title: The effect of bupropion sustained-release on cigarette craving after smoking cessation.
abstract: BACKGROUND
  Most (>50%) smokers who attempt to stop smoking relapse within the first year of abstinence. The effect of continued use of pharmacotherapy for smoking cessation on relapse rates is unknown. Bupropion sustained-release (SR) is the first non-nicotine-based therapy that is effective for achieving abstinence from smoking.
  
  
  OBJECTIVE
  This analysis explored the factors involved in relapse to smoking in patients who had successfully stopped smoking using bupropion SR. These patients were participants in a double-blind, placebo-controlled trial of bupropion SR for the prevention of relapse to smoking.
  
  
  METHODS
  Participants who had stopped smoking with 7 weeks of open-label bupropion SR were randomly assigned to receive double-blind treatment with either bupropion SR or placebo for 45 weeks. The primary efficacy outcome of the main study was the rate of relapse to smoking. The analyses presented here examine the levels of reported cigarette craving and, in those participants who returned to smoking, the reasons associated with relapse, using patient-completed questionnaires.
  
  
  RESULTS
  Craving was cited most frequently as a factor contributing to relapse in those participants receiving placebo (cited by 49.2% of relapsers) but significantly less frequently by participants receiving bupropion SR (cited by 22.4% of relapsers) (P < 0.05). Results from patients' diaries showed no differences between bupropion SR and placebo in terms of "craving in the past 24 hours" but significantly lower scores for "craving right now" for bupropion SR at weeks 11 and 12 (P < 0.05). Results at scheduled visits showed that "craving in the past 24 hours" was significantly less with bupropion SR compared with placebo at weeks 12, 20, and 48, and "craving right now" was significantly less with bupropion SR compared with placebo at weeks 12, 16, 20, 24, 48, and 52 (P < 0.05).
  
  
  CONCLUSIONS
  Craving continues to be a significant concern for individuals even after they have successfully stopped smoking. Bupropion SR appears to reduce reported cravings, which may contribute to the overall reduction in the rate of relapse observed with this pharmacotherapy.
authors.affiliation: GlaxoSmithKline, Research Triangle Park, North Carolina 27709, USA. michael.j.durcan@gsk.com
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Durcan
authors.forename: Greg
authors.initials: G
authors.lastname: Deener
authors.forename: Jonathan
authors.initials: J
authors.lastname: White
authors.forename: J Andrew
authors.initials: JA
authors.lastname: Johnston
authors.forename: David
authors.initials: D
authors.lastname: Gonzales
authors.forename: Raymond
authors.initials: R
authors.lastname: Niaura
authors.forename: Nancy
authors.initials: N
authors.lastname: Rigotti
authors.forename: David P L
authors.initials: DP
authors.lastname: Sachs
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000627:therapeutic use*; D016642:Bupropion / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012008:Recurrence; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion