Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism∗

Hayford, Kyla; Patten, Christi A.; Rummans, Teresa A.; Schroeder, Darrell R.; Offord, Kenneth P.; Croghan, Ivana T.; Glover, Elbert D.; Sachs, David P.L.; Hurt, R. Douglas

doi:10.1192/bjp.174.2.173

Cited by 239 publications

(145 citation statements)

References 11 publications

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“…Depressive symptoms, as measured by the Beck Depression Inventory, have not been found to change following smoking cessation treatment with bupropion lasting either 7 weeks (Hurt et al, 1997) or 9 weeks (Jorenby et al, 1999). However, findings are less consistent when the efficacy of bupropion is examined for cessation among smokers with a history of MDD, with some studies finding bupropion to be more efficacious for past-MDD smokers (Hall et al, 2002;Smith et al, 2003) and some studies finding no such differential efficacy (Cox et al, 2004;Hayford et al, 1999).…”

Section: Introductionmentioning

confidence: 74%

Bupropion and cognitive-behavioral treatment for depression in smoking cessation

Brown

Niaura

Lloyd-Richardson

et al. 2007

CNTR

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This study is a randomized, double-blind, placebo-controlled clinical trial examining the effects of an intensive cognitive-behavioral mood management treatment (CBTD) and of bupropion, both singularly and in combination, on smoking cessation in adult smokers. As an extension of our previous work, we planned to examine the synergistic effects of CBTD and bupropion on smoking cessation outcomes in general and among smokers with depression vulnerability factors. Participants were 524 smokers (47.5% female, M age =44.27 years) who were randomized to one of four 12-week treatments: (a) standard, cognitive-behavioral smoking cessation treatment (ST) plus bupropion (BUP), (b) ST plus placebo (PLAC), (c) standard cessation treatment combined with cognitivebehavioral treatment for depression (CBTD) plus BUP, and (d) CBTD plus PLAC. Follow-up assessments were conducted 2, 6, and 12 months after treatment, and self-reported abstinence was verified biochemically. Consistent with previous studies, bupropion, in comparison with placebo, resulted in better smoking outcomes in both intensive group treatments. Adding CBTD to standard intensive group treatment did not result in improved smoking cessation outcomes. In addition, neither CBTD nor bupropion, either alone or in combination, was differentially effective for smokers with single-past-episode major depressive disorder (MDD), recurrent MDD, or elevated depressive symptoms. However, findings with regard to recurrent MDD and elevated depressive symptoms should be interpreted with caution given the low rate of recurrent MDD and the low level of depressive symptoms in our sample. An a priori test of treatment effects in smokers with these depression vulnerability factors is warranted in future clinical trials.

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Section: Introductionmentioning

confidence: 74%

Bupropion and cognitive-behavioral treatment for depression in smoking cessation

Brown

Niaura

Lloyd-Richardson

et al. 2007

CNTR

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“…Although some studies have found no differences in the ability to quit smoking on the basis of alcohol problems (e.g., Hayford et al 1999;Hughes et al 2003;Hurt et al 1995;Sobell et al 1995), many studies demonstrate that individuals with current or past histories of alcohol problems are less likely to be successful at quitting smoking compared to those without alcohol problems (e.g., Daeppen et al 2000;Di Franza and Guerrera 1990;Hughes 1995). However, little is known about how to best promote smoking cessation in this population of drinkers who are at increased risk for alcohol-mediated tobacco relapse (Baer and Lichenstein 1988;Brandon et al 1990;Sobell et al 1990;Shiffman et al 1994Shiffman et al , 1996Zimmerman et al 1990).…”

Section: Discussionmentioning

confidence: 99%

Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration

et al. 2007

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Rationale-Nicotine replacement is commonly used to treat tobacco use in heavy-drinking smokers. However, few studies have examined the effect of nicotine replacement on subjective and physiological responses to alcohol and alcohol drinking behavior.Objective-The primary aim of this within-subject, double-blind study was to examine whether transdermal nicotine replacement (0 mg vs 21 mg/day) altered response to a low-dose priming drink and subsequent ad libitum drinking behavior.Materials and methods-Subjects (n=19) were non-treatment-seeking, non-dependent heavy drinkers who were daily smokers. Six hours after transdermal patch application, subjective and physiological responses to a priming drink [designed to raise blood alcohol levels (BALs) to 0.03 g/ dl] were assessed. This was followed by a 2-h self-administration period where subjects could choose to consume up to eight additional drinks (each designed to raise BALs by 0.015 g/dl) or to receive monetary reinforcement for drinks not consumed.Results-We found that 6 h after patch application, tobacco craving associated with withdrawal relief was decreased, and systolic blood pressure and heart rate were increased in the active patch condition compared to the placebo patch condition. Subjective intoxication in response to the priming drink was attenuated in the active nicotine patch condition compared to 6 h of nicotine deprivation (i.e., placebo patch). During the self-administration period, subjects had longer latencies to start drinking and consequently appeared to consume fewer drinks when administered the active patch compared to the placebo patch.Conclusions-In heavy drinkers, transdermal nicotine replacement compared to mild nicotine deprivation attenuated subjective and physiological alcohol responses and delayed the initiation of drinking.

