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Recommendation
| Administer bupropion SR, 150 mg po od, for 3 days, followed by 150 mg po bid, for 7 to 12 weeks. Have the patient set a smoking cessation date for about 1 week after starting therapy.
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Evidence:
- In one RCT, bupropion produced a 15% absolute increase in smoking cessation compared to placebo (NNT, 7) and a 14% absolute increase in smoking cessation compared to nicotine replacement therapy (NNT, 7) at 1 year. Combination therapy of bupropion and nicotine replacement therapy increased 1-year smoking cessation rates by 5% over bupropion alone but was not statistically significant. The patients in the bupropion arms received 9 weeks of therapy (bupropion SR, 150 mg po od, for 3 days followed by 150 mg po bid, for the remainder of the 9 weeks) (49).
- The optimal duration of bupropion therapy has not been fully assessed. The medication has been safely used for long periods of time in the treatment of depression (75).
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Comments:
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| Edward Ellerbeck, MD, MPH, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Kumanan Wilson, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott. |
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