Bupropion (Zyban) is an efficacious aid to smoking cessation.

Bupropion SR 150 has been shown to increase quit rates compared to placebo. Bupropion is likely to double the odds of long-term quitting. It is unclear whether bupropion has better efficacy than NRT, and whether the combination of bupropion and NRT increases quit rates over NRT or bupropion alone. The efficacy of bupropion is not due to its antidepressant effects; it works equally well in smokers with and without a history of depression. Doctors prescribing Zyban need to be aware of the contraindications to its use for people such as individuals with a history of a seizure disorder.

The choice between the use of NRT and bupropion is likely to depend on patient preference, contraindications, cost and availability. Where some NRT forms are available without prescription, smokers may choose to use these first.

Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation (Cochrane Review). Cochrane Database of Systematic Reviews 2004; 4. http://www.cochrane.org/reviews/en/ab000031.html

Fiore MC, Bailey WC, Cohen SJ, et al. Treating Tobacco Use and Dependence. A Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services, 2000. http://www.surgeongeneral.gov/tobacco/treating_tobacco_use.pdf