Randomized Clinical Trial of the Efficacy of Bupropion Combined With Nicotine Patch in the Treatment of Adolescent Smokers.

Abstract

Adolescent smokers (N = 211) were randomized to 1 of 2 groups: (a) nicotine patch plus bupropion SR (sustained release; 150 mg per day) or (b) nicotine patch plus placebo. Group skills training sessions were conducted each week by research staff. Abstinence rates at Weeks 10 and 26 were as follows: (a) patch plus bupropion, 23% and 8%, (b) patch plus placebo, 28% and 7%. Despite the lack of a treatment effect, a large majority of adolescents in both treatment groups reduced their consumption to a few cigarettes per day or less and maintained this reduction over time. Similarly, an examination of survival curves revealed that by the end of treatment many had managed to avoid a return to daily smoking. These findings are encouraging and suggest new avenues for research. For example, treatments of the kind examined in this report, augmented by extended maintenance therapies, may yield higher long-term success rates.

Adherence to Varenicline in the COMPASS Smoking Cessation Intervention Trial

“…FTND = Fagerström Test for Nicotine Dependence. (Blondal et al, 1997;Garvey et al, 2000;Hajek et al, 1999;Hurt et al, 1997;Killen et al, 2004;Lam et al, 2005;Mooney et al, 2007;Schmitz et al, 2007;Shiffman et al, 2008). Adherence data for the COMPASS trial were collected prior to the Federal Drug Administration issuing a black box warning about possible neuropsychiatric symptoms associated with varenicline in 2009 and therefore may overestimate future adherence rates for this medication.…”

Can the blind see? Participant guess about treatment arm assignment may influence outcome in a clinical trial of bupropion for smoking cessation

“…Yet, relatively few bupropion studies report data on blind integrity. Ahluwalia, Harris, Catley, Okuyemi & Mayo (2002) and Simon, Duncan, Carmody & Hudes (2004) reported that 58-59% of participants correctly judged they were receiving bupropion and 41-47% correctly guessed that they were receiving placebo (see also Hall et al, 2002;Killen et al, 2004Killen et al, , 2006Wagena et al, 2005). These studies, however, did not assess if failure to maintain blind integrity was related to quit rates.…”

Smoking Cessation for Adolescents: A Review of Pharmacological and Psychosocial Treatments

“…For NRT, it may be that higher doses are necessary to achieve cessation; for bupropion, this appears to be the case. While significant reductions in smoking have been found at 150 mg 38 , one study did not find that 150 mg was effective when combined with NRT 41 . Poor medication adherence likely explains part of these findings, however.…”

“…Participants with a detectable level of bupropion metabolite at Week 5 had a significantly higher abstinence rate than participants without a detectable level, and overall adherence to both NRT and bupropion was low. Together, this implies that bupropion might have aided in quitting smoking when it was taken appropriately 41 .…”

“…Following adult studies on the combination of NRT and bupropion e.g., 40 , Killen and colleagues 41 examined the use of nicotine patch and 150 mg of bupropion for adolescent smoking cessation. Two hundred and eleven participants (50.2% Caucasian) were given the nicotine patch and randomized to either 150 mg bupropion or placebo for 10 weeks.…”