The purpose of this small preliminary study is to determine whether it is feasible to
recruit women smokers who have just delivered a baby and are not breastfeeding into a study
that would test whether starting bupropion, a smoking cessation medication, after a baby's
birth helps a postpartum woman to stop smoking.
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):
1. Study eligibility, recruitment, and retention rates (primary outcome).
2. 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.
3. Postpartum weight loss and symptoms of depression and anxiety.
4. Tolerability of postpartum bupropion, assessed by medication adherence and adverse
Postpartum women who:
- Smoked >1 cigarette in last month of pregnancy
- Deliver a baby at Brigham and Women's Hospital in Boston, MA
- Do not breastfeed or plan to breastfeed.
- Want to attempt to stop smoking
- Age <18 years;
- Current use of bupropion or antidepressant;
- Current major depression or other severe psychiatric illness (e.g., schizophrenia,
- Contraindication to use of bupropion;
- Illegal substance use in past 6 months;
- >1 drink/day of alcohol during pregnancy;
- Newborn with major congenital anomaly or <25 weeks' gestation;
- Inability to speak or read English;
- No telephone.