) Estimates of smoking prevalence indicate increasing smoking rates among youth. In contrast, little is known about smoking rates among college students, a group that has previously been, but no longer appears to be, more resistant to cigarette use than other young adults. Further, technical college students smoke at higher rates than both traditional four-year college students as well as the general population. Given their particular constellation of risk factors, technical college students may be particularly prone to years of continued smoking. Targeting young adults would provide an unexplored window of opportunity for halting the entrenchment of smoking and preventing future detrimental medical, psychological, and economic consequences. The proposed pilot study will test the hypothesis that adding sustained- release bupropion to standard cognitive-behavioral group therapy plus nicotine replacement will enhance the achievement and maintenance of smoking cessation in a sample of young adults (ages 18-30 years) attending technical school. We will also explore the relationship between various risk factors, including sociodemographic and smoking-related variables and psychiatric comorbidity, and smoking cessation outcomes. The study employs a randomized, double-blind, placebo-controlled design to test the incremental efficacy of 1) standard smoking cessation treatment + placebo ,s. z) standard smoking cessation treatment + bupropion hydrochloride. Two hundred smokers will receive 6 group sessions of standard smoking cessation treatment, which includes 7 weeks of transdermal nicotine replacement. Half will receive active bupropion or a matching placebo. Subjects will be treated for 10 weeks and followed for 6 months. Current and past psychiatric symptoms will be assessed. We expect that this study will result in the development of an efficacious treatment for a high-risk young adult population, and will therefore have important clinical and public health significance in reducing prevalence of smoking in future generations. We further expect that this study will increase our knowledge of the interaction of combined pharmacologic and psychosocial treatments on various risk factors for smoking relapse in the process of smoking cessation.
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