title: Effects of contingency management and bupropion on cigarette smoking in smokers with schizophrenia.
abstract: BACKGROUND
  Individuals with schizophrenia have high smoking-related morbidity and mortality rates and need powerful and innovative smoking cessation interventions.
  
  
  OBJECTIVE
  This proof-of-concept study investigated the feasibility and initial efficacy of combining a contingency management intervention with bupropion to reduce smoking in people with schizophrenia.
  
  
  METHODS
  Using a double-blind, placebo-controlled, between-groups design, 57 non-treatment-seeking participants were randomized to receive 300 mg/day bupropion or placebo. One week later, participants were randomized to a contingency management (CM) intervention in which reductions in urinary cotinine levels were reinforced, or a non-contingent reinforcement (NR) condition in which session attendance was reinforced, regardless of cotinine level. Over the 22-day study period, participants visited the laboratory approximately three times per week to provide urine samples for analysis of cotinine levels, to give breath samples for analysis of carbon monoxide (CO) levels, and to report number of cigarettes smoked per day, nicotine withdrawal symptoms, cigarette craving, and psychiatric symptoms.
  
  
  RESULTS
  Cotinine and CO levels significantly decreased during the study period in participants randomized to the CM condition, but not the NR condition. Bupropion did not reduce cotinine levels or increase the efficacy of CM. Cigarette craving and psychiatric symptom levels significantly decreased during the study in all groups.
  
  
  CONCLUSIONS
  The results of this study indicate the efficacy and feasibility of this CM intervention for reducing smoking in individuals with schizophrenia.
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University, Box S-121-5, Providence, RI 02912, USA. Jennifer_Tidey@brown.edu
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Tidey
authors.forename: Damaris J
authors.initials: DJ
authors.lastname: Rohsenow
authors.forename: Gary B
authors.initials: GB
authors.lastname: Kaplan
authors.forename: Robert M
authors.initials: RM
authors.lastname: Swift
authors.forename: Netesha
authors.initials: N
authors.lastname: Reid
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D016739:Behavior, Addictive / Q000188:drug therapy / Q000523:psychology; D001944:Breath Tests; D016642:Bupropion / Q000008:administration & dosage / Q000627:therapeutic use*; D002248:Carbon Monoxide / Q000032:analysis; D003131:Combined Modality Therapy; D003367:Cotinine / Q000652:urine; D017831:Diagnosis, Dual (Psychiatry); D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D010352:Patient Dropouts / Q000523:psychology; D012054:Reinforcement, Psychology; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D012907:Smoking / Q000188:drug therapy* / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control* / Q000523:psychology
chemical_list: D016642:Bupropion; D002248:Carbon Monoxide; D003367:Cotinine