A bupropion smoking cessation clinical trial for cancer patients

Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA, 19104, USA.
Cancer Causes and Control (Impact Factor: 2.74). 06/2010; 21(6):811-20. DOI: 10.1007/s10552-010-9507-8
Source: PubMed


Many cancer patients continue to smoke post diagnosis, yet there have been few smoking cessation trials for this population. Depression, which is prevalent among cancer patients, may be a barrier to cessation.
This double-blind placebo-controlled trial randomized 246 cancer patients to 9 weeks of placebo or bupropion, stratifying by pre-treatment depression symptoms. In addition, all patients received transdermal nicotine and behavioral counseling. Primary outcomes were 7-day point-prevalence abstinence, biochemically confirmed, at the end of treatment (Week 12), and at 6 months post quit day (Week 27). Additional outcomes included: withdrawal, affect, quality of life, compliance, and side effects.
There was no main effect of bupropion vs. placebo on abstinence (Odds Ratio [OR] = 1.36, 95% CI: 0.38-4.81, p = .64). Patients with depression symptoms reported significantly lower abstinence rates vs. patients without depression symptoms (OR = .14, 95% CI: 0.02-0.80, p = .03). Bupropion increased abstinence rates, vs. placebo, more for participants with depression vs. those without depression symptoms. For patients with depression symptoms, bupropion reduced withdrawal symptoms and improved quality of life vs. placebo.
For patients with depression symptoms, bupropion increases abstinence rates, lowers withdrawal, and increases quality of life. However, abstinence rates among patients with depression symptoms were low vs. patients without depression symptoms, who exhibited similar abstinence rates when treated with bupropion or transdermal nicotine and counseling alone. These results can guide future smoking cessation intervention studies with cancer patients.

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    • "Smoking cessation is also part of the treatment in the following conditions: lung cancer [21], breast reconstruction using the free TRAM flap [22], liver transplant [23] [24], colorectal surgery [25], and bone marrow transplant [26]. Evidence-based treatments of smoking habit in oncological patients include nicotine replacement therapies, bupropion , varenicline, and behavioural counselling provided individually, in groups, or by telephone [27] [28] [29]. However, clinical practice in Italian cancer departments is still far from such a standard. "
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