Bupropion combined with weight-focused counseling helps women quit
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Women who are worried about gaining weight if they quit smoking may benefit from a combination of cognitive behavioral therapy (CBT) and treatment with bupropion, according to a new study.
The randomized trial included 349 women who were concerned about their weight and received smoking cessation counseling. The women were divided into four groups: one that received CBT targeted at their smoking-related weight concerns and bupropion hydrochloride sustained release, one that received standard cessation treatment with discussion of smoking but not weight and bupropion, one that received the weight counseling and placebo, and one that received standard counseling with placebo.
After six months of treatment, 34% of the women in the weight counseling plus bupropion group were nonsmoking, compared to 21% in the standard treatment plus bupropion group and 11.5% in the weight counseling with placebo group. However, at 12 months, the study found no difference in abstinence rates associated with the different counseling methods. There was also no difference in weight gain among the abstinent women, or in the study's measurement of women's weight concerns. Women who received the standard counseling did have reduced nicotine withdrawal and depressive symptoms if they took the active drug.
The researchers concluded that bupropion therapy improves cessation rates when used with weight counseling, but not with standard treatment. The weight counseling also appears to improve cessation rates and abstinence duration, at least during active treatment. Although the effect sizes were small, the study's results are noteworthy, the authors said, because the intervention may help women smokers concerned about weight gain, who have been shown to have particularly difficulty with quitting.
The authors noted that some subgroups of the study had quite small sample sizes, and called for future research into the possible mechanisms of action in the studied interventions. The practicality of wider dissemination of the weight counseling program should also be investigated, they said. The study appeared in the March 22 Archives of Internal Medicine.