Clinical Psychiatry News - Bupropion boosts smoking cessation in blacks
The use of sustained-release bupropion can improve smoking-cessation rates in African Americans in conjunction with culturally sensitive counseling, said Dr. Jasjit S. Ahluwalia of the University of Kansas, Kansas City, and colleagues.
In what they called the largest study so far of smoking cessation therapy in an ethnic minority, all patients had brief counseling sessions with African American counselors before setting a quit date, on the quit date, and at weeks 1,3, and 6. The counselors made supportive telephone calls 3 days after the quit date and at weeks 5 and 7. The African American subjects were mostly women (70%), poor, and motivated to quit smoking.
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The 300 patients who were randomized to treatment with bupropion SR had a cessation rate of 36% at the end of treatment (week 7), which was significantly higher than the 19% rate in the 300 patients in the placebo group. Patients who were lost to follow-up were assumed to be smokers (JAMA 288[4]:468-74, 2002).
The patients in the bupropion SR group were significantly more likely to be continuously abstinent at weeks 1, 3, 6, and 26 than were those on placebo. The abstinence rate at 26 weeks was 21% with bupropion SR and 14% with placebo. Previous studies of bupropion SR in mostly white, middle-class individuals have found abstinence rates of 27%-35%. After adjustment for age differences, bupropion SR was associated with a 19% increase in the odds of quitting, compared with placebo.
Besides African Americans, “smoking cessation treatments that address the cultural needs and perspectives of Asian, Hispanic, Native American, and Pacific Islander populations are likely to be more effective than treatments that do not address cultural issues,” Dr. Neal L. Benowitz of the University of California, San Francisco, said in an editorial (JAMA 288[4]:49799, 2002).
The patients who received bupropion SR had significantly lower average weight over time than the patients who received placebo, but the patients who were continuously abstinent for 6 weeks had a significantly higher average weight over time than those who were not continuously abstinent for 6 weeks. A relationship between continuous abstinence and weight gain was independent of the use of the drug.
Dr. Ahluwalia and Dr. Benowitz have served as consultants to GlaxoSmithKline, Research Triangle Park, N.C., the manufacturer of bupropion SR.
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