A PLACEBO-CONTROLLED EVALUATION OF THE EFFECTS OF BUSPIRONE ON SMOKING CESSATION - DIFFERENCES BETWEEN HIGH-ANXIETY AND LOW-ANXIETY SMOKERS

One hundred one smokers were divided into high and low trait anxiety g roups on the basis of a normalized score on the Profile of Mood States Anxiety/Tension Scale and were randomly assigned to receive buspirone or placebo in a double-blind fashion. After a 1-week baseline, smoker s were exposed to an 8-week drug and behavioral intervention involving buspirone or placebo (up to 60 mg/day) with concurrent group cognitiv e behavioral intervention. All smokers were to quit smoking on the tar get date, set at 4 weeks after the program began. Medication was provi ded for an additional 4 weeks after group treatment ended. The results showed that buspirone had a beneficial effect on smoking abstinence b ut only among smokers who were already relatively high in anxiety and only for as long as the drug was available. Moreover, when provided to smokers who mere relatively low in anxiety, the drug appeared to inte rfere with abstinence, although these effects also reversed when the d rug was withdrawn. These effects were associated with an attenuation o f the expected rise in anxiety before the quit date and its actual rev ersal thereafter, but only in the buspirone high-anxiety group. One-mo nth abstinence averaged 88, 61, 60, and 89% for the buspirone high-anx iety, placebo high-anxiety, buspirone low-anxiety, and placebo low-anx iety groups, respectively. By 12 months, abstinence for the buspirone and placebo high- and low-anxiety groups fell to 12, 23, 41, and 36%, respectively. No differences were observed for measures of self-effica cy, symptoms of withdrawal, medication side effects, or compliance.