Two-year follow-up of a smoking cessation trial in patients with schizophrenia: increased rates of smoking cessation and reduction.
BACKGROUND
Long-term success rates of smoking cessation programs for patients with schizophrenia are unknown. This study, conducted between June 2001 and November 2002, evaluated the rate of smoking cessation and reduction in patients with schizophrenia (DSM-IV) 2 years after they had participated in a smoking cessation study in order to determine whether subjects who significantly reduced smoking during the original trial resumed their previous level of smoking at 2 years.


METHODS
Two years following a double-blind placebo-controlled trial of bupropion sustained release, 150 mg/day, added to cognitive-behavioral therapy for smoking cessation in patients with schizophrenia, subjects were interviewed, medical charts were reviewed, and carbon monoxide in expired air was measured.


RESULTS
Seventeen of 18 subjects completed the follow-up assessment. More subjects were abstinent (22% [N = 4]) at the 2-year follow-up than were abstinent at the end of the trial (6% [N = 1]). Subjects who achieved significant smoking reduction during the trial were more likely to be abstinent at 2 years (4/7) than those who did not significantly reduce smoking during the trial (0/11) (chi(2) = 8.1, p <.005). Most subjects who achieved > or = 50% reduction in smoking at the end of the trial maintained at least that level of reduction at 2 years. Smoking reduction during the treatment intervention was correlated with smoking reduction at follow-up (r = 0.60, p =.01).


CONCLUSIONS
The results from this naturalistic study suggest that behavior changes achieved in smoking cessation programs for patients with schizophrenia may be durable and may predict future smoking behavior. We conclude that further investigation into the relationship between smoking reduction and future smoking cessation in special populations is indicated.
Evins
A Eden
AE
Harvard Medical School and the Schizophrenia Research Program, Massachusetts General Hospital, Freedom Trail Clinic, 25 Staniford Street, Boston, MA 02114, USA. a_eden_evins@hms.harvard.edu
Cather
Corinne
C
Rigotti
Nancy A
NA
Freudenreich
Oliver
O
Henderson
David C
DC
Olm-Shipman
Casey M
CM
Goff
Donald C
DC
D000328:Adult; D016642:Bupropion / Q000008:administration & dosage / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018765:Dopamine Uptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000150:complications* / Q000175:diagnosis; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control*
D003692:Delayed-Action Preparations; D018765:Dopamine Uptake Inhibitors; D016642:Bupropion