Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 May;18(5):1202-5.
doi: 10.1093/ntr/ntv179. Epub 2015 Nov 13.

Adolescent Smoking Cessation With Bupropion: The Role of Adherence

Scott J Leischow  1 , Myra L Muramoto  2 , Eva Matthews  2 , Lysbeth L Floden  2 , Rachel A Grana  3
Affiliations
Randomized Controlled Trial

Adolescent Smoking Cessation With Bupropion: The Role of Adherence

Scott J Leischow et al. Nicotine Tob Res. 2016 May.

Abstract

Introduction: While many medications can be effective aids to quitting tobacco, real world adherence to smoking cessation medications may render a potentially effective medication ineffective. The present study investigated the role of adherence on treatment outcomes in a bupropion dose-response study among adolescent smokers trying to quit smoking.

Methods: Three hundred twelve adolescent boys (n = 143) and girls (n = 169) between the ages of 14-17 were enrolled in the study, and were randomly assigned to use either 300 mg, 150 mg or placebo bupropion to quit smoking. Among the eligibility criterion, participants had to smoke at least six cigarettes per day, be motivated to quit smoking (self report), have an exhaled carbon monoxide level greater than or equal to 10 ppm, and report at least two previous quit attempts. Adherence to medication was determined by both self-report and actual counts of unused medication and empty medication packaging. Smoking status was determined by a combination of self-report and biochemical verification (breath carbon monoxide and urine cotinine).

Results: Cotinine-confirmed quit rates were significantly higher as a function of high adherence (20.69%) relative to low adherence (0.00%) in the 300-mg Bupropion Sustained Release group. Overall adherence in all study conditions in this highly controlled study was high (74%), but was significantly lower in non-white participants.

Conclusions: Effectiveness of bupropion for adolescent smoking cessation is contingent on achieving high rates of medication adherence, but considerable variations in adherence impacted outcomes.

Implications: Few studies have assessed the safety and efficacy of medications to help adolescent smokers quit, and we conducted one such study assessing bupropion. In this analysis of that original study, we assess the role of adherence in use of medication and quit rates. We found that adherence was related to outcomes, particularly in the 300-mg dose of bupropion.

PubMed Disclaimer

Conflict of interest statement

SJL has served as a paid consultant to or conducted research for Pfizer, GSK, Cypress BioScience, and McNeil Consumer, and an unpaid consultant to NJOY, Inc and eNicotine Technology. MM, EM, LF, and RG have no declarations of conflict. McNeil Consumer is collaborating with GSK on a current study on nicotine replacement being conducted by Dr Leischow, and GSK markets bupropion.

References

    1. Sussman S, Sun P . Youth tobacco use cessation: 2008 update . Tob Induc Dis . 2009. ; 5 ( 1 ): 3 . doi: 10.1186/1617-9625-5-3 . - PMC - PubMed
    1. Zhu SH, Sun J, Billings SC, Choi WS, Malarcher A . Predictors of smoking cessation in U.S. adolescents . Am J Prev Med . 1999. ; 16 ( 3 ): 202 – 207 . - PubMed
    1. Muramoto ML, Leischow SJ, Sherrill D, Matthews E, Strayer LJ . Randomized, double-blind, placebo-controlled trial of 2 dosages of sustained-release bupropion for adolescent smoking cessation . Arch Pediatr Adolesc Med . 2007. ; 161 ( 11 ): 1068 – 1074 . - PubMed
    1. West R, Hajek P, Stead L, Stapleton J . Outcome criteria in smoking cessation trials: proposal for a common standard . Addiction . 2005. ; 100 ( 3 ): 299 – 303 . - PubMed
    1. Mermelstein R, Colby SM, Patten C, et al. Methodological issues in measuring treatment outcome in adolescent smoking cessation studies . Nicotine Tob Res . 2002. ; 4 ( 4 ): 395 – 403 . - PubMed

Publication types