Bupropion, a drug taken for smoking cessation and prescribed most often for adults, is yielding only short-lived results in adolescents according to an article in the November issue of the Archives of Pediatric and Adolescent Medicine. Each year 1.5 million adolescents in the U.S. light up for the first time and 416,000 of those go on to make it a daily habit. The numbers are staggering and unfortunately our current cessation treatment methods are showing little success, and even that success is often short-lived.
The antidepressant bupropion has been shown to help adults quit smoking. A study in the late 90s showed that adults have a 30% abstinence rate twelve months after undergoing nine weeks treatment of 300 grams a day of the drug, compared to 15% for those taking a placebo. The current study looked at efficacy in adolescents. The study consisted of 312 adolescents age fourteen to seventeen who smoked six or more cigarettes per day and had tried to quit at least twice before. Participants were randomly assigned to receive either 150 milligrams or 300 milligrams of bupropion per day, or a placebo. This was the first study to ever look at the effects of bupropion without nicotine replacement therapy. Participants visited a clinic on a weekly basis for seven weeks. They received six weeks of treatment plus one week post-treatment. They also received short counseling sessions. Follow-up data on cessation rates was also collected at twelve weeks and again at twenty-six weeks.
During treatment, cessation rates were higher for the 300-milligram group compared to the placebo for four of the first six weeks. After six weeks, 5.6% of those in the placebo group, 10.7% of those in the 150-milligram bupropion group, and 14.5% of those in the 300-milligram group had quit smoking. At week twenty-six, the data showed that 10.3% of those who took placebo, 3.1% of those who took 150 milligrams of bupropion and 13.9% of those who took 300 milligrams were still not smoking. Slowly but surely, those who had received the treatment were lighting up again.
Although every participant had tried to quit on more than one occasion, they were not successful -- no surprise, as nicotine is a powerful addiction that is often too difficult to kick. The results of this study show that bupropion does not work nearly as well in teens as it does in adults -- follow up data after twelve months showed a 30% abstinence rate for adults who took 300 grams of the drug for nine weeks. In addition to this, once the treatment was over, many adults also returned to their old smoking habits.
It is imperative that smokers, whether teen or adult, be made aware of alternative methods such as smokeless tobacco. Switching from cigarette smoking to smokeless tobacco reduces the risk of many smoking-related diseases -- including oral cancer -- while still providing a source of nicotine. Of course, quitting tobacco completely is ideal, but in light of how difficult that can be, it is in the best interest of smokers to be educated about smoking alternatives.
Krystal Wilson is a research intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
See also: ACSH's The Irreversible Health Effects of Cigarette Smoking.