sustained release [SR]) and 2 combination therapies (patch + lozenge and bupropion SR + lozenge). Patients were referred to a telephone quit line for cessation counseling. Primary outcomes included 7-day point prevalence abstinence at 1 week, 8 weeks, and 6 months after quitting and number of days to relapse. Among 7128 eligible smokers (> or =10 cigarettes per day) attending routine primary care appointments, 1346 (18.9%) were enrolled in the study. Six-month abstinence rates for the 5 active pharmacotherapies were the following: bupropion SR, 16.8%; lozenge, 19.9%; patch, 17.7%; patch + lozenge, 26.9%; and bupropion SR + lozenge, 29.9%. Bupropion SR + lozenge was superior to all of the monotherapies (odds ratio, 0.46-0.56); patch + lozenge was superior to patch and bupropion monotherapies (odds ratio, 0.56 and 0.54, respectively). One in 5 smokers attending a routine primary care appointment was willing to make a serious quit attempt that included evidence-based counseling and medication. In this comparative effectiveness study of 5 tobacco dependence treatments, combination pharmacotherapy significantly increased abstinence compared with monotherapies. Provision of free cessation medications plus quit line counseling arranged in the primary care setting holds promise for assisting large numbers of smokers to quit. Trial Registration clinicaltrials.gov Identifier: NCT00296647.

Effectiveness of pharmacotherapy and behavioral interventions for smoking cessation in actual clinical practice

This study evaluated the effectiveness of behavioral interventions (brief counseling, nonspecific psychological support in groups - NSGS and cognitive behavioral group therapy - CBGT) in combination with bupropion SR for smoking cessation in the field, through a smoking cessation clinic. Two-hundred-and-five smokers were enrolled in a 19-week course during 2007/ 2008, and were randomly assigned to: bupropion SR combined with brief counseling (group A), bupropion SR combined with NSGS (group B), bupropion SR combined with CBGT (group C), or CBGT as the only approach (group D). Continuous abstinence rates at the end of therapy were 53.2% for group A, 62.9% for group B, 50.0% for group C, and 22.2% (p < 0.05) for group D. Sustained abstinence rates in 12 months were 29.6%, 28.1%, 34.3% and 19.4% (p > 0.05), respectively. Bupropion SR is an effective aid for smoking cessation in clinical practice. NSGT increased the chances for success at the end of therapy when combined with bupropion SR, while CBGT as monotherapy was less effective compared with the approaches including pharmacotherapy. It is suggested that smoking cessation interventions in real-life healthcare settings should be implemented through comprehensive programs using pharmacotherapy where applicable, combined with NSGT, and integrated by specialized healthcare professionals.

The impact of chronic bupropion on plasma cotinine and on the subjective effects of ad lib smoking: A randomized controlled trial in unmotivated smokers

Bupropion is an efficacious non-nicotine medication for smoking cessation; however, its cessation-mediating mechanism is unclear. This randomized, placebo-controlled trial examined the effect of bupropion SR (300 mg/day for 6 weeks) on plasma cotinine and on the subjective effects of smoking in 24 current daily smokers who were not trying to quit or reduce smoking. Subjective effects of smoking, as well as cue-elicited responses were assessed at bi-weekly experimental sessions using validated scales. Several indices of cigarette consumption were measured. Plasma cotinine decreased from 280 (± 133) μg/l at baseline to 205 (± 108) μg/l at end of treatment in the bupropion group ( p = 0.036), but no significant change was found in the placebo group. Daily cigarette count and puff topography did not significantly change in either group. In contrast to placebo, bupropion increased post-smoking satiety ( p = 0.045). Both groups reported higher craving ( p = 0.025) and withdrawal ( p = 0.014) after exposure to smoking-related pictures, compared to neutral pictures. This biased reactivity was not significantly affected by treatment condition ( p > 0.1). Therefore, bupropion does not appear to impact the smokers' response to conditioned smoking-related cues but influences the unconditioned subjective effects of smoking in unmotivated smokers. This study is among the first to systematically investigate the effect of chronic bupropion administration, free from the confounding effect of the smoker's motivation to quit smoking.

