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Drugs
Published in: Drugs 2/2002

01-12-2002 | Review Article

Clinical Efficacy of Bupropion in the Management of Smoking Cessation

Author: Douglas Jorenby

Published in: Drugs | Special Issue 2/2002

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Abstract

Nicotine addiction is a chronic relapsing condition that can be difficult to treat. Until recently, pharmacological options for the treatment of tobacco dependence were primarily limited to nicotine replacement therapy (NRT). Sustained-release bupropion (bupropion SR) is the first non-nicotine pharmacological treatment approved for smoking cessation. Bupropion SR is recommended for first-line pharmacotherapy alongside NRT in the updated US Clinical Practice Guidelines and the UK Health Education Authority Guidelines. The UK National Institute of Clinical Excellence recommends NRT and bupropion SR for smokers who have expressed a desire to quit smoking. This review presents evidence that bupropion SR is an effective first-line therapy for smoking cessation in a wide range of patient populations. It is associated with significantly higher smoking cessation rates compared with placebo in patients with or without a history of prior bupropion SR or NRT use, and its effect is independent of gender. Bupropion SR treatment is effective in the prevention of relapse to smoking in those patients who have successfully quit, and re-treatment is effective in smokers who recommence smoking after a previous course of bupropion SR. Bupropion SR treatment relieves the symptoms of craving and nicotine withdrawal, and attenuates the weight gain that often occurs after smoking cessation. Data collected from motivational support programmes and employer-based studies provide strong evidence of the effectiveness of bupropion SR as an aid to smoking cessation in ‘real life’ situations, and confirm the efficacy seen in clinical trials.
Footnotes
1
Tradenames are used for identification purposes only and do not imply endorsement.
 