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“…Although some studies have found no differences in the ability to quit smoking on the basis of alcohol problems (e.g., Hayford et al, 1999;Sobell et al, 1995), the majority of studies demonstrate that individuals with current or past history of alcohol problems are more nicotine dependent and are less likely to be successful at quitting smoking, compared to those without alcohol problems (e.g., Daeppen et al, 2000;Di Franza & Guerrera, 1990). One possible reason for this population's reduced ability to quit smoking is that alcohol use promotes smoking relapse (Baer & Lichenstein, 1988;Shiffman 1986;Shiffman et al, 1996;Zimmerman et al, 1990).…”

Section: Discussionmentioning

confidence: 99%

Modeling the effect of alcohol on smoking lapse behavior

et al. 2006

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The primary aim of this project was to examine the role of alcohol use in smoking lapse behavior, as alcohol consumption is a known risk factor for poor smoking cessation outcomes. We have developed a novel human laboratory model to examine two primary aspects of alcohol-mediated tobacco relapse: 1) Does alcohol facilitate the initiation of the first cigarette? 2) Once the first cigarette is initiated, does alcohol facilitate subsequent smoking? Using a within-subject design, 16 daily smokers who were also heavy social drinkers received a priming drink (0.03 g/dl or taste masked placebo) and then had the option of initiating a tobacco self-administration session or delaying initiation by five minute increments for up to 50 minutes in exchange for monetary reinforcement. Subsequently, the tobacco self-administration session consisted of a one-hour period, in which subjects could choose to smoke their preferred brand of cigarettes using a smoking topography system or receive monetary reinforcement for cigarettes not smoked. Alcohol craving, tobacco craving, subjective reactivity to alcohol, and nicotine withdrawal were assessed as secondary outcomes. Results demonstrated that after consuming the alcohol beverage, subjects were less able to resist the first cigarette and initiated their smoking sessions sooner, and smoked more cigarettes compared to the placebo beverage. These findings have implications for smoking cessation in alcohol drinkers and model development to assess smoking lapse behavior. Keywordssmoking; lapse behavior; alcohol; craving; human laboratory; monetary reinforcement It is well established that alcohol consumption and tobacco use are highly correlated in both clinical and non-clinical samples. Among alcoholics, 80% to 95% are smokers (DiFranza & Guerrera, 1990;Hughes, 1993;Kalman et al., 2005;Patten et al., 1996;Sobell et al., 1990), as compared to 23% in the general population (CDC, 2003 (DiFranza & Guerrera, 1990;Grant et al., 2004;Hurt et al., 1994) and the severity of alcohol and tobacco dependence is positively correlated (Ellingstad et al., 1999;Gulliver et al., 1995). Smoking is also highly correlated with drinking in nonalcoholic individuals (Carmody et al., 1985;Istvan & Matarazza, 1984), particularly among those who are heavy drinkers. Both laboratory studies and naturalistic observations have demonstrated that alcohol consumption is strongly associated with increased rates of smoking (Glautier et al., 1996;Mitchell et al., 1995;Shiffman et al., 1994). Additionally, there is evidence for cross-substance craving from both clinical and non-clinical samples (Drobes et al., 2000;Tiffany, 1995). Given the high co-occurrence of alcohol and tobacco use, it is not surprising that alcohol has been identified as a risk factor for poor smoking cessation outcomes (Baer & Lichenstein, 1988;Shiffman 1986;Zimmerman et al., 1990). For example, Shiffman (1986) found that 20% of all relapse episodes in smokers involved alcohol consumption. In a real-time examination of first lapse episodes, ...

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Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism∗

Abstract: Bupropion is efficacious for smoking cessation independently of a former history of major depression or alcoholism. Increases in depressive symptoms during an initial period of abstinence are associated with a return to smoking.

Cited by 239 publications

References 11 publications

Bupropion and cognitive-behavioral treatment for depression in smoking cessation

Bupropion and cognitive-behavioral treatment for depression in smoking cessation

Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration

Modeling the effect of alcohol on smoking lapse behavior

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