A tragic triad: coronary artery disease, nicotine addiction, and depression

Despite the availability of multiple resources for treating smoking in patients with cardiovascular disease (CVD) and the well known risks of continued smoking, a majority of smokers resume smoking after hospitalization for acute CVD. Depression is common among patients with CVD and is associated with failure to follow recommendations to reduce cardiac risk. This review examines the complex relationship between smoking and depression in patients with CVD and current evidence for treating this triad. The prevalence of depressive symptoms among smokers hospitalized with CVD is 22-24%. Smokers with depressive symptoms are more likely to return to smoking after hospital discharge compared with nondepressed smokers. Stronger nicotine withdrawal symptoms among the depressed smokers contribute to relapse. Secondary analyses suggest that bupropion SR and cognitive behavioral therapy may be effective treatments for smokers with depression and CVD. A systematic review of smoking interventions in hospitalized patients found that only intensive counseling interventions with follow-up for more than 1 month were effective for smokers with CVD. Clinicians should consider screening all smokers with CVD for depression, particularly during hospitalization for an acute event. Smokers hospitalized with CVD need intensive counseling lasting more than 1 month after discharge, and smokers with depressive symptoms need even more prolonged treatment for quitting. The addition of pharmacotherapy to long-term counseling has the potential to further improve cessation rates.

Racial differences in smoking abstinence rates in a multicenter, randomized, open-label trial in the United States

BackgroundThis study evaluates differences in smoking abstinence between white and minority smokers using pharmaceutical aids.MethodsThis is an analysis of data from a multi-center, randomized, clinical trial conducted in the United States. Of the 1,684 subjects randomized to one of three medications (nicotine inhaler, bupropion, or a combination of both), 60% were women and 10% were minority races.ResultsFactors associated with a decreased likelihood of smoking at 12 weeks were older age (OR = 0.971, p < 0.0001), being married (OR = 0.678, p = 0.0029), using bupropion SR (OR = 0.480, p < 0.0001), and using combination therapy (OR = 0.328, p < 0.0001). Factors associated with an increased likelihood of smoking were higher tobacco dependence scores (OR = 1.244, p < 0.0001), prior quit attempts (OR = 1.812, p = 0.004), and being a minority (OR = 1.849, p = 0.0083). Compared to white smokers, minority smokers were significantly older at time of study entry (46 vs. 42 years, p < 0.0001), less likely to be married (35% vs. 59%, p < 0.0001), older at smoking initiation (21 vs. 19 years of age, p < 0.0001), and had a lower abstinence rate (16% vs. 26%, p = 0.0065).ConclusionRegardless of the treatment used, minority smokers in the US have lower smoking abstinence after treatment for tobacco dependence. Future research should focus on the improvement in treatment strategies for minority smokers.

Smoking cessation: How compelling is the evidence? A review

To provide a short review of the evidence base supporting smoking cessation interventions, including behavioral therapy and pharmacological treatment options. Published meta-analysis was mainly used supplemented with a limited literature search. Effective smoking cessation consists of pharmacotherapy and behavioral support. Counseling increases abstinence rates parallel to the intensity of support. First-line pharmacological drugs for smoking cessation are nicotine replacement products (patch, gum, inhaler, nasal spray, lozenge/tablets), varenicline and bupropion SR with scientific well-documented efficacy when used for 2-3 months and mostly mild side effects. Alternative therapies such as hypnosis and acupuncture have no scientifically proven effects. With the most optimal drugs and counseling today a 1-year abstinence rate of approximately 25% can be expected in smoking cessation. On-going research is examining the potential effects of nicotine vaccination as relapse prevention.

