Both antidepressant therapy and counseling may help smokers achieve short-term abstinence

A study to determine whether counseling increases the efficacy of antidepressants in smoking cessation programs found that such combination therapy did not add benefit to antidepressant therapy. It also found that counseling increased short-term abstinence rates when it was added to medical management, but neither counseling nor antidepressant therapy produced long-term sustained abstinence. Counseling produced higher 7-day abstinence rates than medical management alone, but this improvement was not sustained over the course of the study.

During a year-long study of 220 cigarette smokers, researchers compared the effectiveness of nortriptyline, a drug used to treat depression–and sustained release bupropion–a drug that has FDA approval for smoking cessation treatment. The researchers then assessed the effectiveness of the drugs in combination with counseling and with medical management alone. The medical management intervention included advice to stop smoking, medication, side effects monitoring, and educational materials. The counseling consisted of five group sessions to provide discussion of cessation and health-related information for mood management and smoking cessation.

Less than one-third of the participants were able to remain cigarette-free for a year.

WHAT IT MEANS: Both drugs and counseling have limited effectiveness in helping smokers to completely stop smoking for at least a year, but both can help smokers attain periods of abstinence.

Dr. Sharon Hall, the study's lead author, published the research in the October 2002 issue of the journal Archives of General Psychiatry.

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