A randomized trial of short psychotherapy versus sustained-release bupropion for smoking cessation

  1. Gerald Zernig1,
  2. Reinhild Wallner1,
  3. Ursula Grohs3,
  4. Norbert Kriechbaum3,
  5. Georg Kemmler2,
  6. Alois Saria1

Article first published online: 6 NOV 2008

DOI: 10.1111/j.1360-0443.2008.02348.x

Issue

Addiction

Addiction

Volume 103, Issue 12, pages 2024–2031, December 2008

Additional Information

How to Cite

Zernig, G., Wallner, R., Grohs, U., Kriechbaum, N., Kemmler, G. and Saria, A. (2008), A randomized trial of short psychotherapy versus sustained-release bupropion for smoking cessation. Addiction, 103: 2024–2031. doi: 10.1111/j.1360-0443.2008.02348.x

Author Information

  1. 1

    Experimental Psychiatry Unit and

  2. 2

    Department of General Psychiatry and Social Psychiatry,

  3. 3

    Centre of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck and Private psychiatric practice, Graz, Austria

*Gerald Zernig, Experimental Psychiatry Unit, Department of General Psychiatry and Social Psychiatry, Centre of Psychiatry and Psychotherapy, Medical University Innsbruck, Innrain 66 a 1.Stock, A-6020 Innsbruck, Austria. E-mail: gerald.zernig@i-med.ac.at

Publication History

  1. Issue published online: 6 NOV 2008
  2. Article first published online: 6 NOV 2008
  3. Submitted 21 December 2007; initial review completed 1 May 2008; final version accepted 21 July 2008

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article with Supporting Information (HTML) Get PDF (149K)

Keywords:

  • Nicotine dependence;
  • psychodynamic model training;
  • psychotherapy;
  • randomized controlled trial;
  • smoking cessation;
  • sustained-release bupropion

ABSTRACT

Aims  To compare the efficacy and safety of a novel psychological intervention for smoking cessation called psychodynamic model (PDM) training to an active control condition of sustained-release bupropion.

Design  Randomized controlled clinical trial with allocation concealment.

Setting  Private psychiatric practice.

Participants  Seven hundred and seventy-nine adult smokers recruited by advertising.

Interventions  PDM training (n = 366 participants) consisted of a very brief (1.5 days) psychoeducation and a supervised training in autosuggestion techniques (guided imageries) aimed at enhancing self-management, decidedness, assertiveness, security and competence in relationships, natural functions of organs and awareness of bodily functions. Bupropion SR (n = 413) was increased to 150 mg twice daily over 1 week and given over a 8-week period.

Measurements  Twelve-month continuous abstinence confirmed by exhaled carbon monoxide (CO) of 9 parts per million (p.p.m.) or less at all interviews conducted at 3, 6 and 12 months.

Findings  Intention-to-treat analysis revealed Russell standard 12-month continuous abstinence rates of 39.1% in the psychotherapy group versus 12.3% in the bupropion SR group (P < 0.001) with a relative benefit (RB) of 3.16 (2.38–4.26). Completer analysis revealed 12-month continuous abstinence rates of 39.9% in the psychotherapy group versus 22.5% in the bupropion group [P < 0.001; RB 1.78 (1.35–2.34)]. Of note, bupropion abstinence rates were comparable to previous medications/placebo-only comparisons in geographically different samples.

Conclusions  The 1.5-day psychotherapy exceeded bupropion's efficacy, presenting an alternative to pharmacological smoking cessation aids, especially for smokers who reject drugs to treat their substance dependence, at a similar cost (€350) as the bupropion treatment (€355).

View Full Article with Supporting Information (HTML) Get PDF (149K)