Literature
1.
World Health Organization (WHO). Tobacco or health: a global status report. Geneva: WHO, 1997
2.
Royal College of Physicians. Nicotine addiction in Britain. London: Royal College of Physicians, 2000
3.
Anonymous. Smoking cessation during previous year among adults: United States, 1990 and 1991. Morb Mortal Wkly Rep 1993; 42: 504–7
4.
Fiore M, Bailey W, Cohen S, et al. Treating tobacco use and dependence: clinical practice guideline. Rockville (MD): US Department of Health and Human Services. Public Health Service, 2000 Jun
5.
West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Health Education Authority. Thorax 2000; 55: 987–99PubMedCrossRef
6.
National Institute for Clinical Excellence. Guidance on the use of nicotine replacement therapy (NRT) and bupropion for smoking cessation. National Institute for Clinical Excellence Technology Appraisal Guidance No. 39. Available from: URL: http://​www.​nice.​org.​uk [Accessed 2002 Apr 16]
7.
Ascher JA, Cole JO, Colin J-N, et al. Bupropion: a review of its mechanism of antidepressant activity. J Clin Psychiatry 1995; 56: 395–401PubMed
8.
Johnston AJ, Ascher J, Leadbetter R, et al. Pharmacokinetic optimisation of sustained-release bupropion for smoking cessation. Drugs 2002; 62 Suppl. 2: 11–25PubMedCrossRef
9.
Hurt RD, Sachs DPL, Glover ED, et al. A comparison of sustained-release bupropion and placebo for smoking cessation. N Engl J Med 1997; 337: 1195–202PubMedCrossRef
10.
Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustained-release bupropion, a nicotine patch or both for smoking cessation. N Engl J Med 1999; 340: 685–91PubMedCrossRef
11.
Bolliger CT, Gilljam H, Lebargy F, et al. Burpropion hydrochloride (Zyban®) is effective and well tolerated as an aid to smoking cessation: a multicountry study. Eur Respir J 2001; 18 Suppl. 33: US
12.
Tonstad S, Aaserud E, Hjalmarson A, et al. Zyban® is an effective and well-tolerated aid to smoking cessation in a general smoking population: a multicountry study [poster no. 24]. Third Annual Conference of the European Society for Research on Nicotine and Tobacco; 2001 Sep 20–22; Paris, France: Part II
13.
Hays JT, Hurt RD, Rigotti NA, et al. Sustained-release bupropion for pharmacologic relapse prevention after smoking cessation: a randomized, controlled trial. Ann Intern Med 2001; 135: 423–33PubMed
14.
Gonzales DH, Nides MA, Ferry LH, et al. Bupropion SR as an aid to smoking cessation in smokers treated previously with bupropion: a randomized placebo-controlled study. Clin Pharmacol Ther 2001; 69: 438–44PubMedCrossRef
15.
Durcan MJ, White J, Jorenby DE, et al. Impact of previous nicotine replacement therapy on the efficacy of bupropion SR, nicotine transdermal system, and combination treatment for smoking cessation. Am J Health Behav 2002. In Press
16.
Puska PMJ, Brath H, Astbury CA, et al. Zyban® is an effective and well tolerated aid to smoking cessation in a health care professionals population: a multicountry study [poster no.22]. Third Annual Conference of the European Society for Research on Nicotine and Tobacco; 2001 Sep 20–22; Paris, France: Part II
17.
Roussos C, Aigner K, Astbury C, et al. Involvement of healthcare professionals in a smoking-cessation programme positively benefits attitudes towards smoking [abstract]. European Society of Cardiology; 2001 Sep 1–5; Stockholm, Sweden
18.
Scharf D, Shiffman S. Are women less able to quit smoking than men? A pooled analysis of published trials of bupropion SR [poster no. RP-82]. 8th Annual Meeting of the Society for Research on Nicotine and Tobacco; 2002 Feb 20–23; Savannah, Georgia
19.
Tashkin D, Kanner R, Bailey W, et al. Smoking cessation in patients with chronic obstructive pulmonary disease: a double-blind, placebo-controlled, randomised trial. Lancet 2001; 357: 1571–5PubMedCrossRef
20.
Chengappa KN, Kambhampati RK, Perkins K, et al. Bupropion sustained release as a smoking cessation treatment in remitted depressed patients maintained on treatment with selective serotonin reuptake inhibitor antidepressants. J Clin Psychiatry 2001; 62: 503–8PubMedCrossRef
21.
Hayford KE, Patten CA, Rummans TA, et al. Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism. Br J Psychiatry 1999; 174: 173–8PubMedCrossRef
22.
Hertzberg MA, Moore SD, Feldman ME, et al. A preliminary study of bupropion sustained-release for smoking cessation in patients with chronic posttraumatic stress disorder. Clin Psychopharmacol 2001; 21: 94–8CrossRef
23.
Evins AE, Mays VK, Rigotti NA, et al. A pilot trial of bupropion added to cognitive behavioral therapy for smoking cessation in schizophrenia. Nicotine Tob Res 2001; 3: 397–403PubMedCrossRef
24.
Weiner E, Ball MP, Summerfeit AA, et al. Effects of sustainedrelease bupropion and supportive group therapy on cigarette consumption in patients with schizophrenia. Am J Psychiatry 2001; 158: 635–7PubMedCrossRef
25.
Hays JL. Tobacco dependence treatment in patients with heart & lung disease: implications for intervention and review of pharmacological therapy. J Cardiopulm Rehabil 2000; 20: 215–23PubMedCrossRef
26.
Tonstad S. Use of sustained-release bupropion in specific patient populations for smoking cessation. Drugs 2002; 62 Suppl. 2: 37–43PubMedCrossRef
27.
Johnston JA, Fiedler-Kelly J, Glover ED, et al. Relationship between drug exposure and the efficacy and safety of bupropion sustained release for smoking cessation. Nicotine Tob Res 2001; 3: 131–40PubMedCrossRef
28.
Van der Molen T, Raaijmakers JAM. Afkicken Met Bupropion. Medisch Contact 2001; 56(37): 1333–6
