***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
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    Input: The authors present results of a r and omized clinical trial of the efficacy of extended treatment with bupropion SR in producing longer term cigarette smoking cessation .  Adult smokers ( N = 362 ) received  open-label treatment  ( 11 weeks ) that combined relapse prevention training , bupropion SR , and nicotine patch followed by extended treatment ( 14 weeks ) with bupropion SR or matching placebo .  Abstinence percentages were relatively high ( week 11 : 52 % ; week 25 : bupropion , 42 % ; placebo , 38 % ; week 52 : bupropion , 33 % ; placebo , 34 % ) , but bupropion SR did not surpass placebo .  Gender and baseline craving level were identified as significant , independent moderators of treatment response . Men were more likely to abstain than women ( week 11 : 59 % vs. 43 % , p = .001 ; week 25 : 48 % vs. 31 % , p = .001 ; week 52 : 39 % vs. 27 % , p = .01 ) . Because most smokers suffer relapse with any current cessation treatment , the comparatively high abstinence percentages achieved in this trial are of interest INTRODUCTION Varenicline , a first-line non-nicotine medication , has not been evaluated in Black smokers , and limited attention has been paid to pharmacotherapy adherence in smoking cessation trials . This pilot study estimated quit rates for Black smokers treated with varenicline and tested a behavioral intervention to aid varenicline adherence . METHODS Seventy-two Black smokers ( > 10 cigarettes per day ; cpd ) were r and omly assigned to adherence support ( AS ; n = 36 ) or st and ard care ( n = 36 ) . All participants received 3 months of varenicline and a single counseling session focused on making a quit plan . AS participants received 5 additional counseling sessions to encourage medication use . Outcome measures included salivary cotinine , and carbon monoxide confirmed smoking abstinence , reductions in self-reported cpd , and pill counts of varenicline adherence at Months 1 , 2 , and 3 . RESULTS Sixty-one participants ( 84.7 % ) completed follow-up at Month 3 . Participants were female ( 62.5 % ) , 46.8 years of age , and smoked 16.3 cpd . No treatment group differences were found on the smoking or adherence outcome measures ( p > .05 ) . Collapsing across treatment ,  varenicline adherence was adequate ( 86.1 % ) , yet despite a reduction of 12.2 ( 6.5 ) cpd from baseline to Month 3 ( p < 0.001 ) , only 23.6 % were confirmed quit at Month 3 . Participants who were quit at Month 3 had higher  varenicline adherence rates ( 95.8 % ) than those who continued to smoke ( 80.8 % , p ≤ .05 ) . CONCLUSIONS Studies are needed to examine the efficacy of varenicline among Black smokers . Interventions to facilitate adherence to pharmacotherapy warrant further attention as adherence is linked to improved tobacco abstinence Rationale There are over 300 million Chinese smokers , but use of nicotine replacement therapy ( NRT ) is rare . On the other h and , data on the factors associated with quitting and adherence to NRT use are scarce in the East . Objectives To describe adherence and other predictors of quitting smoking at the 12-month follow-up amongst Chinese smokers in Hong Kong . Methods Chinese smokers ( 1186 ) who attended the Smoking Cessation Health Centre from August 2000 through January 2002 were studied . Trained counsellors provided individual counselling and carried out follow-up interviews . We used structured question naires at baseline and at 1 , 3 and 12 months and an intention-to-treat approach for analysis . Results Among those who received NRT ( 1051/1186 ) , the prevalence of adherence ( self-reported NRT use for at least 4 weeks ) was 16 % ( 95 % confidence interval 14–18 % ) . The 7-day point prevalence quit rate at 12 months ( not smoking any cigarette during the past 7 days at the 12 month follow-up ) was 27 % ( 95 % CI , CI 24–29 % ) . Stepwise logistic regression model showed that adherence to NRT use , a higher income , good perceived health and having more confidence in quitting were significant predictors of quitting . The quit rate in the adherent group ( 40 % ) was greater than that of the non-adherent group ( 25 % ) ( P<0.001 ) . Older age , male , higher education , experience of NRT use , perceiving quitting as more difficult and willingness to pay were significant predictors of adherence . Conclusions Clinical ly significant smoking cessation rates can be achieved among Chinese smokers in a clinic-based smoking cessation service . The NRT adherence was low and low adherence was associated with a lower quit rate . Trials of interventions to improve adherence and increase quit rates are needed BACKGROUND A high proportion of African-American smokers are light smokers , and they experience low smoking cessation rates and disproportionately high tobacco-related morbidity ; yet no studies have examined tobacco treatment adherence in this group . OBJECTIVES To determine the predictors of adherence to nicotine gum and counseling among African-American light smokers ( defined as smoking ≤10 cigarettes/day ) , and the effects of adherence on smoking cessation . DESIGN Data were from a 2 × 2 r and omized , placebo-controlled smoking cessation trial of nicotine gum ( 2 mg versus placebo ) and counseling ( motivational interviewing versus health education ) . PARTICIPANTS Seven hundred fifty-five African-American light smokers at a community-based clinic . MEASUREMENTS Demographic and health-related information , smoking behaviors , psychosocial variables , adherence to nicotine gum and counseling , and cotinine-verified 7-day abstinence from smoking  at week-26 follow-up . RESULTS A logistic regression model showed that having a higher body mass index ( OR = 1.03 , 95 % CI = 1.01 to 1.05 ) , more quit attempts in the past year ( OR = 1.04 , 95 % CI = 1.01 to 1.07 ) , higher baseline exhaled carbon monoxide ( OR = 1.22 , 95 % CI = 1.01 to 1.48 ) , and higher perceived