Pragmatic, observational study of bupropion treatment for smoking cessation in general practice.

BACKGROUND Cigarette smoking remains the single largest cause of premature death in the United Kingdom. As part of the government's national service framework for coronary heart disease, smoking cessation forms a key part of the strategy. OBJECTIVES To determine the effectiveness of bupropion treatment for smoking cessation in a general practice setting, measuring continuous abstinence from smoking, from 8 weeks to 52 weeks. DESIGN Prospective observational study. SETTING One general practice (six whole time equivalent doctors, 11,070 patients) in rural Northumberland. SUBJECTS Of the 243 patients who presented to the practice over a one year period for smoking cessation, a total of 227 motivated people, who were appropriate for bupropion treatment as a pharmacological aid for smoking cessation, entered the study. Continuous smoking cessation at one year was validated by an exhaled carbon monoxide level of 10 ppm or less. RESULTS Fifty patients successfully gave up smoking, giving a one year smoking cessation prevalence with bupropion of 22% (95% confidence intervals (CI) 17% to 28%). There was no difference in success rate for sex, number of cigarettes smoked, the number of years smoking, or whether there were other smokers in the household or not. CONCLUSION Bupropion treatment in this general practice helped 22% of motivated people to quit and remain stopped smoking at one year. Mainly nurses, whose prescribing rights are restricted and currently exclude bupropion, deliver smoking cessation services in primary care.