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A bupropion smoking cessation clinical trial for cancer patients

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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.

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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.

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA, 19104, USA

    Robert A. Schnoll & E. Paul Wileyto

  2. Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA

    Elisa Martinez, Kristina L. Tatum, Dorothy M. Weber, Natalie Kuzla, Marcella Glass & John A. Ridge

  3. Abramson Cancer Center, University of Pennsylvania, 3400 Spruce Street, 12 Penn Tower, Philadelphia, PA, 19104, USA

    Corey Langer

  4. Department of Radiation Oncology, Temple University Hospital, 3401 N. Broad Street, Philadelphia, PA, 19140, USA

    Curtis Miyamoto

  5. Department of Pulmonary Medicine, Presbyterian Medical Center - 1 PHI, University of Pennsylvania, 51 N. 39th Street, Philadelphia, PA, 19104, USA

    Frank Leone

  6. Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA, 19104, USA

    Robert A. Schnoll

Authors
  1. Robert A. Schnoll
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  2. Elisa Martinez
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  9. Curtis Miyamoto
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  10. E. Paul Wileyto
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Correspondence to Robert A. Schnoll.

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Schnoll, R.A., Martinez, E., Tatum, K.L. et al. A bupropion smoking cessation clinical trial for cancer patients. Cancer Causes Control 21, 811–820 (2010). https://doi.org/10.1007/s10552-010-9507-8

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  • DOI: https://doi.org/10.1007/s10552-010-9507-8

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