Treatment Options in Smoking Cessation: What Place for Bupropion Sustained-Release?

2009 ◽  
Vol 1 ◽  
pp. CMT.S2044
Author(s):  
Danielle E McCarthy ◽  
Douglas E Jorenby ◽  
Haruka Minami ◽  
Vivian Yeh
Keyword(s):  
Smoking Cessation ◽  
Acetylcholine Receptors ◽  
Treatment Options ◽  
Mechanisms Of Action ◽  
Health Conditions ◽  
Controlled Clinical Trials ◽  
Quit Attempt ◽  
Stop Smoking ◽  
Quitting Smoking ◽  
Treatment Of Tobacco Dependence

Bupropion SR is approved for the treatment of tobacco dependence in adult smokers. Bupropion SR is an atypical antidepressant that has been shown to double the likelihood of quitting smoking (to roughly 19%-24% six months into a quit attempt), perhaps by acting on dopaminergic and noradrenergic systems and by acting as an antagonist of nicotine acetylcholine receptors. Head-to-head comparisons of bupropion SR and other stop-smoking treatments suggest that bupropion SR is as or more efficacious than nicotine replacement therapies, equally efficacious as nortriptyline, and less efficacious than varenicline. The evidence available regarding the effectiveness of bupropion SR in real-world settings suggests that abstinence rates are similar to those seen in controlled clinical trials. Bupropion SR appears to be safe and efficacious for both men and women and for people with comorbid medical or mental health conditions. Evidence collected to date supports the use of bupropion SR as a safe, tolerable pharmacotherapy for smoking cessation among adult smokers without a predisposition to seizures, but also suggests that benefits in terms of abstinence last only as long as treatment continues. This review focuses on recent evidence regarding bupropion SR effects and highlights important questions regarding the duration of effects, relative efficacy, effectiveness in clinical use, mechanisms of action, and utilization of bupropion SR that remain unanswered.

Empowered to stop smoking: The impact of a SDT smoking cessation intervention on economically disadvantaged whites and blacks

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 1012-1012
Author(s):  
C. D. Figueroa-Moseley ◽  
G. C. Williams ◽  
G. R. Morrow ◽  
P. Jean-Pierre ◽  
J. Carroll ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Usual Care ◽  
Self Regulation ◽  
Health Behavior Change ◽  
Quit Smoking ◽  
Stop Smoking ◽  
Treatment Conditions ◽  
Quitting Smoking ◽  
Smoking Behaviors ◽  
The Impact

1012 Background: Few studies have examined the potential influence of an empowering Self Determination Theory (SDT) intervention on reducing smoking behaviors and outcomes for Whites and Blacks. Objectives: To determine if empowerment to stop smoking is associated with smoking outcomes in Whites and Blacks, and to examine if empowerment to stop smoking improved under the SDT Intervention vs. Usual Care conditions. Methods: A longitudinal randomized trial study was conducted to examine the effect of a SDT and health behavior change intervention for tobacco cessation among adult smokers. Participants were randomized into the SDT Intervention or the Usual Care condition. The present study includes data from a sample of 821 Whites and 177 Blacks who completed anonymous surveys at 1, 6, and 18-months intervals on empowerment to stop smoking (Perceived Competence Scale, Treatment Self-Regulation Questionnaire), demographics, and smoking behaviors. Results: Stepwise logistic regressions showed that empowerment to stop smoking was associated with quitting smoking at 1, 6, and 18 month follow-up for both treatment conditions. At one month, participants in the SDT Intervention with the highest levels of empowerment were 6.3 times more likely to quit smoking as compared with those in the usual care condition who were only 3.15 times as likely to quit smoking. Similar findings were found at 6 months and at 18 months (6- month SDT Intervention Empowerment High: (OR = 8.66, 95% C.I. 4.6, 16.3); 6 month Usual Care Empowerment High: (OR = 3.10, 95% C.I. 1.4, 7.0); 18- month SDT Intervention Empowerment High: (OR = 4.10, 95% C.I. 2.2, 7.5); 18 month Usual Care Empowerment High: (OR = 3.11, 95% C.I. 1.3, 7.7). In the SDT Intervention at 6 months being Black increased successful quitting by 2.4 times. Conclusions: Findings indicate that at each time-point the SDT Intervention empowered more participants to stop smoking than usual care alone. Findings also suggest that Blacks may increase their ability to stop smoking in the SDT Intervention condition. These preliminary findings highlight the need to further investigate the possible roles of empowerment interventions in smoking cessation among Whites and Blacks, especially cancer patients. No significant financial relationships to disclose.

