A Controlled Trial of Sustained-Release Bupropion, a Nicotine Patch, or Both for Smoking Cessation

作者：Douglas E. Jorenby, Scott James Leischow, Mitchell A. Nides, Stephen I. Rennard, Joseph Andrew Johnston, Arlene R. Hughes, Stevens S. Smith, Myra L Muramoto, David M. Daughton, Kimberli Doan, Michael C. Fiore, Timothy B. Baker · 发表于：New England Journal of Medicine · 年份：1999 · DOI：10.1056/nejm199903043400903 · 被引用次数：1606 · 研究领域：Smoking Behavior and Cessation、Nicotinic Acetylcholine Receptors Study、Substance Abuse Treatment and Outcomes

BACKGROUND AND METHODS: Use of nicotine-replacement therapies and the antidepressant bupropion helps people stop smoking. We conducted a double-blind, placebo-controlled comparison of sustained-release bupropion (244 subjects), a nicotine patch (244 subjects), bupropion and a nicotine patch (245 subjects), and placebo (160 subjects) for smoking cessation. Smokers with clinical depression were excluded. Treatment consisted of nine weeks of bupropion (150 mg a day for the first three days, and then 150 mg twice daily) or placebo, as well as eight weeks of nicotine-patch therapy (21 mg per day during weeks 2 through 7, 14 mg per day during week 8, and 7 mg per day during week 9) or placebo. The target day for quitting smoking was usually day 8. RESULTS: The abstinence rates at 12 months were 15.6 percent in the placebo group, as compared with 16.4 percent in the nicotine-patch group, 30.3 percent in the bupropion group (P<0.001), and 35.5 percent in the group given bupropion and the nicotine patch (P<0.001). By week 7, subjects in the placebo group had gained an average of 2.1 kg, as compared with a gain of 1.6 kg in the nicotine-patch group, a gain of 1.7 kg in the bupropion group, and a gain of 1.1 kg in the combined-treatment group (P<0.05). Weight gain at seven weeks was significantly less in the combined-treatment group than in the bupropion group and the placebo group (P<0.05 for both comparisons). A total of 311 subjects (34.8 percent) discontinued one or both medications...