title: Does Extended Pre Quit Bupropion Aid in Extinguishing Smoking Behavior?
abstract: BACKGROUND
  Understanding the mechanisms by which bupropion promotes smoking cessation may lead to more effective treatment. To the extent that reduced smoking reinforcement is one such mechanism, a longer duration of pre quit bupropion treatment should promote extinction of smoking behavior. We evaluated whether 4 weeks of pre quit bupropion (extended run-in) results in greater pre quit reductions in smoking rate and cotinine and, secondarily, greater short-term abstinence, than standard 1 week of pre quit bupropion (standard run-in).
  
  
  METHODS
  Adult smokers (n = 95; 48 females) were randomized to a standard run-in group (n = 48; 3-week placebo, then 1-week bupropion pre quit) or an extended run-in group (4-week pre quit bupropion; n = 47). Both groups received group behavioral counseling and 7 weeks of post quit bupropion. Smoking rate (and craving, withdrawal, and subjective effects) was collected daily during the pre quit period; biochemical data (cotinine and carbon monoxide) were collected at study visits.
  
  
  RESULTS
  During the pre quit period, the extended run-in group exhibited a greater decrease in smoking rate, compared to the standard run-in group, interaction p = .03. Cigarette craving and salivary cotinine followed a similar pattern, though the latter was evident only among women. Biochemically verified 4-week continuous abstinence rates were higher in the extended run-in group (53%) than the standard run-in group (31%), p = .033.
  
  
  CONCLUSIONS
  The extended use of bupropion prior to a quit attempt reduces smoking behavior during the pre quit period and improved short-term abstinence rates. The data are consistent with an extinction-of-reinforcement model and support further investigation of extended run-in bupropion therapy for smoking cessation.
authors.affiliation: Department of Psychology, State University of New York at Buffalo, Buffalo, NY; Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY; lhawk@buffalo.edu.
authors.forename: Larry W
authors.initials: LW
authors.lastname: Hawk
authors.affiliation: Department of Psychology, State University of New York at Buffalo, Buffalo, NY; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Ashare
authors.affiliation: Department of Psychology, State University of New York at Buffalo, Buffalo, NY; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA;
authors.forename: Jessica D
authors.initials: JD
authors.lastname: Rhodes
authors.affiliation: Department of Psychology, State University of New York at Buffalo, Buffalo, NY; Department of Psychiatry, Yale University, New Haven, CT;
authors.forename: Jason A
authors.initials: JA
authors.lastname: Oliver
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC.
authors.forename: Kenneth Michael
authors.initials: KM
authors.lastname: Cummings
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY;
authors.forename: Martin C
authors.initials: MC
authors.lastname: Mahoney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000627:therapeutic use*; D016642:Bupropion / Q000008:administration & dosage / Q000627:therapeutic use*; D003367:Cotinine / Q000097:blood; D003376:Counseling; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D012907:Smoking / Q000097:blood / Q000188:drug therapy*; D016540:Smoking Cessation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion; D003367:Cotinine