scholarly journals Varenicline for Smoking Cessation: a Review

2016 ◽  
Vol 12 (3) ◽  
pp. 215-220
Author(s):  
G P Rauniar ◽  
A Mishra ◽  
D P Sarraf
Keyword(s):  
Smoking Cessation ◽  
Tobacco Use ◽  
Nicotinic Acetylcholine Receptors ◽  
Acetylcholine Receptors ◽  
Smoking Prevalence ◽  
Meta Analysis ◽  
Developed Countries ◽  
First Line ◽  
The World ◽  
Quitting Smoking

Tobacco use is the leading cause of preventable death and disability in the world. Although gradually declining in most developed countries, the prevalence of tobacco use has increased among developing countries. Nicotine is an addictive chemical that is inhaled from the tobacco present in the cigarettes. It acts on neuronal nicotinic acetylcholine receptors within the ventral tegmental area of the brain, causing dopamine release in the nucleus accumbens which reinforces nicotine-seeking behavior. Reward through the dopaminergic system is a common thread among many drugs of addiction. According to the National Anti-Tobacco Communication Campaign Strategy for Nepal smoking prevalence in Nepal is higher (38.4%) than the smoking prevalence in the world (29%). Smoking attributable annual deaths in Nepal is estimated at nearly 14,000 (9,000 male deaths and 5,000 female deaths) for population aged 35 and over. First-line pharmacotherapies for smoking cessation are varenicline, sustained-release bupropion and various forms of nicotine replacement therapy (i.e., patch, gum, lozenge, inhaler, nasal spray). These drugs can be used as monotherapy or combination therapy for the treatment of smoking cessation. After studying the outcome of many clinical trials and meta-analysis, it is concluded that cigarette smokers taking varenicline have the most success quitting smoking as compared with those taking other first-line pharmacotherapies for treating smoking cessation.  Health Renaissance 2014;12(3): 215-220

scholarly journals The Roy Castle Fag Ends Stop Smoking Service: A Successful Client-Led Approach to Smoking Cessation

2006 ◽  
Vol 1 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Christine Owens ◽  
Jane Springett
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Smoking Cessation Service ◽  
Cessation Rate ◽  
Quit Attempt ◽  
Community Approach ◽  
Stop Smoking ◽  
Stop Smoking Services ◽  
Patient Barriers ◽  
Stop Smoking Service

AbstractThe Roy Castle Fag Ends Community Stop Smoking Service (RCFE) is commissioned by three primary care trusts (PCTs) to provide the adult smoking-cessation service across Liverpool. The service is not theoretically driven but there are several principles governing RCFE, which maintain the client-led, person-centred philosophy. Unique aspects are that the service is provided by trained lay advisors with a nonmedical background and there is no waiting list — clients can self-refer by calling a helpline or walking into a meeting. At RCFE, clients control their own quit attempt as well as self-regulating attendance at meetings and discharge from the service. Relapsed clients are also welcomed back without fear of criticism or the need for an appointment. Possible reasons for the success of RCFE include the client-led methodology, the community approach that removes doctor–patient barriers that may exist, and the nature of the group meetings, which allows interaction between clients who are at different stages of the quit process. Introducing some of the RCFE principles into other stop-smoking services may help to increase the overall smoking-cessation rate in England.

Revealing the complexity of quitting smoking: a qualitative grounded theory study of the natural history of quitting in Australian ex-smokers

2017 ◽  
Vol 27 (5) ◽  
pp. 568-576 ◽  
Author(s):  
Andrea L Smith ◽  
Stacy M Carter ◽  
Sally M Dunlop ◽  
Becky Freeman ◽  
Simon Chapman
Keyword(s):  
Smoking Cessation ◽  
Grounded Theory ◽  
Grounded Theory Study ◽  
The Past ◽  
Quit Attempt ◽  
Quitting Smoking ◽  
History Of ◽  
Almost All ◽  
Depth Interviews ◽  
Insight Into

