Bupropion for pharmacologic relapse prevention to smoking: Predictors of outcome
Section snippets
Background
Despite recent advances in the treatment of nicotine dependence, relapse to smoking after initial successful abstinence remains a major treatment issue. This occurs despite an increasing array of effective pharmacotherapies, both nicotine and nonnicotine, that have been shown to help smokers to stop smoking Hughes et al., 1999, The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff and Consortium Representatives, 2000. Until recently, long-term pharmacotherapy had not been
Methods
The subjects for this analysis were part of a previously reported randomized, double-blind, placebo-controlled trial using sustained-release bupropion for relapse prevention (Hays et al., in press). The methodology for the study is detailed in that report. The study was performed at five sites (Mayo Clinic, Rochester, MN; the Palo Alto Center for Pulmonary Disease Prevention, Palo Alto, CA; Brown University, Providence, RI; Oregon Health Sciences University, Portland, OR; and Harvard Medical
Statistical analysis
We utilized both univariate and multivariate analyses in a similar fashion to our previous work Dale et al., 1997, Dale et al., 2001 because each type of analysis gives a different perspective of the data. Initially, a univariate analysis was used to determine, on an individual basis, which factors were associated with smoking abstinence. However, since factors identified univariately may be associated (correlated) with other factors (i.e., no adjustment is made for other factors), we also
Results
This study included 784 cigarette smokers who received 7 weeks of open-label, sustained-release bupropion 300 mg/day. The 1-week, biochemically confirmed abstinence rate during the final week of open-label medication was 58.8% (461/784). Among the 461 subjects biochemically confirmed abstinent from smoking at the end of the open-label phase (Week 7) and eligible, 429 were randomized to an additional 45 weeks of treatment with either placebo (N=215) or bupropion 300 mg/day (N=214). The percent
Discussion
In this paper, we report the first predictors analysis of the first pharmacotherapy trial for relapse prevention using sustained-release bupropion. When taking the findings from this study in aggregate, it is apparent that bupropion can be prescribed to diverse populations of smokers with expected comparable results. There were, however, some factors that seem to be predictive of successful relapse prevention. At Week 52, we found that there was a medication effect that was independent of any
Acknowledgements
This study was supported in part by a grant from Glaxo Wellcome, Research Triangle Park, NC. Special thanks to Rhonda Baumberger and Debi Judy for manuscript preparation.
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Probability and predictors of relapse to smoking: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)
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Predictors of success in smoking cessation among Italian adults motivated to quit
2013, Journal of Substance Abuse TreatmentCitation Excerpt :Yet, a factor addressing the intensity of nicotine dependence, such as FTQ, has revealed to reach statistical significant levels (despite previous studies' results, wherein it showed weak or no predictive efficacy of smoking cessation) (Etter, 2005), as at the second step of the multivariate forward stepwise conditional logistic analysis, as subjects with high Fagerström score (OR = 1.79; 95% CI 1.40–2.28) were significantly more likely to smoke than subjects with low/middle Fagerström (− 2logLikelihood = 1475.70; χ2 = 92.74; p = .000). Our data seem, hence, to confirm the predictive value of FTQ for smoking cessation described by other authors (Chatkin, Mariante de Abreu, Haggstram, Wagner, & Fritscher, 2004; Dale et al., 2001; Hurt et al., 2002; Swan et al., 2003), even though it does not cover items that capture the compulsive dimension of addiction, i.e. unsuccessful attempts to quit smoking. Moreover, consistent with other authors' results (Nides et al., 2008; Ravva, Gastonguay, French, Tensfeldt, & Faessel, 2010) suggesting that the efficacy of VAR depends on nicotine dependence level, other factors addressing higher dependence were associated with a lower probability of being abstinent at 1 year in spite of drug treatment, such as levels of exhaled CO and number of cigarettes smoked daily (Grassi et al., 2011).
Predictors of quit attempts and successful quit attempts in a nationally representative sample of smokers
2013, Addictive BehaviorsCitation Excerpt :Unfortunately, most quit attempts fail (Malarcher, Dube, Shaw, Babb, & Kaufmann, 2011) suggesting that predictors of quitting attempts may differ from those of successful attempts (Borland et al., 2010; Zhou et al., 2009). In clinical samples, which include smokers seeking treatment at outpatient and inpatient treatments, unsuccessful attempts have been related to the presence of withdrawal symptoms, higher levels of nicotine dependence (Hurt et al., 2002), female gender (Piper et al., 2010), younger age (Harris et al., 2004), history of past or current psychiatric disorders (Ziedonis et al., 2008), and lack of tobacco-related diseases (Azevedo & Fernandes, 2011). In general population samples, not being married (Derby, Lasater, Vass, Gonzalez, & Carleton, 1994) and lower socioeconomic status (SES) (Barbeau, Krieger, & Soobader, 2004) have been related to unsuccessful attempts to quit.
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