Predictors of cessation in African American light smokers enrolled in a bupropion clinical trial

Abstract

Background This is the first study to examine predictors of successful cessation in African American (AA) light smokers treated within a placebo-controlled trial of bupropion. Methods We analyzed data from a randomized, double-blind, placebo-controlled trial of bupropion and health education for 540 African American light smokers. African American light smokers (≤ 10 cigarettes per day, cpd) were randomly assigned to receive 150mg bid bupropion SR (n=270) or placebo (n=270) for 7 weeks. All participants received health education counseling at Weeks 0, 1, 3, 5 and 7. Using chi-square tests, two sample t-tests, and multiple logistic regression analyses, we examined baseline psychosocial and smoking characteristics as predictors of cotinine-verified 7-day point prevalence smoking abstinence among study participants at the end treatment (week 7) and at the end of follow up (week 26). Results Participants who received bupropion were significantly more likely to quit smoking compared to those who received placebo (OR = 2.72, 95% CI = 1.60–4.62, P = 0.0002). Greater study session attendance (OR = 2.47, 95% CI = 1.76–3.46, P = 0.0001), and smoking non-menthol cigarettes increased the likelihood of quitting (OR = 1.84, 95% CI = 1.01–3.36, P = 0.05); while longer years of smoking (OR = 0.98, 95% CI = 0.96–1.00, P = 0.05) and higher baseline cotinine (OR = 0.97, 95% CI = 0.95–0.99, P = 0.002) significantly reduced the odds of quitting at Week 7. Conversely, at the end of follow-up (week 26), treatment with bupropion vs. placebo (OR =1.14, 95% CI = 0.65–2.02, P = 0.64) was not significantly associated with quitting and type of cigarette smoked (menthol vs. non-menthol) did not appear in the final logistic regression model. Greater study session attendance (OR = 1.96, 95% CI = 1.44–2.66, P = 0.0001); BMI (OR = 1.03, 95% CI = 1.00–1.07, P = 0.04); and weight efficacy (OR = 1.03, 95% CI = 1.01–1.05, P = 0.01) increased the likelihood of quitting at Week 26. Similar to our findings at Week 7, longer years of smoking (OR = 0.96, 95% CI = 0.94–0.99, P = 0.01) and higher baseline cotinine (OR = 0.97, 95% CI = 0.95–0.99, P = 0.02) significantly reduced the odds of quitting at Week 26. Conclusions Baseline cotinine levels, number of years smoked and study session attendance are associated with both short- and long-term smoking cessation, while bupropion and the type of cigarette smoked were associated with quitting on short term only.

Factors associated with the efficacy of smoking cessation treatments and predictors of smoking abstinence in EAGLES

“…Evidence suggests that older age and markers of lower cigarette dependence are predictive of success 2, 3, 4, 5, 6, although not all studies show these results 7. There is less consistent, conflicting or negative evidence on the effects of age of smoking onset 2, 3, substance use disorder 8, psychiatric disorder 6, 9, gender 4, 6, 10, geographical location 11, 12, body mass index (BMI) 2, 3, 10, 13, 14 and prior use of smoking cessation treatments 15. These covariates were assessed in the EAGLES trial.…”

Smoking Cessation Among Racial/Ethnic Minorities, 2010–2014

“…Research investigating their influence among racial/ethnic minorities is limited. Faseru et al [23] was the first to investigate predictors of smoking abstinence among African Americans enrolled in an RCT testing the efficacy of bupropion. They found that treatment with bupropion was positively predictive of shortterm (week 7), but not longer-term (week 26) abstinence.…”

Nicotine Metabolism in Young Adult Daily Menthol and Nonmenthol Smokers

“…Studies suggest that persons with a lower NMR have better success at quitting than smokers with a higher NMR, [34][35][36] while other studies show no differences in quit rates 37 and no difference in the NMR in persons who quit compared with continued smokers. 38 Since the NMR has been proposed as a valid biomarker for predicting quitting success, 26,34 then understanding this biomarker as it relates to menthol smoking, which increases nicotine dependence and quitting difficulty, 10,11 is critically important.…”