Predictors of cessation in African American light smokers enrolled in a bupropion clinical trial

Babalola Faseru, Nicole L. Nollen, Matthew S. Mayo, Ron Krebill, Won S. Choi, Neal L. Benowitz, Rachel F. Tyndale, Kolawole S. Okuyemi, Jasjit S. Ahluwalia, Lisa Sanderson Cox

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Abstract

Background: This is the first study to examine predictors of successful cessation in African American (AA) light smokers treated within a placebo-controlled trial of bupropion. Methods: We analyzed data from a randomized, double-blind, placebo-controlled trial of bupropion and health education for 540 African American light smokers. African American light smokers (≤ 10 cigarettes per day, cpd) were randomly assigned to receive 150. mg bid bupropion SR (n = 270) or placebo (n = 270) for 7. weeks. All participants received health education counseling at weeks 0, 1, 3, 5 and 7. Using chi-square tests, two sample t-tests, and multiple logistic regression analyses, we examined baseline psychosocial and smoking characteristics as predictors of cotinine-verified 7-day point prevalence smoking abstinence among study participants at the end treatment (Week 7) and at the end of follow-up (Week 26). Results: Participants who received bupropion were significantly more likely to quit smoking compared to those who received placebo (OR = 2.72, 95% CI = 1.60-4.62, P = 0.0002). Greater study session attendance (OR = 2.47, 95% CI = 1.76-3.46, P = 0.0001), and smoking non-menthol cigarettes increased the likelihood of quitting (OR = 1.84, 95% CI = 1.01-3.36, P = 0.05); while longer years of smoking (OR = 0.98, 95% CI = 0.96-1.00, P = 0.05) and higher baseline cotinine (OR = 0.97, 95% CI = 0.95-0.99, P = 0.002) significantly reduced the odds of quitting at Week 7. Conversely, at the end of follow-up (Week 26), treatment with bupropion vs. placebo (OR = 1.14, 95% CI = 0.65-2.02, P = 0.64) was not significantly associated with quitting and type of cigarette smoked (menthol vs. non-menthol) did not appear in the final logistic regression model. Greater study session attendance (OR = 1.96, 95% CI = 1.44-2.66, P = 0.0001); BMI (OR = 1.03, 95% CI = 1.00-1.07, P=0.04); and weight efficacy (OR = 1.03, 95% CI = 1.01-1.05, P = 0.01) increased the likelihood of quitting at Week 26. Similar to our findings at Week 7, longer years of smoking (OR = 0.96, 95% CI = 0.94-0.99, P = 0.01) and higher baseline cotinine (OR = 0.97, 95% CI = 0.95-0.99, P = 0.02) significantly reduced the odds of quitting at Week 26. Conclusions: Baseline cotinine levels, number of years smoked and study session attendance are associated with both short- and long-term smoking cessation, while bupropion and the type of cigarette smoked were associated with quitting on short term only.

Original languageEnglish (US)
Pages (from-to)1796-1803
Number of pages8
JournalAddictive Behaviors
Volume38
Issue number3
DOIs
StatePublished - Mar 2013

Bibliographical note

Funding Information:
This research is supported by the National Cancer Institute at the National Institutes of Health R01CA091912. Dr. Faseru is supported in part by National Institutes of Health R01CA091912-09S1, U01 HL105232, P20 MD004805, U54 CA154253, HRSA Bureau of Health Promotion 5 D34 HP16041-03-0 and American Cancer Society Institutional Research Grant 116481-IRG-09-062-01. Dr. Ahluwalia is supported in part by the National Institute for Minority Health and Disparities (NIMHD/NIH - 1P60MD003422). Dr. Tyndale is supported by CAMH and by a Canada Research Chair in Pharmacogenetics. Cotinine analyses were supported in part by National Institutes on Drug Abuse (P30DA12393).

Keywords

  • African American
  • Bupropion
  • Cotinine
  • Light smokers
  • Menthol
  • Smoking cessation

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