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APHA Scientific Session and Event Listing

Joel D. Killen, PhD¹, Stephen Fortmann, MD², and Christina J. Arredondo, BA¹. (1) Stanford Prevention Research Center, Stanford UIniversity, Hoover Pavillion, Room N229, 211 Quarry Road, Stanford, CA 94305, 510-967-6041, christina.arredondo@gmail.com, (2) Stanford Prevention Research Center, Stanford Univeristy, 211 Quarry Road, Stanford, CA 94305-5705

We present results of a NIH funded randomized clinical trial investigating the efficacy of extended treatment with bupropion SR in producing longer-term cigarette smoking cessation. Using an intent-to-treat model, adult smokers (N=362) received open label treatment (11 weeks) that combined relapse prevention training, bupropion SR and nicotine patch followed by extended treatment (14 weeks) with bupropion SR or matching placebo. Our results showed that while abstinence percentages were relatively high (week 11: 52%; week 25: bupropion: 42%; placebo: 38%; week 52: bupropion: 33%; placebo: 34%), bupropion SR did not surpass placebo. Despite the lack of a treatment effect, several findings are of considerable interest. While gender and baseline cravings were identified as significant, independent moderators of treatment response, the combination of these variables produced groups with different treatment outcomes. Overall, men were more likely to abstain than women (week 11: 59% vs. 43%; p=.001; week 25: 48% vs. 31%, p=.001; week 52: 39% vs. 27%, p=.01). Yet, only 25% of women with higher initial levels of craving were abstinent compared to 46% of men with low initial craving levels. Because most smokers suffer relapse with any current cessation treatment, the comparatively high abstinence percentages achieved in this trial are of interest. Our results provide guidance for treatment decisions while supporting the necessity for further smoking cessation research to investigate issues of gender, cravings, and treatment compliance.

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