Naturalistic, self-assignment comparative trial of bupropion SR, a nicotine patch, or both for smoking cessation treatment in primary care

The effectiveness of bupropion SR, a nicotine patch, or both, when co-administered with cognitive-behavioral therapy, on smoking cessation was evaluated under treatment-as-usual conditions in a primary care smoking cessation clinic. Consecutive consenting patients (n = 189) assigned themselves to one of three treatments according to personal preference: nicotine patch (NTP; n = 27), bupropion SR (B; n = 101), and bupropion SR plus nicotine patch (B + NTP; n = 61). Six-month self-reported abstinence rates were 14.8%, 27.7%, and 34.4%, respectively. Odds ratios for 6-month abstinence, with NTP as reference, were 2.2 (CI = 0.7-5.9; p = .19) for B, and 3.0. (CI = 0.9-9.9; p = .07) for B + NTP. Resemblance of abstinence pattern and magnitude between this naturalistic study and randomized clinical trials of bupropion SR may support tentative inferences of stability and generalizability of clinical trial efficacy findings.