title: A randomized, controlled trial of bupropion sustained-release for preventing tobacco relapse in recovering alcoholics.
abstract: BACKGROUND
  Studies examining the efficacy of tobacco dependence treatment among recovering alcoholic smokers have produced mixed findings. We set out to investigate this issue further by conducting a randomized, double-blind, placebo-controlled trial of bupropion sustained-release (SR) for smoking relapse prevention among abstinent alcoholic smokers.
  
  
  METHODS
  Participants (N = 195) met DSM-IV criteria for a history of alcohol abuse or dependence and had at least 1 year of continuous abstinence from alcohol and drugs. Open-label treatment with nicotine patch therapy was provided to all subjects for 8 weeks. The initial nicotine patch dose was determined by the subject's baseline serum cotinine concentration with an aim to achieve 100% cotinine replacement. All subjects who were confirmed abstinent from smoking throughout the final week of nicotine patch therapy (Week 8) were randomly assigned to receive bupropion SR 300 mg/day or placebo through Week 52.
  
  
  RESULTS
  A total of 110 participants were randomized to the double-blind treatment. No significant difference was observed between the bupropion and placebo groups for rates of continuous smoking abstinence, 41.1% (95% CI = 28.1%-55.0%) versus 40.7% (95% CI = 27.6%-55.0%), respectively, p = 1.0, or point prevalence abstinence, 39.3% (95% CI = 26.5%-53.3%) versus 40.7% (95% CI = 27.6%-55.0%), respectively, p = 1.0, at the end of the treatment (Week 52). Relapse to alcohol occurred in 4% of subjects (n = 4) during the study.
  
  
  CONCLUSIONS
  Treatment with bupropion SR among abstinent alcoholic smokers did not delay relapse or result in improved long-term smoking abstinence.
authors.affiliation: Department of Internal Medicine, Mayo Clinic College of Medicine, Mayo Clinic Nicotine Dependence Center, 200 1st Street Southwest, Rochester, MN 55905, USA. hays.taylor@mayo.edu
authors.forename: J Taylor
authors.initials: JT
authors.lastname: Hays
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hurt
authors.forename: Paul A
authors.initials: PA
authors.lastname: Decker
authors.forename: Ivana T
authors.initials: IT
authors.lastname: Croghan
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Offord
authors.forename: Christi A
authors.initials: CA
authors.lastname: Patten
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000534:rehabilitation*; D016642:Bupropion / Q000008:administration & dosage*; D003692:Delayed-Action Preparations; D018765:Dopamine Uptake Inhibitors / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D003692:Delayed-Action Preparations; D018765:Dopamine Uptake Inhibitors; D016642:Bupropion