Bupropion SR for Smoking Cessation in Hospitalized Acute Coronary Heart Disease Patients

Every year, around 2 million people in the U.S. are hospitalized due to heart disease, specifically conditions like heart attack or unstable angina. For the 20% of these patients who smoke, quitting smoking is highly recommended and cost-effective. Hospitalization is a great opportunity to start smoking cessation, as it enforces temporary smoking abstinence and increases smokers' motivation to quit. However, even with the best counseling, at least 40% of smokers fail to quit. This study aims to test if adding a medication called Sustained-Release (SR) Bupropion (Zyban, Wellbutrin SR) to behavioral counseling can help. This drug is a non-nicotine antidepressant that has shown to be effective for smoking cessation and safe for heart patients. It may also prevent depression after a heart attack, which is a separate risk factor for death. In this study, adult smokers hospitalized with heart attack or unstable angina are given SR Bupropion or a placebo, starting in the hospital and continuing for 12 weeks. This is done along with comprehensive smoking counseling. The main goal is to see if the drug helps patients stay away from tobacco for a week at the one-year follow-up. Secondary goals include checking if the drug helps patients stay away from tobacco for a week at the end of treatment (12 weeks), delays the time to smoking relapse, reduces heart disease complications and depressive symptoms, and improves quality of life over one year.