EXPERTS TOUT NEW THERAPY FOR SMOKERS TRYING TO QUIT

A new approach combining an antidepressant, nicotine replacement and
counseling is sharply increasing the chance of success among people
who are trying to give up smoking.

Typically, according to scientists at the Centers for Disease Control
and Prevention and other experts on smoking, fewer than 5 percent of
smokers who seek to quit without outside help are successful. But when
the new approach was tried with 4,000 smokers at centers across the
country, 40 percent to 60 percent remained smoke-free a year after
completing the program.

Dr. Linda Ferry, chief of preventive medicine at the Veterans Affairs
Medical Center in Loma Linda, Calif., who first proposed the
combination treatment, said that it involves bupropion, a drug
originally developed as a treatment for depression; varying dosages of
nicotine replacement delivered through patches, gum nasal spray or
inhalers, and counseling individually tailored to the patient.

Dr. John Slade of the American Society of Addictive Medicine, an
organization of doctors and others who treat alcoholism, drug abuse
and nicotine addiction, called the new results "very exciting."

Dr. C. Everett Koop, the former surgeon general, said the results so
far were "highly encouraging for 45 million Americans who smoke but
now have a much better chance of quitting."

Experts in tobacco dependence caution that the findings on the new
approach must be regarded as preliminary. Nicotine addiction is
notoriously tenacious, and smokers can relapse even after going 5 to
10 years without smoking.

Dr. Richard Hurt, director of the Nicotine Dependence Center at the
Mayo Clinic in Rochester, Minn., said that much more needed to be
learned about the addiction. Still, he said, the addition of bupropion
to programs for ending the smoking habit represents the biggest
development in the field since nicotine-replacement therapy was
introduced in 1971.

Bupropion, made by Glaxo Wellcome, was first marketed in 1989 as an
antidepressant under the name Wellbutrin.

A slow-release form of bupropion, approved by the Food and Drug
Administration in 1997 for treatment of nicotine addiction, is
marketed under the name Zyban.

The new combination approach is being widely used in clinics across
the country, including the center in Loma Linda; the University of
Wisconsin in Madison; the Army base at Ft. Knox, Ky., and the Mayo
Clinic's Nicotine Dependence Center, as well as private clinics.

The success rates of 40 percent to 60 percent that were achieved
compare with 10 percent to 26 percent success rates among smokers who
try to quit by using nicotine replacement alone.