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Treatment of Nicotine Dependence in a Healthcare Setting
SRI is analyzing the genetics of smoking and related characteristics, using data from a large-scale National Cancer Institute study on smoking cessation.
As an outgrowth of its work in two prior studies on the use of prescription drugs in smoking cessation programs, SRI is studying information from the latest clinical trial in 2004 to learn how genetics may play a role in smoking and related characteristics.
The latest trial, the 2004 COMPASS study, comprised 1,202 adult smokers who were interested in quitting and were randomly assigned to one of three smoking cessation interventions:
- Web-based counseling
- Proactive telephone-based counseling (PTC)
- Combined PTC and web counseling
All participants received a standard 12-week FDA-approved course of varenicline (brand name Chantix, Pfizer, Inc.).
Intent-to-treat analyses revealed relatively high rates of abstinence for the web, PTC, and PTC-web groups, respectively, at three months (38.9%, 48.5%, 43.4%) and at six months (30.7%, 34.3%, 33.8%). The PTC group had significantly higher abstinence than the web group at three months, but no between-group differences were seen at six months.
The COMPASS study was funded by a grant renewal SRI received in 1997 from the National Cancer Institute to conduct a clinical effectiveness trial of bupropion SR (brand name Zyban, GlaxoSmithKline, Inc.) for smoking cessation. For this open-label trial (Project EZ), a total of 1,524 adult smokers interested in quitting were randomly assigned to receive one of two doses of bupropion SR (150 mg or 300 mg) paired with minimal or moderate behavioral counseling. They were assessed for point-prevalent smoking status at three and 12 months.
At three months, a significantly higher rate of nonsmoking was observed among patients who received the higher bupropion SR dose. The group receiving 300 mg and moderate counseling had a significantly higher rate of nonsmoking (35.0%) than the other treatment groups (for which nonsmoking rates ranged from 24.2% to 26.7%). At 12 months, patients receiving moderate counseling showed a higher rate of nonsmoking (32.3%) than patients who received minimal counseling (24.6%), but the advantage previously observed for the higher bupropion SR dose was no longer apparent.