NDLI: Randomized trial of nicotine replacement therapy (NRT), bupropion and NRT plus bupropion for smoking cessation: effectiveness in clinical practice.

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Randomized trial of nicotine replacement therapy (NRT), bupropion and NRT plus bupropion for smoking cessation: effectiveness in clinical practice.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Stapleton, John West, Robert Hajek, Peter Wheeler, Jenny Vangeli, Eleni Abdi, Zeinab O'Gara, Colin McRobbie, Hayden Humphrey, Kirsty Ali, Rachel Strang, John Sutherland, Gay
Description	Country affiliation: United kingdom Author Affiliation: Stapleton J ( Addictions Department, Institute of Psychiatry, Kings College London, London, UK)
Abstract	BACKGROUND AND AIMS: Bupropion was introduced for smoking cessation following a pivotal trial showing that it gave improved efficacy over the nicotine patch and also suggesting combination treatment was beneficial. We tested in clinical practice for an effectiveness difference between bupropion and nicotine replacement therapy (NRT), whether the combination improves effectiveness and whether either treatment might be more beneficial for certain subgroups of smokers. DESIGN: Open-label randomized controlled trial with 6-month follow-up. SETTING: Four UK National Health Service (NHS) smoking cessation clinics. PARTICIPANTS: Smokers (n = 1071) received seven weekly behavioural support sessions and were randomized to an NRT product of their choice (n = 418), bupropion (n = 409) or NRT plus bupropion (n = 244). MEASURES: The primary outcome was self-reported cessation over 6 months, with biochemical verification at 1 and 6 months. Also measured were baseline demographics, health history, smoking characteristics and unwanted events during treatment. FINDINGS: Abstinence rates for bupropion (27.9%) and NRT (24.2%) were not significantly different (odds ratio = 1.21, 95% confidence interval = 0.883-1.67), and the combination rate (24.2%) was similar to that for either treatment alone. There was some evidence that the relative effectiveness of bupropion and NRT differed according to depression (χ(2) = 2.86, P = 0.091), with bupropion appearing more beneficial than NRT in those with a history of depression (29.8 versus 18.5%). Several unwanted symptoms were more common with bupropion. CONCLUSION: There is no difference in smoking cessation effectiveness among bupropion, nicotine replacement therapy and their combination when used with behavioural support in clinical practice. There is some evidence that bupropion is more beneficial than nicotine replacement therapy for smokers with a history of depression.
File Format	HTM / HTML
ISSN	09652140
e-ISSN	13600443
DOI	10.1111/add.12304
Journal	Addiction
Issue Number	12
Volume Number	108
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2013-12-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Behavior Therapy Prevention & Control Combined Modality Therapy Randomized Controlled Trial Discipline Addiction Therapeutic Use Bupropion Tobacco Use Cessation Products Multicenter Study Dopamine Uptake Inhibitors Smoking Cessation Smoking
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health

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