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* From the Nicotine Research Center (Drs. Dale, Hurt, and Croghan) and the Section of Biostatistics (Messrs. Schroeder and Offord), Mayo Clinic and Mayo Foundation, Rochester, MN; the Robert C. Byrd Health Sciences Center (Dr. Glover), West Virginia University, Morgantown, WV; and the Palo Alto Center for Pulmonary Disease Prevention (Dr. Sachs), Palo Alto, CA.
Correspondence to: Lowell C. Dale, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail: dale.lowell{at}mayo.edu
Objectives: To identify predictors of smoking abstinence at the end of medication use that could assist in the optimal use of a sustained-release (SR) form of bupropion for treating cigarette smokers.
Design: A double-blind, placebo-controlled, dose-response trial.
Setting: Multicenter (three sites) study conducted in the United States.
Participants: Six hundred fifteen healthy men and women
(
18 years of age) who were smoking 15 cigarettes per day and
who were motivated to stop smoking.
Intervention: Random assignment of patients to placebo or SR bupropion treatment, 100, 150, or 300 mg/d, for 7 weeks (total duration of study was 52 weeks: 7 weeks of treatment and 45 weeks of follow-up).
Measurements and results: Logistic regression was used to identify predictors of abstinence at the end of the medication phase. Univariate predictors included the following: bupropion dose (p < 0.001); older age (p = 0.024); lower number of cigarettes smoked per day (cpd) (p < 0.001); lower Fagerström Tolerance Questionnaire score (p = 0.011); longest time previously abstinent that was < 24 h or > 4 weeks (p < 0.001); absence of other smokers in the household (p = 0.021); greater number of previous stop attempts (p = 0.019); and study site (p = 0.004). Multivariate predictors of abstinence at the end of the medication phase were the following: higher bupropion dose (p < 0.001); lower number of cpd (p < 0.001); longest time previously abstinent from smoking (p = 0.002); male gender (p = 0.014); and study site (p = 0.021).
Conclusion: Bupropion SR therapy was effective in treating cigarette smokers independently of all other characteristics studied. Lower smoking rate, brief periods (ie, < 24 h) or long periods (ie, > 4 weeks) of abstinence with previous attempts to stop smoking, and male gender were predictive of better outcomes, independent of the dose of bupropion that was used.
Key Words: abstinence • bupropion • nicotine • nicotine dependence • smoking
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