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Bupropion for smoking cessation

Institution: University of California, San Francisco
Investigator(s): Joel Simon, M.D., M.P.H.
Award Cycle: 1998 (Cycle 7) Grant #: 7RT-0033 Award: $471,154
Subject Area: Nicotine Dependence
Award Type: Research Project Awards
Abstracts

Initial Award Abstract
The US Surgeon General has identified smoking as the single largest cause of premature loss of life in the United States. It has been estimated that more than 400,000 deaths occur each year in this country as a result of tobacco use. Recent data indicate that approximately one in four Americans are current smokers. Because of the large disease burden associated with cigarette smoking, decreasing the percentage of Americans who smoke is an important public health goal.

Standard smoking cessation interventions include counseling, nicotine replacement therapy, and self help literature. Because smokers are more likely to have a past history of depression and smoking cessation may increase symptoms of depression, the use of antidepressant medication for smoking cessation has been proposed. A small number of studies of varying quality have examined the effectiveness of antidepressants for smoking cessation. One recent study found that bupropion, an antidepressant recently approved by the Food and Drug Administration for use in smoking cessation, was effective. The long term effectiveness of bupropion, which is now being marketed directly in the US, when used in combination with standard smoking cessation treatment, has not been examined.

Because the long term effectiveness of bupropion when combined with standard treatment for smoking cessation has not been studied previously, we propose a double blind, placebo controlled clinical trial in which all 360 study participants will receive standard treatment that includes 2 months of treatment with the nicotine patch, counseling, and use of self help literature. In addition, approximately 50% of participants will be randomly assigned to receive 7 weeks of bupropion whereas the remaining 50% of participants will be randomly assigned to receive an identical placebo. Neither the participants nor the investigators will know who has been assigned to receive the active drug, thereby avoiding biases based on the expectations associated with treatment. If the addition of bupropion to standard therapy increases biochemically confirmed smoking cessation rates at one year, it may become an important addition to smoking cessation programs.

Although 40 million Americans have quit smoking, approximately 50 million continue to smoke. Effective, economical, targeted smoking cessation and relapse prevention programs that are capable of reaching millions of American smokers who see their doctors each year have the potential to decrease the burden of disease, disability, and death resulting from tobacco use. The effectiveness of bupropion combined with standard smoking cessation treatment needs to be evaluated in a placebo controlled study and among diverse populations of smokers. The proposed study would be an important contribution to this understudied area of smoking cessation research.
Publications

Transdermal nicotine replacement for hospitalized smokers: a randomized trial
Periodical: Proceedings of the TRDRP Annual Investigator's Meeting Index Medicus:
Authors: Simon JA, Carmody TP, Snyder E, Tcheou YM, Murray J ABS
Yr: 1998 Vol: Nbr: 3I Abs: Pg: 22

Transdermal nicotine replacement for hospitalized smokers: a randomized trial
Periodical: Proceedings of the TRDRP Annual Investigator's Meeting Index Medicus:
Authors: Simon JA, Carmody TP, Snyder E, Murray J, Solkowitz S ABS
Yr: 1999 Vol: Nbr: E15 Abs: Pg: 47

Bupropion for smoking cessation: a randomized trial
Periodical: Proceedings of the TRDRP Annual Investigator's Meeting Index Medicus:
Authors: Simon JA, Carmody TP, Duncan C, Snyder E ABS
Yr: 1999 Vol: Nbr: E16 Abs: Pg: 48