Sustained-release bupropion for hospital-based smoking cessation: a randomized trial

Area of Science:

• Clinical Trials
• Pharmacology
• Public Health

Background:

• Bupropion is a first-line aid for smoking cessation.
• No prior clinical trials evaluated bupropion in hospitalized smokers.

Purpose of the Study:

• To assess the efficacy of sustained-release bupropion combined with cognitive-behavioral counseling for smoking cessation in hospitalized smokers.
• To determine smoking cessation rates at various time points during and after treatment.

Main Methods:

• A randomized trial involving 85 hospitalized smokers at the San Francisco Veterans Affairs Medical Center.
• Participants received either 7-week sustained-release bupropion or placebo, alongside cognitive-behavioral counseling.
• Smoking cessation rates were assessed at the end of medication, 3 months, and 6 months, with validation methods including salivary cotinine and spousal proxy.

Main Results:

• End-of-treatment self-reported quit rates were similar: 37% for bupropion vs. 33% for placebo.
• Validated quit rates at the end of treatment were also comparable: 27% for bupropion vs. 29% for placebo.
• At 6 months, validated quit rates showed a non-significant trend favoring placebo (31% vs. 15%).

Conclusions:

• Sustained-release bupropion, when added to counseling, did not significantly increase smoking cessation rates in hospitalized smokers.
• The study was underpowered to detect a significant difference.
• Recruitment difficulties due to shorter hospital stays raise concerns about the feasibility of future hospital-based smoking cessation trials.