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Bupropion and cognitive-behavioral treatment for depression in smoking cessation 

Authors: Richard A. Browna; Raymond Niauraa; Elizabeth E. Lloyd-Richardsonb; David R. Stronga; Christopher W. Kahlerc; Ana M. Abrantesa; David Abramsd; Ivan W. Millera
Affiliations:   a Brown Medical School, Department of Psychiatry and Human Behavior and Butler Hospital, Providence, RI
b Brown Medical School, Department of Psychiatry and Human Behavior and The Miriam Hospital, Providence, RI
c Brown Medical School, Department of Psychiatry and Human Behavior and Brown University Center for Alcohol and Addiction Studies,
d Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD
DOI: 10.1080/14622200701416955
Publication Frequency: 12 issues per year
Published in: journal Nicotine & Tobacco Research, Volume 9, Issue 7 July 2007 , pages 721 - 730
Formats available: HTML (English) : PDF (English)

The circumstances under which this title is published have changed:

Reason for change: Changed Publisher
Now published by: Oxford University Press

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Abstract

This study is a randomized, double-blind, placebo-controlled clinical trial examining the effects of an intensive cognitive-behavioral mood management treatment (CBTD) and of bupropion, both singularly and in combination, on smoking cessation in adult smokers. As an extension of our previous work, we planned to examine the synergistic effects of CBTD and bupropion on smoking cessation outcomes in general and among smokers with depression vulnerability factors. Participants were 524 smokers (47.5% female, M age = 44.27 years) who were randomized to one of four 12-week treatments: (a) standard, cognitive-behavioral smoking cessation treatment (ST) plus bupropion (BUP), (b) ST plus placebo (PLAC), (c) standard cessation treatment combined with cognitive-behavioral treatment for depression (CBTD) plus BUP, and (d) CBTD plus PLAC. Follow-up assessments were conducted 2, 6, and 12 months after treatment, and self-reported abstinence was verified biochemically. Consistent with previous studies, bupropion, in comparison with placebo, resulted in better smoking outcomes in both intensive group treatments. Adding CBTD to standard intensive group treatment did not result in improved smoking cessation outcomes. In addition, neither CBTD nor bupropion, either alone or in combination, was differentially effective for smokers with single-past-episode major depressive disorder (MDD), recurrent MDD, or elevated depressive symptoms. However, findings with regard to recurrent MDD and elevated depressive symptoms should be interpreted with caution given the low rate of recurrent MDD and the low level of depressive symptoms in our sample. An a priori test of treatment effects in smokers with these depression vulnerability factors is warranted in future clinical trials.
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