Primary Outcome Measures:
- Proportion of women who are eligible for the study
- Proportion of eligible women who enroll in the study
- Proportion of enrolled women who complete the study
Secondary Outcome Measures:
- Cotinine-verified 7-day tobacco abstinence at 2 weeks
- Cotinine-verified 7-day tobacco abstinence at 8 weeks
- Cotinine-verified 7-day tobacco abstinence at 12 weeks
- Symptoms of depression at 2, 8, and 12 weeks postpartum
- Symptoms of anxiety at 2, 8, and 12 weeks postpartum
- Adherence to study drug at 2 and 8 weeks postpartum
- Rate of adverse effects at 2 and 8 weeks postpartum
Purpose: A pilot randomized double-blind placebo-controlled trial is testing the feasibility of conducting a full-scale trial of the efficacy of bupropion SR vs. placebo in non-breastfeeding postpartum women who smoked >1 cigarette in the last month of pregnancy and want to stop smoking. The study will estimate achievable enrollment and retention rates; estimate the effect size of the drug on tobacco abstinence; assess the tolerability of bupropion in postpartum women; and allow refinement of recruitment, retention, intervention, and assessment protocols.
Research Design: Pilot double-blind placebo-controlled randomized clinical trial.
Study Population: 40 postpartum women aged 18 years or older who smoked > 1 cigarette in the last month of pregnancy, want to stop smoking, and are not breastfeeding. Subjects will be recruited postpartum while hospitalized after delivery.
Intervention: Bupropion SR (or matching placebo) for 8 weeks, starting immediately post-delivery. The dose is 150 mg qd for one week then 150 mg bid for 7 weeks. All subjects will receive behavioral counseling delivered face-to-face during the post-delivery hospitalization and by telephone 4 times over 8 weeks.
Outcome Measures: (assessed at 2, 4, 8, and 12 weeks postpartum):
- Study eligibility, recruitment, and retention rates (primary outcome).
- Tobacco abstinence (7-day point prevalence nonsmoking by self-report and confirmed by saliva cotinine at 2 weeks, 8 weeks (end of drug treatment), and 12 weeks postpartum.
- Postpartum weight loss and symptoms of depression and anxiety.
- Tolerability of postpartum bupropion, assessed by medication adherence and adverse effects.