According to a new report, the medication bupropion with counselling appears to help adolescents quit cigarette smoking in the short term.

Many teen smokers want to give up, but studies estimate that only about 4 percent of those who try are successful each year. The antidepressant bupropion has been shown to help adults quit smoking.

Myra L. Muramoto and Scott J. Leischow at the University of Arizona, Tucson, conducted a clinical trial of 312 adolescents aged 14 to 17 who smoked six or more cigarettes per day and had tried to quit at least twice before. They were randomly assigned to receive 150 milligrams or 300 milligrams of bupropion per day, or a placebo. Participants visited the clinic weekly for seven weeks, six weeks of treatment plus one week post-treatment and received 10 to 20 minute individual cessation counselling sessions. They were interviewed by phone after 12 weeks and in person after 26 weeks.

During the treatment, quit rates were higher for the 300-milligram group than for placebo. After six weeks, 5.6 percent of those in the placebo group, 10.7 percent of those in the 150-milligram bupropion group and 14.5 percent of those in the 300-milligram group had quit smoking. At the 26-week follow-up, 10.3 percent of those who took placebo, 3.1 percent of those who took 150 milligrams of bupropion and 13.9 percent of those who took 300 milligrams were still abstaining from cigarettes. The teens' reported quit rates were verified by checking the level of cotinine, a byproduct of nicotine processing, in the urine.

Though the results suggest that 300 milligrams of bupropion plus brief counseling sessions may help teens quit smoking over the short term, abstinence rates at the end of the treatment period were lower than those seen in adults taking the same medication. In addition, the high rate of relapse after stopping medication suggests that a longer treatment period, such as the 12 weeks recommended for adult smokers may be needed.

"Nonetheless, this study provides hope for helping a generation of smokers quit before they become adults. These results are critically important because few effective treatment options are available for adolescent smokers who want to quit," the authors conclude.

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