title: Factors associated with discontinuation of bupropion and counseling among African American light smokers in a randomized clinical trial.
abstract: BACKGROUND
  African Americans are at risk of inadequate adherence to smoking cessation treatment, yet little is known about what leads to treatment discontinuation.
  
  
  OBJECTIVE
  The purpose of this study was to examine the factors associated with discontinuation of treatment in African American light smokers (≤10 cigarettes per day).
  
  
  METHODS
  Bupropion plasma levels and counseling attendance were measured among 540 African American light smokers in a placebo-controlled randomized trial of bupropion.
  
  
  RESULTS
  By week 3, 28.0 % of subjects in the bupropion arm had discontinued bupropion, and only moderate associations were found between the plasma levels and self-reported bupropion use (r s = 0.38). By week 16, 36.9 % of all subjects had discontinued counseling. Males had greater odds of discontinuing medication (OR = 2.02, 95% CI = 1.10-3.71, p = 0.02), and older adults had lower odds of discontinuing counseling (OR = 0.96, 95% CI = 0.94-0.97, p < 0.0001).
  
  
  CONCLUSIONS
  Bupropion and smoking cessation counseling are underutilized even when provided within the context of a randomized trial. Future research is needed to examine strategies for improving treatment utilization among African American smokers.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Mail Stop 1030, Kansas City, KS, 66160, USA, nnollen@kumc.edu.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Nollen
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Mayo
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
authors.forename: Rachel F
authors.initials: RF
authors.lastname: Tyndale
authors.forename: Neal L
authors.initials: NL
authors.lastname: Benowitz
authors.forename: Babalola
authors.initials: B
authors.lastname: Faseru
authors.forename: Taneisha S
authors.initials: TS
authors.lastname: Buchanan
authors.forename: Lisa Sanderson
authors.initials: LS
authors.lastname: Cox
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000375:Aging / Q000523:psychology; D016642:Bupropion / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use*; D003376:Counseling; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D012727:Sex Characteristics; D016540:Smoking Cessation / Q000523:psychology*
chemical_list: D003692:Delayed-Action Preparations; D016642:Bupropion