Varenicline versus Bupropion XL for Smoking Cessation in Older Adolescents A Randomized, Double-Blind Pilot Trial

• Published in: Nicotine & tobacco research Vol. 14; no. 2; pp. 234 - 239
• Main Authors: Gray, Kevin M., Carpenter, Matthew J., Lewis, A. Lee, Klintworth, Erin M., Upadhyaya, Himanshu P.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-02-2012
• Subjects: Adolescent; Benzazepines - adverse effects; Benzazepines - therapeutic use; BRIEF REPORTS; Bupropion - administration & dosage; Bupropion - adverse effects; Bupropion - therapeutic use; Double-Blind Method; Female; Humans; Male; Nausea - chemically induced; Pilot Projects; Quinoxalines - adverse effects; Quinoxalines - therapeutic use; Sleep Initiation and Maintenance Disorders - chemically induced; Smoking - drug therapy; Smoking Cessation - methods; Tobacco Use Cessation Products; Treatment Outcome; Varenicline; Young Adult
• ISSN: 1462-2203; 1469-994X
• DOI: 10.1093/ntr/ntr130

Introduction:
Despite tremendous potential public health impact, little work has focused on development of evidence-based smoking cessation treatments for adolescents, including pharmacotherapies. No prior studies have explored the feasibility and safety of varenicline and bupropion XL, 2 potentially promising pharmacotherapies, as smoking cessation treatments in adolescents.
Methods:
Treatment-seeking older adolescent smokers (ages 15-20) were randomized (double-blind) to varenicline (n = 15) or bupropion XL (n = 14), with 1-week titration and active treatment for 7 weeks. Structured safety, tolerability, and efficacy assessments (cotinine-confirmed 7-day point prevalence abstinence) were conducted weekly.
Results:
There were no serious adverse events. Two participants discontinued bupropion XL due to adverse effects, and none discontinued varenicline. Over the course of treatment, participants receiving varenicline reduced from 14.1 ± 6.3 (mean ± SD) to 0.9 ± 2.1 cigarettes/day (CPD, 4 achieved abstinence), while those receiving bupropion XL reduced from 15.8 ± 4.4 to 3.1 ± 4.0 CPD (2 achieved abstinence).
Conclusions:
These preliminary results support the feasibility and safety of conducting adequately powered, placebo-controlled efficacy studies of varenicline and bupropion XL for adolescent smoking cessation.