GROUP COUNSELING AND BUPROPION: A SIX-YEAR SURVEY OF A SMOKING CESSATION TREATMENT IN ROME

Actually the most effective therapies for nicotine addiction are individual or group counseling therapy, nicotine replacement therapy, Bupropion Therapy (BT) and from 2006 (in Italy from July 2007) varenicline therapy. Counseling and pharmacotherapy in combination has been found to achieve the highest rate of smoking cessation, then the aim of the present study is to evaluate the outcome at one-year follow-up (the rate of success among subjects enrolled in a program of smoking cessation) of subjects enrolled in a program of smoking cessation treatment over a six-year period. From January 2001 to December 2006, 706 volunteers motivated to quit smoking (44.9% males, 55.1% females, average age 47.1±10.6 yrs and smoking an average of 24.3±10.4 cigarettes/day for a period of 30.0±10.8 yrs, range 2-61) were recruited by our Unit. After an individual motivational interview, patients started a Six-week Group Counseling Program SGCP for smoking cessation and were asked to begin a seven week pharmacotherapy consisting of 300 mg Bupropion SR/daily. The amount of exhaled carbon monoxide was taken as a measure of abstinence; counselors called in the patients after 3, 6 and 12 months to check their smoking habit. The majority of the subjects were in their late forties, had a high school education and regular employment and 90% had a family history of tobacco smoking. Significative differences resulted between the subjects enrolled in these six years: subjects were each year older than previous year an with a higher craving for nicotine as evaluated through the Visual Analogue Scale (VAS) at enrollment, besides they tried more times to stop smoking before engaging in SGCP and experienced less withdrawal symptoms during the first 5-day of SGCP of nicotine cessation. More than one-third of the all subjects enrolled accepted BT, while the remaining chose SGCP only, with no differences between the six-year. During all the period subjects treated with BT achieved a significant higher cessation rate with respect to SGCP only during all the follow-up period (60.5% and 40.5% respectively a one-year follow-up). Conclusions. Subjects enrolled in a SGCP smoking cessation treatment from 2001 to 2006 showed a high smoking cessation rate either at the short-term follow-up (75.1%: at the end of the SGCP) either at the three-month, six-month and one-year follow-up (67.7%, 54.8%, 48.0% respectively). In conclusion our data suggest that a SGCP can help heavy smokers to quit.