Bupropion and cognitive behavioral therapy for weight-concerned women smokers

January 01, 0001

Bupropion and cognitive behavioral therapy for weight-concerned women smokers

These US authors previously published that cognitive behavioral therapy for smoking-related weight concerns (CONCERNS) improves cessation rates. Here they report their study of the combination of CONCERNS and bupropion therapy to enhance abstinence for weight-concerned women smokers. They conducted a randomized, double-blind, placebo-controlled trial, weight- concerned women (n = 349; 86% white) received smoking cessation counseling and randomized them to 1 of 2 adjunctive counseling components: CONCERNS or STANDARD (standard cessation treatment with added discussion of smoking topics but no specific weight focus), and 1 of 2 medication conditions: bupropion hydrochloride sustained release (B) or placebo (P) for 6 months.

They found: "Women in the CONCERNS + B group had higher rates of abstinence (34.0%) and longer time to relapse than did those in the STANDARD + B (21%) or CONCERNS + P (11.5%) groups at 6 months, although rates of prolonged abstinence in the CONCERNS + B and STANDARD + B groups did not differ significantly at 12 months. Abstinence rates and duration did not differ in the STANDARD + B group (21% and 19%) compared with the STANDARD + P group (10% and 7%) at 6 and 12 months, respectively. There were no differences among abstinent women in postcessation weight gain or weight concerns, although STANDARD + B produced greater decreases in nicotine withdrawal and depressive symptoms than did STANDARD + P."

The authors concluded: "Weight-concerned women smokers receiving the combination of CONCERNS + B were most likely to sustain abstinence. This effect was not related to differences in postcessation weight gain or changes in weight concerns."

The authors’ conclusion is not well supported by their own data, which showed that there was a not a statistically significant difference between quit rates at one year between groups receiving bupropion with and without the behavioral intervention (CONCERNS).

For the full abstract, click here.

Arch Intern Med 170(6):543-550, 22 March 2010
© 2010 to the American Medical Association
Bupropion and Cognitive Behavioral Therapy for Weight- Concerned Women Smokers. Michele D. Levine, Kenneth A. Perkins, Melissa A. Kalarchian, et al. Correspondence to Dr. Levine: [email protected]

Category: Z. Social Problems, P. Psychological. Keywords: smoking cessation, women, weight gain, bupropion, cognitive behavioral therapy, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 6 April 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.