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Do small lapses predict relapse to smoking behavior under bupropion treatment?
Paul Wileyto1, Freda Patterson, Raymond Niaura
1University of Pennsylvania, Philadelphia, PA 19104-3309, USA. epw@mail.med.upenn.edu
Summary
Bupropion effectively aids smoking cessation by reducing relapse probability during treatment. However, it does not prevent lapses from predicting future relapse, suggesting its effectiveness isn't solely due to mitigating lapse impact.
Area of Science:
- Pharmacology
- Addiction Medicine
- Clinical Trials
Background:
- Bupropion is an established smoking cessation aid.
- Its precise mechanism of action, particularly regarding lapses and relapse, remains unclear.
Purpose of the Study:
- To investigate if bupropion reduces the likelihood of a smoking lapse leading to relapse.
- To analyze the predictive role of lapse history on relapse during and after treatment.
Main Methods:
- A clinical trial design was employed.
- Cox regression analysis was used with lapse history as a time-varying covariate.
- Data were analyzed for both the treatment phase and a 6-month follow-up period.
Main Results:
- Bupropion significantly reduced relapse probability during treatment (HR=.421, p<.000).
- Lapses during treatment predicted subsequent relapse both during treatment (HR=2.897, p<.000) and follow-up (HR=2.320, p<.008).
- Bupropion did not significantly reduce relapse probability during the follow-up phase (HR=.896, p=.67).
Conclusions:
- Bupropion's effectiveness in smoking cessation is not attributable to reducing the impact of lapses on relapse.
- While bupropion reduces relapse during treatment, its mechanism may not involve altering the predictive relationship between lapses and relapse.