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Pragmatic, observational study of bupropion treatment for smoking cessation in general practice
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  1. S Wilkes1,
  2. A Evans2,
  3. M Henderson2,
  4. J Gibson2
  1. 1Centre for Primary and Community Care, School of Health Natural and Social Sciences, University of Sunderland, UK
  2. 2Coquet Medical Group, Broomhill Health Centre, Morpeth, Northumberland, UK
  1. Correspondence to:
 Dr S Wilkes
 Centre for Primary and Community Care, School of Health Natural and Social Sciences, Benedict Building, St George’s Way, University of Sunderland SR2 7BW, UK; scott.wilkessunderland.ac.uk

Abstract

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.

  • CO, carbon monoxide
  • NRT, nicotine replacement therapy
  • smoking cessation
  • bupropion
  • motivation
  • counselling
  • primary care
  • family practice
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Footnotes

  • Ethical approval: permission from Northumberland Local Research Ethics Committee for evaluation of this service implementation has been given.

  • Funding: the authors acknowledge a £1000 grant from the Northumberland Care Trust Smoking Cessation Strategy Group for their support and help with funding this project.

  • Competing interests: none declared.

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