For the study, the researchers recruited 314 women and 241 men who smoked at least 10 cigarettes per day. Participants were assigned to receive bupropion, commonly known as Zyban or Wellbutrin, accompanied by behavioral counseling or counseling only. Behavioral counseling was designed to help participants reduce smoking, learn to cope with stress and situations that trigger their desire to smoke, and prevent relapse. Two weeks after participants began taking bupropion, or on the day of the third counseling session, they were instructed to stop smoking. Abstinence from smoking was evaluated at 8 weeks (end of treatment) and 6 months after the quit date, and was verified by saliva analysis for the presence of cotinine, an indicator of smoking.
At the end of treatment, 51 percent of the men and 40 percent of the women had remained abstinent from smoking. At the 6-month follow-up, about 32 percent of the men and 22 percent of the women were abstinent from smoking. The researchers found that, overall, women receiving both bupropion and behavioral counseling had abstinence rates similar to those of the men. However, women receiving behavioral counseling alone were more likely to relapse to smoking than the men. At the end of treatment, about 55 percent of the women receiving bupropion were abstinent from smoking compared with 35 percent of those receiving behavioral counseling alone. Women who received bupropion and smoked fewer than 20 cigarettes per day were twice as likely to remain abstinent than those receiving behavioral counseling alone. However, bupropion had little effect on the abstinence rates of women who smoked more than 20 cigarettes per day. For men, however, bupropion was more effective for heavy smokers than light smokers.
WHAT IT MEANS: These findings indicate that bupropion may be an effective treatment for women who are light smokers. Identifying gender-specific smoking cessation factors will aid in the development of more effective treatment programs targeted to women.
This study was published in the February 2004 issue of Nicotine and Tobacco Research by lead investigator Bradley Collins at the University of Pennsylvania.