Are There Gender Differences in Smoking Cessation, with and Without Bupropion? Pooled- and Meta-analyses of Clinical Trials of Bupropion SR

Aims: In this study, we examine gender differences in smoking cessation with and without treatment with Bupropion SR. We test whether women and men have comparable success rates quitting smoking regardless of treatment, whether Bupropion SR is effective for women, and whether Bupropion SR efficacy differs for men and women.

Design: A literature search was conducted to identify relevant trials. Data were analyzed with individual-level (pooled) and study-level (meta-analytical) statistics.

Participants: Data from 4421 participants in 12 randomized smoking cessation trials of Bupropion SR 300 mg versus placebo were analyzed.

Findings: Results from the meta-analysis revealed that Bupropion SR was an effective aid to smoking cessation [odds ratio (OR) = 2.49, 95% confidence interval (CI) = 2.06-3.00]. Moreover, Bupropion SR proved to be an effective cessation aid for women (OR = 2.47, 95% CI = 1.92-3.17). No treatment-gender interaction was observed; women and men benefited equally from treatment with Bupropion SR (Q = 0.01, NS). Overall, women were less successful at quitting than men, regardless of treatment (OR = 0.79, 95% CI = 0.65-0.95). These results were replicated with pooled, individual-level analyses.

Conclusions: Bupropion SR is an effective smoking cessation aid for women. In these trials, women have less success quitting smoking than men, whether treated with Bupropion SR or placebo. There is a need to understand more about why women are less able to quit.