Contingent Incentives Plus Bupropion for Smoking in People With Schizophrenia

There is a high prevalence of smoking among people with schizophrenia, and there are few
smoking treatment programs for these smokers. In this study, we are investigating whether
the combination of bupropion (also called Zyban and Wellbutrin) and a behavioral treatment
program (contingent vouchers) can reduce smoking in people with schizophrenia. This is a
3-week study aimed to investigate the feasibility of this treatment approach. Participants
are randomly assigned to bupropion (300 mg/day, in 2 divided doses) or placebo. After one
week on medication, participants are randomly assigned to the active behavioral treatment
(contingent vouchers) or the control treatment (non-contingent vouchers). Over a 3-week
period, participants come to the study site about 2-3 times per week, and provide
information about their recent smoking and nicotine withdrawal symptoms. They also give
saliva and urine samples that are analyzed for levels of cotinine, a nicotine metabolite.
Participants in the active behavioral treatment group receive gift cards to local grocery
stores when their cotinine levels indicate that they have reduced their smoking.
Participants in the control behavioral treatment group receive gift cards regardless of
cotinine level. Any participant who significantly reduces their smoking at the end of the
trial is followed up 2 and 4 weeks after the end of the trial too see if they have sustained
these smoking reductions. If we have favorable results from this trial, we will expand it
into a smoking treatment program.

Inclusion Criteria:

Diagnosis of schizophrenia or schizoaffective disorder, smoke 20-50 cpd, clinically stable
on antipsychotic and antidepressant medications

Exclusion Criteria:

Pregnant/nursing women, seizure disorder, lowered seizure threshold due to other medical
conditions, positive urine drug screen positive breath alcohol test, past 2 weeks use of
MAO inhibitors, any form of bupropion, cimetidine, phenobarbital, phenytoin, DA agonists,
anorectics, stimulants