Factors associated with discontinuation of bupropion and counseling among African American light smokers in a randomized clinical trial.

BackgroundAfrican Americans are at risk of inadequate adherence to smoking cessation treatment, yet little is known about what leads to treatment discontinuation.PurposeThe purpose of this study was to examine the factors associated with discontinuation of treatment in African American light smokers (≤10 cigarettes per day).MethodsBupropion plasma levels and counseling attendance were measured among 540 African American light smokers in a placebo-controlled randomized trial of bupropion.ResultsBy week 3, 28.0 % of subjects in the bupropion arm had discontinued bupropion, and only moderate associations were found between the plasma levels and self-reported bupropion use (r s = 0.38). By week 16, 36.9 % of all subjects had discontinued counseling. Males had greater odds of discontinuing medication (OR = 2.02, 95% CI = 1.10-3.71, p = 0.02), and older adults had lower odds of discontinuing counseling (OR = 0.96, 95% CI = 0.94-0.97, p < 0.0001).ConclusionsBupropion and smoking cessation counseling are underutilized even when provided within the context of a randomized trial. Future research is needed to examine strategies for improving treatment utilization among African American smokers