ObjectiveTo explore the quitting histories of Australian ex-smokers in order to develop an understanding of the varied contribution of smoking cessation assistance (either pharmacotherapy or professionally mediated behavioural support) to the process of quitting.DesignQualitative grounded theory study; in-depth interviews.Participants37 Australian adult ex-smokers (24–68 years; 15 men, 22 women) who quit in the past 6–24 months.ResultsAlthough participants’ individual quitting histories and their overall experiences of quitting were unique, when the 37 quitting histories were compared it was clear two experiences were common to almost all participants: almost no one quit at their first quit attempt and almost everyone started out quitting unassisted. Furthermore, distinct patterns existed in the timing and use of assistance, in particular the age at which assistance was first used, how some participants were resolutely uninterested in assistance, and how assistance might have contributed to the process of successful quitting even if not used on the final quit attempt. Importantly, three patterns in use of assistance were identified: (1) only ever tried to quit unassisted (n=13); (2) started unassisted, tried assistance but reverted back to unassisted (n=13); (3) started unassisted, tried assistance and quit with assistance (n=11). For most participants, insight into what quitting would require was only gained through prior quitting experiences with and without assistance. For a number of participants, interest in assistance was at its lowest when the participant was most ready to quit.ConclusionQuitting should be viewed as a process drawing on elements of assisted and unassisted quitting rather than a stand-alone event that can be labelled as strictly assisted or unassisted.

1442Implementation and outcomes of systematic approaches to tobacco treatment: the Ottawa Model for Smoking Cessation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Coja ◽  
K A Mullen ◽  
A L Pipe ◽  
R D Reid
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Smoking Status ◽  
Evidence Based ◽  
Quit Attempt ◽  
Healthcare Settings ◽  
Tobacco Treatment ◽  
Quit Rate ◽  
Quitting Smoking

Abstract Background/Introduction Tobacco use is a major risk factor for the leading chronic diseases, is a leading cause of preventable death worldwide, and is a large cost driver of healthcare spending. Quitting smoking is the single most effective thing a patient can do to improve their health. The Ottawa Model for Smoking Cessation (OMSC) is a systematic, comprehensive approach to clinical tobacco dependence treatment. It provides support to healthcare settings in establishing a high quality tobacco treatment protocol and addressing common barriers to ensure optimal delivery of evidence-based smoking cessation interventions. Purpose The OMSC assists healthcare professionals to transform clinical practices through knowledge translation, implementation support, and quality evaluation. It promotes the delivery of evidence-based interventions to a greater number of smokers using a systematic approach, ultimately increasing cessation rates. The OMSC assists providers to identify smoking status, provide strategic advice to quit, support patients in making a quit attempt, and provide follow-up support. Methods OMSC Outreach Facilitators work with healthcare setting to assist with implementing evidence-based smoking cessation interventions. This is guided by an OMSC workplan which covers planning, implementing, evaluating and sustainability. Pre and post implementation along with program-level data is collected and used to determine rates of smoking status documentation, brief advice to stop smoking, delivery of cessation support and patient quit rates. Results The OMSC program has worked with approximately 450 healthcare settings, trained over 20,000 healthcare professionals, and supported approximately 500,000 patients with quitting smoking. Of those not ready to quit, 45% of patients seen in primary care were supported in reducing the amount they smoke. For OMSC hospital and specialty care patients receiving follow-up support, the six month responder-quit rate was 48%. For OMSC primary care patients, the two month responder-quit rate was 57%. Patients who had previously been supported by their OMSC primary care practice but had not presented to their provider in at least 6 months were contacted to assess their smoking status. Of those reached, 44% were smoke-free. Of those who relapsed, 53% indicated they would be willing to make another quit attempt, 37% of which went back to their healthcare provider to try again. Conclusion The OMSC has shown to be a simple, systematic step-by-step approach to addressing tobacco use in healthcare settings. It provides a way to create clinical efficiencies while increasing the rates at which evidence-based smoking cessation interventions are being delivered to patients, which leads to more patients making further quit attempts. The OMSC continues to expand across Canada and internationally in hopes of creating a wider smoking cessation network to support more patients with quitting smoking. Acknowledgement/Funding Ontario Ministry of Health and Long-Term Care

scholarly journals Addiction and Smoking Cessation

2015 ◽  
Vol 27 (1) ◽  
pp. 30-33
Author(s):  
Md Delwar Hossain ◽  
SAHM Mesbahul Islam ◽  
Md Mamunur Rashid ◽  
Md Ashfaqul Islam Chowdhury ◽  
Kazi Saifuddin Bennoor ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cigarette Smoke ◽  
Premature Death ◽  
Health Problems ◽  
Current Smoking ◽  
Stop Smoking ◽  
The World ◽  
Quitting Smoking ◽  
Medicine Today ◽  
Smoking Trends

