title: Varenicline versus bupropion XL for smoking cessation in older adolescents: a randomized, double-blind pilot trial.
abstract: BACKGROUND
  Despite tremendous potential public health impact, little work has focused on development of evidence-based smoking cessation treatments for adolescents, including pharmacotherapies. No prior studies have explored the feasibility and safety of varenicline and bupropion XL, 2 potentially promising pharmacotherapies, as smoking cessation treatments in adolescents.
  
  
  METHODS
  Treatment-seeking older adolescent smokers (ages 15-20) were randomized (double-blind) to varenicline (n = 15) or bupropion XL (n = 14), with 1-week titration and active treatment for 7 weeks. Structured safety, tolerability, and efficacy assessments (cotinine-confirmed 7-day point prevalence abstinence) were conducted weekly.
  
  
  RESULTS
  There were no serious adverse events. Two participants discontinued bupropion XL due to adverse effects, and none discontinued varenicline. Over the course of treatment, participants receiving varenicline reduced from 14.1 ± 6.3 (mean ± SD) to 0.9 ± 2.1 cigarettes/day (CPD, 4 achieved abstinence), while those receiving bupropion XL reduced from 15.8 ± 4.4 to 3.1 ± 4.0 CPD (2 achieved abstinence).
  
  
  CONCLUSIONS
  These preliminary results support the feasibility and safety of conducting adequately powered, placebo-controlled efficacy studies of varenicline and bupropion XL for adolescent smoking cessation.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC861, Charleston, SC 29425, USA. graykm@musc.edu
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Gray
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carpenter
authors.forename: A Lee
authors.initials: AL
authors.lastname: Lewis
authors.forename: Erin M
authors.initials: EM
authors.lastname: Klintworth
authors.forename: Himanshu P
authors.initials: HP
authors.lastname: Upadhyaya
mesh_terms: D000293:Adolescent; D001552:Benzazepines / Q000009:adverse effects / Q000627:therapeutic use*; D016642:Bupropion / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D009325:Nausea / Q000139:chemically induced; D010865:Pilot Projects; D011810:Quinoxalines / Q000009:adverse effects / Q000627:therapeutic use*; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D012907:Smoking / Q000188:drug therapy*; D016540:Smoking Cessation / Q000379:methods*; D061485:Tobacco Use Cessation Devices; D016896:Treatment Outcome; D000068580:Varenicline; D055815:Young Adult
chemical_list: D001552:Benzazepines; D011810:Quinoxalines; D016642:Bupropion; D000068580:Varenicline