Mayo Clinic study identifies predictors of smoking cessation

May 13, 2001

ROCHESTER, MINN. -- A multi-center study led by researchers at Mayo Clinic's Nicotine Dependence Center finds that men tend to be more successful at stopping smoking than women, and that the first two weeks of abstinence are critical in predicting long-term cessation.

The study, published in the May issue of Chest, also shows that the non-nicotine pill bupropion is an effective stop-smoking aid for all types of patients.

Conducted at Mayo Clinic, Palo Alto Center for Pulmonary Disease Prevention and West Virginia University, the research focused on 615 smokers who were randomly assigned to receive the drug bupropion or placebo. The goal of the study was to identify factors that contribute to a patient's success or failure in stopping smoking.

"By identifying smokers who are more likely to succeed or fail with bupropion therapy, treatment decisions can be made that might increase the patient's likelihood of stopping," says Lowell Dale, M.D., associate director of the Mayo Clinic Nicotine Dependence Center and principal author of the study. "We can use this study's findings to determine who should receive a brief behavioral intervention and who might need more intense therapy."

Several characteristics of smokers predicted greater rates of abstinence:
* Gender -- Male gender is predictive of a better outcome.
* Previous abstinence from smoking -- People who have never quit or who have quit for at least a month are more likely to succeed.
* Average number of cigarettes per day -- Lighter smokers are more likely to stop.
* Bupropion -- People on a higher dose were more successful.
* Age -- Older people stopped at higher rates.
* Household smoking -- People living in smoke-free households were more successful.
* Stop attempts -- People with a greater number of stop attempts did better.

"Interestingly, male gender predicted greater abstinence rates than did female gender," says Dr. Dale. "While some studies have not found a gender difference in ability to stop smoking, other studies have noted that women have more trouble quitting than men. This has been attributed to women's greater concerns about weight gain when they stop. Women also have higher rates of depression than men and are more likely to use smoking as a means of managing mood."

Another key finding: abstinence during the first two weeks after stopping was predictive of long-term success.

"Patients and physicians must put more effort into those first few weeks of treatment," notes Dr. Dale. "The key is to aggressively treat patients during the first weeks of their stop attempt. This may need to include counseling, bupropion and nicotine replacement in order to help patients increase their likelihood of quitting for good."
Note: The prescription drug bupropion SR (Zyban) used in this study is manufactured by Glaxo-SmithKline. GSK provided a grant for this research.

Shelly Plutowski
507-284-5005 (days)
507-284-2511 (evenings)

Mayo Clinic

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