Mediating mechanisms for the impact of bupropion in smoking cessation treatment
Abstract
Several studies have documented the effectiveness of bupropion for smoking cessation, yet little is known about the mechanisms by which it facilitates abstinence. In this placebo-controlled randomized trial. We examined whether bupropion's effects on cessation were mediated by changes in withdrawal and/or negative or positive affect (PA). Two hundred and fifty-one smokers received 10-week treatment with bupropion or placebo, plus behavioral counseling. Changes in affect and withdrawal symptoms from pre-quit to 1 week post quit were examined as mediating variables in structural equation models. Cotinine-verified 7-day point prevalence cessation rates at the end of treatment (8-weeks post quit date) were 48% for bupropion and 29% for placebo (P=0.001). There were significant treatment effects on withdrawal and negative affect (NA); however, only change in NA predicted cessation. In a path model, change in NA was a significant mediator of bupropion's effects on cessation. However, the proportion of variance accounted for by this mediator was small, suggesting that other unmeasured factors play an important role. Laboratory-based paradigms may be useful to identify other mediators of bupropion's effects, thereby pointing to mechanisms of effect that can be bolstered in future treatment studies.
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Increases in negative affect predict clinical relapse.
“Further, increases in negative affect predict clinical relapse (45–47).”
From Varenicline improves mood and cognition during smoking abstinence (2009) · cites this paper as [46]
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- Authors
- Lerman, C., Roth, D., Kaufmann, V., Audrain, J., Hawk, L., Liu, A., Niaura, R., & Epstein, L.
- Affiliations
- University of Pennsylvania Health System (US)
- University of Alabama at Birmingham (US)
- State University of New York (US)
- Georgetown University (US)
- University at Buffalo, State University of New York (US)
- Corresponding author
- Lerman, Caryn
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2002-07
- Volume
- 67
- Issue
- 2
- Pages
- 219-223
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W2081438909
- Cited by
- 155
- References
- 18
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 2 · 2017: 4 · 2016: 6 · 2015: 8 · 2014: 3 · 2013: 8 · 2012: 3
- FWCI
- 6.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (P50CA084718, R01CA63562, P50-CA84718, R01CA063562)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- bupropion, smoking cessation, nicotine withdrawal symptoms, negative affect, positive affect, mediation analysis, behavioral counseling, nicotine dependence, abstinence
- MeSH terms
- Adult, Aged, Analysis of Variance, Female, Humans, Male, Middle Aged, Smoking, Smoking Cessation, Bupropion, Treatment Outcome
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