Monday, April 2, 2007

Unveil Philippines: Smokers

A Study By Manuel Hector Solis, Lenora C. Fernandez, Lirio Covey: Published in Chest, October 2005

PURPOSE: Smoking is very prevalent in the Philippines with 45% among Filipinos being ever-smokers and the number of current smokers increased from 32.7% in 1999 to 34.8% in 2003. This study aims to assess the rate of successful smoking cessation among Filipino smokers with the use sustained-release bupropion hydrochloride as the pharmacologic aid in achieving abstinence. Safety in the use of bupropion hydrochloride and factors that may promote smoking abstinence among Filipinos were also determined.

METHODS: This was a non-randomized, non-comparative and prospective study where willing smokers underwent individualized smoking cessation sessions at the Philippine General Hospital and took Sustained-Release Buproprion hydrochloride at 300 mg/day for 8 weeks. They returned weekly during the first four weeks and then at 6 and 8 weeks for follow-up. Self-report of smoking abstinence at the end of 8 weeks was confirmed by urine cotininine determination. Psychological well-being and adverse effects were also monitored during the study.

RESULTS: A total of 84 Filipino smokers were included and all of the subjects completed 8 weeks of sustained release bupropion hydrochloride treatment at 150 to 300 mg/day. Urine cotinine-confirmed abstinence rate was 57% after 8 weeks in the study. Predictors of smoking abstinence were higher educational attainment (odds ratio 3.17, 95% confidence interval 1.1-9.2), older age when the subject started smoking (p value <0.05), absence of another smoker at home (p<0.05), and lower baseline carbon monoxide level (p<0.05). There was no difference between abstainers and non-abstainers regarding safety and psychological well-being. There were no serious adverse events in the study.

CONCLUSION: Urine cotinine-confirmed smoking abstinence was 57% after 8 weeks of individualized smoking cessation intervention and sustained-release bupropion hydrochloride administration among Filipinos. Minimal adverse effects were encountered with the use of bupropion hydrochloride.

CLINICAL IMPLICATIONS: Smoking cessation intervention with the concomitant use of sustained-release bupropion hydrochloride was quite effective among Filipinos and was at par in effectivity with other Asian and developed countries. Side effects to pharmacologic treatment for smoking cessation were minimal.

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