Mediating mechanisms for the impact of bupropion in smoking cessation treatment

Caryn Lerman, David Roth, Vyga Kaufmann, Janet Audrain, Larry Hawk, Aiyi Liu, Ray Niaura, Leonard Epstein

Research output: Contribution to journalArticlepeer-review

Abstract

Several studies have documented the effectiveness of bupropion for smoking cessation, yet little is known about the mechanisms by which it facilitates abstinence. In this placebo-controlled randomized trial. We examined whether bupropion's effects on cessation were mediated by changes in withdrawal and/or negative or positive affect (PA). Two hundred and fifty-one smokers received 10-week treatment with bupropion or placebo, plus behavioral counseling. Changes in affect and withdrawal symptoms from pre-quit to 1 week post quit were examined as mediating variables in structural equation models. Cotinine-verified 7-day point prevalence cessation rates at the end of treatment (8-weeks post quit date) were 48% for bupropion and 29% for placebo (P=0.001). There were significant treatment effects on withdrawal and negative affect (NA); however, only change in NA predicted cessation. In a path model, change in NA was a significant mediator of bupropion's effects on cessation. However, the proportion of variance accounted for by this mediator was small, suggesting that other unmeasured factors play an important role. Laboratory-based paradigms may be useful to identify other mediators of bupropion's effects, thereby pointing to mechanisms of effect that can be bolstered in future treatment studies.

Original languageEnglish (US)
Pages (from-to)219-223
Number of pages5
JournalDrug and alcohol dependence
Volume67
Issue number2
DOIs
StatePublished - Jul 1 2002

Keywords

  • Bupropion
  • Mood
  • Pharmacotherapy
  • Smoking cessation

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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