title: Bupropion for smoking cessation in African American light smokers: a randomized controlled trial.
abstract: BACKGROUND
  Previous research demonstrated the efficacy of sustained release bupropion (bupropion SR) for smoking cessation in whites as well as moderate to heavy (≥10 cigarettes per day [CPD]) African American smokers. We evaluated whether bupropion SR was effective for smoking cessation among African American light smokers (≤10 CPD).
  
  
  METHODS
  A randomized, double-blind placebo-controlled trial was conducted from December 27, 2007, to May 13, 2010. All participants were African American light smokers (≤10 CPD), aged 18 years or older. Participants were randomly assigned to receive 300 mg bupropion SR (150 mg once daily for 3 days and then 150 mg twice daily) (n = 270 participants) or placebo (n = 270 participants) for 7 weeks, and up to six sessions of health education counseling. Serum cotinine was measured at baseline (week 0). The primary outcome was salivary cotinine-verified 7-day point prevalence smoking abstinence at week 26; a cut point of 15 ng/mL differentiated smokers from nonsmokers. Salivary cotinine-verified smoking abstinence at end of medication treatment at week 7 was also examined. Odds ratios (OR) for smoking abstinence and 95% confidence intervals (CIs) were calculated using logistic regression models. All statistical tests were two-sided.
  
  
  RESULTS
  Participants at baseline visit (week 0) smoked an average of 8.0 CPD and had a mean serum cotinine level of 275.8 ng/mL (SD = 155.8 ng/mL); most used menthol cigarettes (83.7%) and smoked within 30 minutes of waking (72.2%). After imputing those lost to follow-up as smokers, no statistically significant difference in long-term smoking abstinence rates at week 26 was observed between bupropion SR and placebo groups (13.3% vs 10.0%, OR = 1.39, 95% CI = 0.82 to 2.35, P = .23). Cotinine-verified smoking abstinence rate at end of medication week 7 was higher in the bupropion SR vs placebo group (23.7% vs 9.6%, OR = 2.92, 95% CI = 1.78 to 4.77, P < .001).
  
  
  CONCLUSIONS
  Bupropion SR was effective in promoting smoking cessation during the medication phase of treatment but showed no effect on long-term smoking cessation among African American light smokers. More research is needed to identify strategies for sustaining abstinence among African American light smokers.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA. lcox@kumc.edu
authors.forename: Lisa Sanderson
authors.initials: LS
authors.lastname: Cox
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Nollen
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Mayo
authors.forename: Won S
authors.initials: WS
authors.lastname: Choi
authors.forename: Babalola
authors.initials: B
authors.lastname: Faseru
authors.forename: Neal L
authors.initials: NL
authors.lastname: Benowitz
authors.forename: Rachel F
authors.initials: RF
authors.lastname: Tyndale
authors.forename: Kolawole S
authors.initials: KS
authors.lastname: Okuyemi
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016642:Bupropion / Q000008:administration & dosage / Q000627:therapeutic use*; D003367:Cotinine / Q000378:metabolism; D003863:Depression / Q000139:chemically induced; D018765:Dopamine Uptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012463:Saliva / Q000378:metabolism; D012907:Smoking / Q000188:drug therapy* / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D018765:Dopamine Uptake Inhibitors; D016642:Bupropion; D003367:Cotinine