Late-term smoking cessation despite initial failure: An evaluation of bupropion sustained release, nicotine patch, combination therapy, and placebo

Brenda D. Jamerson, Mitchell Nides, Douglas E. Jorenby, Rafe Donahue, Peter Garrett, J. Andrew Johnston, Michael C. Fiore, Stephen I. Rennard, Scott J. Leischow

Research output: Contribution to journalArticle

68 Scopus citations

Abstract

Objective: The purpose of this study was to evaluate the efficacy of long-term use of bupropion sustained release (SR), the nicotine patch, and the combination of these 2 treatments in patients who initially failed treatment. Methods: This was a post hoc analysis of a multicenter, double-blind, randomized, placebo-controlled clinical trial in 893 smokers. Patients were randomly assigned to 9 weeks of treatment with placebo (n = 160), bupropion SR (n = 244), nicotine patch (n = 244), or a combination of nicotine patch and bupropion SR (n = 245). The study was originally designed with a follow-up period of 52 weeks. In this analysis, short-term success was defined as smoking cessation after 14 or 21 days of therapy and long-term success was defined as smoking cessation after >21 days of therapy. Patients who did not achieve short-term success were evaluated for long-term success at week 9 (end of treatment), 6 months, and 1 year after the start of the study. Results: The mean age of the smokers was 44 years. The majority (93%) of patients were white, and 52% were female. The study subjects smoked an average of 27 cigarettes per day. Among the 467 patients who initially failed treatment in the first 3 weeks, treatment with bupropion SR alone and in combination with the nicotine patch produced significant increases in successful smoking cessation rates from weeks 4 to 9 (19% bupropion SR or combination, 7% nicotine patch, 7% placebo), at month 6 (11% bupropion SR, 13% combination, 2% nicotine patch, 3% placebo), and at month 12 (10% bupropion SR, 7% combination, 2% nicotine patch, 1% placebo) (P < 0.05 for bupropion SR and combination vs nicotine patch or placebo). Conclusion: Among patients who initially failed treatment, continued therapy with bupropion SR, either alone or in combination with the nicotine patch, resulted in significantly higher short- and long-term smoking cessation rates than treatment with the nicotine patch alone or placebo.

Original languageEnglish (US)
Pages (from-to)744-752
Number of pages9
JournalClinical Therapeutics
Volume23
Issue number5
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Keywords

  • Bupropion SR
  • Nicotine patch
  • Smoking
  • Smoking cessation

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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