Clinical Psychiatry News - Counseling fails to increase rate of smoking cessation in bupropion users
SCOTTSDALE, ARIZ. — Providing counseling on smoking cessation did not boost quit rates in patients being treated with bupropion SR, Danielle E. McCarthy reported in a poster presentation at the annual meeting of the Society for Research on Nicotine and Tobacco.
She and her colleagues recruited 463 adults who reported smoking at least 10 cigarettes per day and wanted to quit. Half the participants were female, and the mean age was 39 years.
The participants were randomly placed in one of four groups that received bupropion with or without counseling or placebo with or without counseling. Counseling consisted of two 10-minute individual counseling sessions before the quit date and six after. Counseling included motivational enhancement, social support, and training in problem-solving and coping skills, said Ms. McCarthy of the University of Wisconsin, Madison.
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Participants also attended 12 office visits across the 2 weeks preceding and 8 weeks following the quit date. At the 8-week visit, 7-day abstinence rates were confirmed with carbon monoxide testing.
The participants who received the bupropion were twice as likely to be abstinent as those receiving placebo. Of those who received no pharmacotherapy or counseling, only 18% achieved abstinence, compared with 20% of those who received counseling and a placebo, 31% of those who received bupropion but no counseling, and 35% of those who received both bupropion and counseling. Contrary to past studies, however, counseling was not associated with a significantly higher abstinence rate in either the active-medication or the placebo group.
“Although counseling appears to increase the odds of successful tobacco cessation when offered as a primary intervention, it does not consistently increase abstinence rates when offered in conjunction with pharmacotherapy,” Ms. McCarthy noted. Also, women were less likely to achieve abstinence in this study, and bupropion did not equalize quit rates across genders.
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