Depression with Panic Episodes and Coronary Vasospasm

Variant (Prinzmetal's) angina is an uncommon cause of precordial pain caused by coronary vasospasm and characterized by transient ST elevation and negative markers of myocardial necrosis. This is the case of a female patient with a prior history of depression and panic attacks who presented with recurrent symptoms including chest pain. A cardiac event monitor positively documented coronary vasospasm associated with anxiety-provoking chest pain, whereas the coronary arteries were angiographically normal. We noted that the frequency of angina attacks apparently increased during the period that coincided with the introduction of Bupropion SR for treatment of the patient's depression. Considering the possibility of bupropion-associated negative impact on coronary vasospasm, the antidepressant therapy was adjusted to exclude this drug. Although Prinzmetal's angina is relatively uncommon, we suspect that a routine use of cardiac event monitors in subjects with panic disorder might reveal a greater incidence of coronary vasospasm in this patient population.

Treatment Options in Smoking Cessation: What Place for Bupropion Sustained-Release?

Bupropion SR is approved for the treatment of tobacco dependence in adult smokers. Bupropion SR is an atypical antidepressant that has been shown to double the likelihood of quitting smoking (to roughly 19%-24% six months into a quit attempt), perhaps by acting on dopaminergic and noradrenergic systems and by acting as an antagonist of nicotine acetylcholine receptors. Head-to-head comparisons of bupropion SR and other stop-smoking treatments suggest that bupropion SR is as or more efficacious than nicotine replacement therapies, equally efficacious as nortriptyline, and less efficacious than varenicline. The evidence available regarding the effectiveness of bupropion SR in real-world settings suggests that abstinence rates are similar to those seen in controlled clinical trials. Bupropion SR appears to be safe and efficacious for both men and women and for people with comorbid medical or mental health conditions. Evidence collected to date supports the use of bupropion SR as a safe, tolerable pharmacotherapy for smoking cessation among adult smokers without a predisposition to seizures, but also suggests that benefits in terms of abstinence last only as long as treatment continues. This review focuses on recent evidence regarding bupropion SR effects and highlights important questions regarding the duration of effects, relative efficacy, effectiveness in clinical use, mechanisms of action, and utilization of bupropion SR that remain unanswered.

Canary in a coal mine? Interest in bupropion SR use among smokers in the COMPASS trial

Journal Article Canary in a coal mine? Interest in bupropion SR use among smokers in the COMPASS trial Get access Jennifer B. McClure, Jennifer B. McClure 1 1Group Health Center for Health StudiesSeattle, WA Correspondence: Jennifer B. McClure, Ph.D., Group Health Center for Health Studies, 1730 Minor Ave., Suite 1600, Seattle, WA 98101, USA. Tel: +1 (206) 287-2737; Fax: +1 (206) 287-2871; E-mail: McClure.J@GHC.org Search for other works by this author on: Oxford Academic PubMed Google Scholar Lisa Jack, Lisa Jack 2SRI InternationalMenlo Park, CA Search for other works by this author on: Oxford Academic PubMed Google Scholar Mona Deprey, Mona Deprey 3Free & Clear, Inc.Seattle, WA Search for other works by this author on: Oxford Academic PubMed Google Scholar Sheryl Catz, Sheryl Catz 1Group Health Center for Health StudiesSeattle, WA Search for other works by this author on: Oxford Academic PubMed Google Scholar Tim McAfee, Tim McAfee 3Free & Clear, Inc.Seattle, WA Search for other works by this author on: Oxford Academic PubMed Google Scholar Susan Zbikowski, Susan Zbikowski 3Free & Clear, Inc.Seattle, WA Search for other works by this author on: Oxford Academic PubMed Google Scholar Emily Westbrook, Emily Westbrook 1Group Health Center for Health StudiesSeattle, WA Search for other works by this author on: Oxford Academic PubMed Google Scholar Gary Swan Gary Swan 2SRI InternationalMenlo Park, CA Search for other works by this author on: Oxford Academic PubMed Google Scholar Nicotine & Tobacco Research, Volume 10, Issue 12, December 2008, Pages 1815–1816, https://doi.org/10.1080/14622200802488358 Published: 01 December 2008 Article history Received: 14 February 2008 Accepted: 20 March 2008 Published: 01 December 2008