29.
Jamerson BD, Nides M, Jorenby DE, et al. Late-term smoking cessation despite initial failure: an evaluation of bupropion sustained release, nicotine patch, combination therapy, and placebo. Clin Ther 2001; 23: 744–52PubMedCrossRef
30.
Selby P, Brosky G, Baker R, et al. Zyban® is effective in the retreatment of relapsed adult smokers [poster no. 14]. Third Annual Conference of the European Society for Research on Nicotine and Tobacco; 2001 Sep 20–22; Paris, France: Part II
31.
Gonzales DH, Nides MA, Ferry LH, et al. Re-treating relapse: bupropion SR vs placebo in adult cigarette smokers previously treated with bupropion SR [poster no. 13]. Third Annual Conference of the European Society for Research on Nicotine and Tobacco; 2001 Sep 20–22; Paris, France: Part II
32.
Tonnesen P, Norregaard J, Sawe U, et al. Recycling with nicotine patches in smoking cessation. Addiction 1993; 88: 533–9PubMedCrossRef
33.
Gourlay SG, Forbes A, Marriner T, et al. Double blind trial of repeated treatment with transdermal nicotine for relapsed smokers. BMJ 1995; 311: 363–6PubMedCrossRef
34.
Hughes JR, Grass JA, Pillitteri JL. Treatment resistant smokers: a pilot study of nicotine nasal spray and inhaler. J Addict Dis 2000; 19: 95–100PubMedCrossRef
35.
Hatsukami D, Rennard S, Malcolm R, et al. A multi-center study examining the effects of Zyban® (bupropion HCI SR) vs placebo as an aid to smoking reduction leading to cessation among smokers unwilling and unable to quit smoking [poster no. 50]. Third Annual Conference of the European Society for Research on Nicotine and Tobacco; 2001 Sep 20–22; Paris, France: Part II
36.
Osier M, Prescott E, Godtfredsen N, et al. Gender and determinants of smoking cessation: a longitudinal study. Prev Med 1999; 29: 57–62CrossRef
37.
Royce J, Corbett K, Sorensen G, et al. Gender, social pressure and smoking cessation: the Community Intervention Trial for Smoking Cessation (COMMIT) at baseline. Soc Sci Med 1997; 44: 359–70PubMedCrossRef
38.
Gonzales D, Bjornson W, Durcan MJ, et al. Effects of gender on relapse prevention in smokers treated with bupropion SR. Am J Prev Med 2002; 22: 234–9PubMedCrossRef
39.
Swan GE, Jack LM, Ward MM. Sub-groups of smokers with different success rates after use of transdermal nicotine. Addiction 1997; 92: 207–17PubMedCrossRef
40.
Wetter DW, Kenford SL, Smith SS, et al. Gender differences in smoking cessation. J Consult Clin Psychol 1999; 67: 555–62PubMedCrossRef
41.
Shiffman S, Johnston JA, Khayrallah M, et al. The effect of bupropion on nicotine craving and withdrawal. Psychopharmacol 2000; 148: 33–40CrossRef
42.
Teneggi V, Squassante L, Iavarone L, et al. Craving and withdrawal symptoms, in a short term period (72 hours) of enforced smoking cessation in healthy volunteers [poster no. 4]. Third Annual Conference of the European Society for Research on Nicotine and Tobacco; 2001 Sep 20–22; Paris, France: Part II
43.
Durcan MJ, Deener G, White J, et al. The effect of bupropion sustained-release on cigarette craving after smoking cessation. Clin Ther 2002; 24: 540–51PubMedCrossRef
44.
Dale LC, Schroeder DR, Wolter TD, et al. Weight change after smoking cessation using variable doses of transdermal nicotine replacement. J Gen Intern Med 1998; 13: 9–15PubMedCrossRef
45.
Hill AL, Roe DJ, Taren DL, et al. Efficacy of transdermal nicotine in reducing post-cessation weight gain in a Hispanic sample. Nicotine Tob Res 2000; 2: 247–53PubMedCrossRef
46.
Westlund R, Jamerson B, Glover E, et al. Bupropion hydrochloride sustained release tablets (BUP SR) is associated with reduced weight gain during quitting smoking: aggregated analyses of BUP SR vs placebo in quitters and non-quitters [abstract]. Abstracts of the World Conference on Tobacco OR Health (WCTOH) 2000; 1: 122
47.
Rigotti NA, Thorndike AN, Durcan MJ, et al. Attenuation of post-cessation weight gain in smokers taking bupropion: the effect of gender [abstract]. Sixth Annual Conference of the Society for Research on Nicotine and Tobacco; 2000 Feb 18–20; Arlington, Virginia
48.
Williamson DF, Madans J, Anda RF, et al. Smoking cessation and severity of weight gain in a national cohort. N Engl J Med 1991; 324: 739–45PubMedCrossRef
49.
Holmes S, Browning D, Powell S, et al. Real-World smoking cessation rates with bupropion SR in general practice in the UK [abstract]. Accepted by the 3rd European Conference on Tobacco OR Health; 2002 Jun 20–22; Warsaw, Poland
50.
Bergman L. An open-label, multicentre study with general practitioners to assess efficacy and safety of bupropion SR (2 x 150mg per day) dependent on (sub-) depression and motivation. Presented at the 107th Congress of German Society of Internal Medicine; 2001 Apr21–25; Wiesbaden, Germany
51.
Jarvis MJ, Powell S, Marsh H, et al. A meta-analysis of clinical studies confirms the effectiveness of bupropion SR (Zyban®) in smoking cessation [abstract]. Presented at the Seventh Annual Conference of the Society for Research on Nicotine and Tobacco; 2001 Mar 23–25; Seattle, Washington
52.
Hughes JR, Stead LF, Lancaster T. Anti-depressants for smoking cessation. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 4. Oxford: Update Software, 1997
Metadata
Title
Clinical Efficacy of Bupropion in the Management of Smoking Cessation
Author
Douglas Jorenby
Publication date
01-12-2002
Publisher
Springer International Publishing
Published in
Drugs / Issue Special Issue 2/2002
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.2165/00003495-200262002-00003

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