Cigarette smoke contains a deadly mix of more than 7,000 chemicals, hundreds are toxic and about 70 can cause cancer. Cigarette smoke can cause serious health problems, numerous diseases and death. Fortunately, people who stop smoking greatly reduce their risk for disease and premature death. Although the health benefits are greater for people who stop at earlier ages, cessation is beneficial at all ages. There are various methods and approaches in quitting smoking. Currently, there are about 1.3 billion smokers the world, most (84%) of them in developing countries.If current smoking trends continue, tobacco will kill 10 million people each year by 2020.Medicine Today 2015 Vol.27(1): 30-33

scholarly journals Quitting smoking does not increase the risk of major depressive episodes among users of Internet smoking cessation interventions

2009 ◽  
Vol 40 (3) ◽  
pp. 441-449 ◽  
Author(s):  
L. D. Torres ◽  
A. Z. Barrera ◽  
K. Delucchi ◽  
C. Penilla ◽  
E. J. Pérez-Stable ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Major Depressive ◽  
Quit Attempt ◽  
Quitting Smoking ◽  
History Of ◽  
English Speaking ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Depression History ◽  
History Of Depression

BackgroundLimited evidence has suggested that quitting smoking increases the incidence of major depressive episodes (MDEs), particularly for smokers with a history of depression. Further evidence for this increase would have important implications for guiding smoking cessation.MethodSpanish- and English-speaking smokers without a current MDE (n=3056) from an international, online smoking cessation trial were assessed for abstinence 1 month after their initial quit date and followed for a total of 12 months. Incidence of screened MDE was examined as a function of abstinence and depression history.ResultsContinued smoking, not abstinence, predicted MDE screened at 1 month [smoking 11.5% v. abstinence 7.8%, odds ratio (OR) 1.36, 95% confidence interval (CI) 1.04–1.78, p=0.02] but not afterwards (smoking 11.1% v. abstinence 9.8%, OR 1.05, 95% CI 0.77–1.45, p=0.74). Depression history predicted MDE screened at 1 month (history 17.1% v. no history 8.6%, OR 1.71, 95% CI 1.29–2.27, p<0.001) and afterwards (history 21.7% v. no history 8.3%, OR 3.87, 95% CI 2.25–6.65, p<0.001), although the interaction between history and abstinence did not.ConclusionsQuitting smoking was not associated with increased MDE, even for smokers with a history of depression, although a history of depression was. Instead, not quitting was associated with increased MDE shortly following a quit attempt. Results from this online, large, international sample of smokers converge with similar findings from smaller, clinic-based samples, suggesting that in general, quitting smoking does not increase the incidence of MDEs.

scholarly journals Predictive Power of Dependence Measures for Quitting Smoking. Findings From the 2016 to 2018 ITC Four Country Smoking and Vaping Surveys

2020 ◽  
Author(s):  
Michael Le Grande ◽  
Ron Borland ◽  
Hua-Hie Yong ◽  
K Michael Cummings ◽  
Ann McNeill ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Explanatory Power ◽  
Short Term ◽  
Logistic Regression Models ◽  
Quit Attempt ◽  
Dependence Measure ◽  
Quit Attempts ◽  
Quitting Smoking ◽  
Dependence Measures ◽  
Variance Explained

Abstract Introduction To test whether urges to smoke and perceived addiction to smoking have independent predictive value for quit attempts and short-term quit success over and above the Heaviness of Smoking Index (HSI). Aims and Methods Data were from the International Tobacco Control Four Country Smoking and Vaping Wave 1 (2016) and Wave 2 (2018) surveys. About 3661 daily smokers (daily vapers excluded) provided data in both waves. A series of multivariable logistic regression models assessed the association of each dependence measure on odds of making a quit attempt and at least 1-month smoking abstinence. Results Of the 3661 participants, 1594 (43.5%) reported a quit attempt. Of those who reported a quit attempt, 546 (34.9%) reported short-term quit success. Fully adjusted models showed that making quit attempts was associated with lower HSI (adjusted odds ratio [aOR] = 0.81, 95% confidence interval [CI] = 0.73 to 0.90, p &lt; .001), stronger urges to smoke (aOR = 1.08, 95% CI = 1.04 to 1.20, p = .002), and higher perceived addiction to smoking (aOR = 0.52, 95% CI = 0.32 to 0.84, p = .008). Lower HSI (aOR = 0.57, 95% CI = 0.40 to 0.87, p &lt; .001), weaker urges to smoke (aOR = 0.85, 95% CI = 0.76 to 0.95, p = .006), and lower perceived addiction to smoking (aOR = 0.55, 95% CI = 0.32 to 0.91, p = .021) were associated with greater odds of short-term quit success. In both cases, overall R2 was around 0.5. Conclusions The two additional dependence measures were complementary to HSI adding explanatory power to smoking cessation models, but variance explained remains small. Implications Strength of urges to smoke and perceived addiction to smoking may significantly improve prediction of cessation attempts and short-term quit success over and above routinely assessed demographic variables and the HSI. Stratification of analyses by age group is recommended because the relationship between dependence measures and outcomes differs significantly for younger (aged 18–39) compared to older (aged older than 40) participants. Even with the addition of these extra measures of dependence, the overall variance explained in predicting smoking cessation outcomes remains very low. These measures can only be thought of as assessing some aspects of dependence. Current understanding of the factors that ultimately determine quit success remains limited.

