Long-term Zyban use curbs smoking relapse
An added bonus: much smaller weight gain seen
If you’re running, or plan to run, a smoking cessation program, here’s something you should know: Longer-term use of the drug bupropion (Zyban) will reduce the likelihood that your employees who stop smoking will resume the habit. That’s among the key findings of a study conducted at the Mayo Clinic in Rochester, MN.1 The researchers found that smokers were less likely to relapse if they used the medication for one year.
The study involved not only the Mayo Clinic, but the Palo Alto Center for Pulmonary Disease Prevention, in Palo Alto, CA; Brown University, Providence, RI; Oregon Health Sciences University, Portland, OR; and Massachusetts General Hospital in Boston. This was reportedly the first long-term, multi-center study to evaluate the use of the antidepressant bupropion to prevent relapse.
In the study, 784 participants took the drug to help them stop smoking. After seven weeks of treatment, 461 participants had successfully stopped. Half of that group continued with bupropion for a year, and the other half took a placebo. At the end of one year, 55% of the group continuing to take bupropion were abstinent, compared with 42% in the placebo group. "That’s a significant and encouraging difference," says J. Taylor Hays, MD, associate medical director of the Mayo Clinic Nicotine Dependence Center and lead investigator in the study.
At the two-year follow-up, however, the abstinence rates were nearly the same for both groups, about 40%. This underscores the difficulty in helping employees quit smoking; research shows that 70% - 80% of smokers who stop, relapse within six to 12 months, according to the Mayo Clinic.
Nevertheless, Sue Jackson, vice president of the Farmington Hills, MI-based American Institute for Preventive Medicine, is encouraged by the findings. "It makes perfect sense, and I’m glad to see this study come out," says Jackson, who coordinates a large number of smoking cessation programs. "Zyban is a really great product, but there are a lot of smokers who are hesitant to take it. Many times it gets portrayed to them as an antidepressant and they don’t understand how an antidepressant can treat nicotine addiction." Jackson points out that the dosages are different when the drug is being used to combat nicotine addiction vs. when it is being used as an antidepressant.
She also cites another fear the general public tends to have about drugs. "People tend to be afraid of medications, and they think the less they take the better they are. This study contradicts that belief," she notes.
Jackson is quick to point out that no drug, in and of itself, will be an effective cure for nicotine addiction. "In our experience, we’ve seen that Zyban should be used in conjunction with behavioral programs like our Smokeless,’ which really looks at smoking from many different directions. You must explore how to change daily routines to eliminate the triggers of smoking, what to eat and drink, how to handle stress, and so on," she explains. "But Zyban definitely enhances the program’s effectiveness."
Jackson notes that generally at the end of a behavioral program, you will see between 20% and 50% abstinence after a period of one year. "With this study, you’re looking at 55%, which is really wonderful," she enthuses. "In our programs, not all the employees take some kind of medicine," she explains, noting that such a choice is always voluntary. "But Zyban is most appropriate for any smoker."
Jackson observes that the study also showed the participants who took the Zyban had a smaller weight gain. "That’s also a really significant finding," she asserts. "People who quit smoking fear weight gain because nicotine helps burn calories. But the people on Zyban had weight gains that were an average of seven pounds less, which is very significant to people who want to quit."
[For more information, contact:
• The Mayo Clinic, East 18B, Rochester, MN 55905.
• Sue Jackson, vice president, American Institute for Preventive Medicine, 30445 Northwestern Highway, Suite 350, Farmington Hills, MI 48334. Telephone: (248) 539-1800. Fax: (248) 539-1808. Web: www.healthylife.com.]
Reference
1. Hays JT, Hurt RD, Rigotti NA, et al. Sustained-release bupropion for pharmacologic relapse prevention after smoking cessation. A randomized, controlled trial. Ann Intern Med. 2001;135:423-433.
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