Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism

Background A past history of major depression or alcoholism has been associ ated with poorer smoking trealment outcomes Aim To evaluate the efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism, and changes in dep ressive symptoms du ring smoking abstinence. Method Data were drawn from a multicentre trial of bupropion for smoking ce ssation. Smokers (n=615) received placebo or bupropion sustained-release at 100, 150, or 300 mg/day for six weeks after target quit date (TQD). The pr imary outcome was the point prevalence smoking abstinence at the end of tre atment and at one year. The Beck Depression Inventory (BDI) was used to ass ess depressive symptoms. Results A significant dose-response effect of bupropion for smoking cessati on was found. This was independent of history of major depression or alcoho lism. Among those continuously abstinent from smoking for two weeks followi ng TQD, an increase in BDI score was associated with a return to smoking at end of treatment. Conclusions Bupropion is efficacious for smoking cessation independently of a former history of major depression or alcoholism. Increases in depressiv e symptoms during an initial period of abstinence are associated with a ret urn to smoking. Declaration of interest Supported by a grant from Glare Wellcome inc.