CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Smoking cessation - Management
How long should I prescribe bupropion for?
- The recommended course of treatment is for 7–9 weeks, after which time bupropion should be stopped.
- If no effect is seen after 7 weeks, treatment should be discontinued at this stage.
- Evidence is conflicting regarding longer-term use (up to 1 year) of bupropion to prevent relapse in people who are abstinent after 7–9 weeks of bupropion. This is an unlicensed use of bupropion, and further evidence is needed before this approach can be recommended:
- In one randomized controlled trial (RCT), people who were abstinent after 7 weeks of bupropion were randomized to receive bupropion (n = 214) or placebo (n = 215) for a further 45 weeks (total duration of treatment = 52 weeks) [Hays et al, 2001]. Abstinence at week 52 was significantly greater in the bupropion group than in the placebo group (55.1% compared to 42.3%, p = 0.008), but by week 104, the difference was no longer significant.
- In a second RCT, people who were abstinent after 8 weeks of tailored nicotine replacement therapy were randomized to receive bupropion (n = 88) or placebo (n = 88) for a further 26 weeks [Hurt et al, 2003]. At the end of the 26-week continuation phase, the abstinence rates between the bupropion and placebo groups did not significantly differ (28% compared with 25%).
© NHS Institute for Innovation and Improvement