scholarly journals Conflict About Quitting Predicts the Decision to Stop Smoking Gradually or Abruptly: Evidence From Stop Smoking Clinics in Malaysia

2011 ◽  
Vol 6 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Lei Hum Wee ◽  
Lion Shahab ◽  
Awang Bulgiba ◽  
Robert West
Keyword(s):  
Smoking Cessation ◽  
Single Factor ◽  
Cross Sectional Survey ◽  
Internal Reliability ◽  
Cross Sectional ◽  
Single Dimension ◽  
Quit Attempt ◽  
Quit Smoking ◽  
Stop Smoking ◽  
Conflict Scale

AbstractBackground: Little is known about the extent to which smokers attending stop-smoking clinics experience conflicting motivations about their quit attempt, whether such conflict can be understood in terms of a single dimension and if this ‘conflict about quitting’ differs from motivation to stop smoking and is associated with a smoker's choice of method to stop smoking (stopping gradually or abruptly). Method: Sociodemographic, smoking and quit attempt characteristics as well as measures relating to conflict about stopping smoking were recorded in a cross-sectional survey of 198 smokers attending five quit smoking clinics in Malaysia. Results: Five measures (having seriously thought about quitting before, being happy about becoming a non-smoker, being strongly motivated to stop, intending to stop smoking completely and believing in stopping for good this time) were loaded onto a single factor that could be labelled ‘conflict about quitting’. The resultant scale had moderate internal reliability (Cronbach's α= .625). Most smokers exhibited conflicting motivations about stopping smoking, with over half (52.0%, 95% CI 45.1–59.1) scoring 2 or higher on the 5-point conflict scale. ‘Conflict about quitting’ was significantly associated with the decision to stop smoking gradually rather than abruptly controlling for other variables (OR 1.36, 95% CI 1.05–1.76) and was more strongly associated with the choice of smoking cessation method than motivation to stop smoking. Conclusions: ‘Conflict about quitting’ can be conceptualised as a single dimension and is prevalent among smokers voluntarily attending stop-smoking clinics. The finding that smokers who display greater conflict about quitting are more likely to choose gradual cessation may explain contradictory findings in the literature regarding the effectiveness of different methods of smoking cessation.

scholarly journals A review on current therapies and its problems in smoking cessation

2020 ◽  
Vol 11 (3) ◽  
pp. 3946-3956
Author(s):  
Aravind S R ◽  
Jawahar N ◽  
Senthil V
Keyword(s):  
Smoking Cessation ◽  
Treatment Options ◽  
Premature Death ◽  
Pharmaceutical Formulations ◽  
Therapeutic Effects ◽  
Pharmacological Interventions ◽  
First Line ◽  
Quitting Smoking ◽  
Current Therapies ◽  
New Treatment

Smoking is likely the most preventable reason for ailments and premature death in the world. In 2010 it was estimated that approximately there are 120 million smokers in India. Around 70% of tobacco smokers are willing to stop, yet just 2-3% prevail with regards to doing so for all time every year. The first line pharmacotherapies normally used for smoking cessation include Nicotine substitution products (gum, transdermal patch, nasal spray, inhaler, and lozenge), varenicline and bupropion. Non-pharmacological therapies such as patient education, Counselling when used by physicians along with pharmacotherapies are found to increase the cessation rates by two folds within a single year. Blend pharmacotherapies are expanding the smoking restraint rates and furthermore lessens the withdrawal manifestations and are demonstrated to be as powerful as monotherapies. Physicians assume a significant job in the smoking discontinuance process. Significant rates of quitting smoking are accomplished when non-pharmacologic help is joined with pharmacological interventions. New treatment options such as nicotine vaccines are found to have better therapeutic effects and abstinence rates on smokers compared to other pharmacotherapies available. This review article deals with the available therapies (pharmacological and non-pharmacological) for smoking cessation along with the limitations and adverse effects associated with different pharmaceutical formulations.

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