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Cancer Causes & Control

, Volume 21, Issue 6, pp 811–820 | Cite as

A bupropion smoking cessation clinical trial for cancer patients

  • Robert A. Schnoll
  • Elisa Martinez
  • Kristina L. Tatum
  • Dorothy M. Weber
  • Natalie Kuzla
  • Marcella Glass
  • John A. Ridge
  • Corey Langer
  • Curtis Miyamoto
  • E. Paul Wileyto
  • Frank Leone
Original paper

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Cancer patients Smoking Bupropion Depression 

Notes

Acknowledgments

The authors would like to thank Ms. Jeanne Pomenti for assisting with the preparation of this manuscript. This study was funded by grant R01 CA95678 from the National Cancer Institute. Transdermal nicotine patches were provided free-of-charge by GlaxoSmithKline. All sites provided Institutional Review Board approval. All patients provided informed consent for this study.

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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Robert A. Schnoll
    • 1
    • 6
  • Elisa Martinez
    • 2
  • Kristina L. Tatum
    • 2
  • Dorothy M. Weber
    • 2
  • Natalie Kuzla
    • 2
  • Marcella Glass
    • 2
  • John A. Ridge
    • 2
  • Corey Langer
    • 3
  • Curtis Miyamoto
    • 4
  • E. Paul Wileyto
    • 1
  • Frank Leone
    • 5
  1. 1.Department of PsychiatryUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Fox Chase Cancer CenterPhiladelphiaUSA
  3. 3.Abramson Cancer CenterUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.Department of Radiation OncologyTemple University HospitalPhiladelphiaUSA
  5. 5.Department of Pulmonary Medicine, Presbyterian Medical Center - 1 PHIUniversity of PennsylvaniaPhiladelphiaUSA
  6. 6.Department of PsychiatryUniversity of PennsylvaniaPhiladelphiaUSA

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