stress ( OR = 1.12 , 95 % CI = 1.03 to 1.22 ) increased the likelihood of adherence to nicotine gum . Being a high school graduate was a predictor of adherence to counseling ( OR = 1.58 , 95 % CI = 1.02 to 2.44 ) . Surprisingly , being adherent to nicotine gum significantly reduced the odds of smoking cessation ( OR = 0.50 , CI = 0.28 to 0.87 ) . On the other h and , adherence to counseling dramatically increased the likelihood of smoking cessation ( OR = 3.32 , CI = 1.36 to 8.08 ) . CONCLUSIONS Individual risk factors may influence adherence to nicotine gum and counseling . Improving psychological interventions and promoting adherence to counseling may increase overall smoking cessation success among African-American light smokers Nicotine gum has been shown to be effective in improving abstinence rates , and in reducing post-cessation withdrawal distress and weight gain . However , the dose effects of nicotine gum on these outcomes is not known . In the present study , we varied the amount of 2 mg nicotine gum prescribed to motivated quitters to explore the hypotheses ( a ) that motivated quitters would use more pieces of gum when coached and counseled to do so and ( b ) that there would be a dose-related effect of gum use on abstinence , withdrawal symptoms , and weight gain .  One hundred seventy-seven volunteers were assigned to chew either 0 , 7 , 15 , or 30 , pieces per day of 2 mg nicotine gum . Biological verification of gum use and smoking abstinence were assessed in community volunteers who attended an intensive behavioral counseling program for smoking cessation while using nicotine gum for 3 months . In the survival analysis at 12 weeks , gum-group assignment was not related to successful abstinence . In the subset of 42 abstinent subjects , there was a strong positive relationship between pieces per day of nicotine gum used and saliva cotinine . However , there was substantial variability in groups of subjects reporting similar amounts of gum use . Withdrawal symptom reporting was not related to either gum use or cotinine levels . Weight gain was significantly related in a dose-dependent manner to salivary cotinine levels , but not to gum group assignment , with high and low cotinine subjects gaining on average , 4.0 and 6.6 pounds , respectively . Discussion of the use of high levels of nicotine gum is addressed . Consistent with earlier work , the study provided further support for the relationship between nicotine replacement level and post-cessation weight gain PURPOSE To determine the effectiveness of the 4-mg and 2-mg dosages of nicotine polacrilex vs placebo through the first 6 weeks of treatment ( during which 75 % of relapse occurs when there is no treatment ) in assisting high-dependent smokers to stop smoking when instructed to use a fixed number ( 12 pieces ) of medication daily . SUBJECTS AND METHODS Ninety high-dependent ( Fagerström Tolerance Question naire score > or = 7 plus baseline carbon monoxide level > 15 ppm ) healthy male and female smokers , highly motivated to quit smoking , were enrolled in a 6-week , r and omized , double-blind , placebo-controlled trial in which they were instructed to use 12 pieces per day of their assigned dosage formulation : 4 mg , 2 mg , or 0.5 mg ( placebo ) of nicotine polacrilex . The behavioral intervention did not depend on providing any special psychological training , skills , or services but rather employed a st and ard medical practice model that could easily be implemented by any primary care physician . RESULTS Sustained abstinence from weeks 2 through 6 , determined at each visit by absolutely no cigarette use plus a carbon monoxide level of 8 ppm or lower was 59 % ( 4-mg group ) , 30 % ( 2-mg group ) , and 39 % ( placebo group ) ( P < .02 ) . For the 55 of the 90 smokers who met the originally planned definition of high dependence ( Fagerström Tolerance Question naire score > or = 7 plus baseline smoking serum cotinine level > 250 ng/mL plus baseline carbon monoxide level > 15 ppm ) , results were 63 % ( 4-mg group ) , 25 % ( 2-mg group ) , and 25 % ( placebo group ) ( P < .02 ) . In addition , the 4-mg dose produced statistically significantly higher abstinence rates in compliant subjects ( P < .02 ) and also in subjects with high baseline serum continine levels who were compliant ( P < .01 ) than did either the 2-mg dose or placebo . CONCLUSIONS It appears that the 4-mg dose of nicotine polacrilex is the drug and dose of choice for the initial phase of tobacco dependence treatment in high-dependent smokers ; the 2-mg dose of nicotine polacrilex is not better than placebo during the first 6 weeks of treatment for high-dependent cigarette smokers , and thus should not be used for these patients during the initial treatment phase This correlational study examined the adherence rates of  transdermal nicotine ( TN ) use among a population of males and females 18 years of age and older ( N = 619 ) who received varying levels of behavioral intervention .  Rates of patch adherence were assessed for demographic ( e.g. , gender , ethnicity , and age ) , income- , smoking- [ e.g. , baseline carbon monoxide ( CO ) , nicotine dependence , and follow-up quit status ] , and treatment-related ( e.g. , condition , and drop status ) variables . Loglinear and logistic regression analyses were performed to assess adherence rates . Results indicated that male gender [ chi2(2 , n = 485 ) = 20.39 , P = .038 ] , not dropping out of the study [ chi2(2 , n = 485 ) = 13.94 , P < .001 ] , and intensive treatment ( compared to the st and ard care ) [ chi2(4 , n = 485 ) = 14.96 , P = .005 ] were associated with greater adherence to TN . Furthermore , patch adherence was associated with quit status at 6 months ( OR = 2.47 , CI = 1.56 - 3.91 , P < .001 ) and 12 months ( OR = 2.12 , CI = 1.34 - 3.37 , P = .001 ) . Complete and partial patch adherence ( compared to minimal/no adherence ) were associated with a greater number of telephone intervention contacts completed ( OR = 2.621 , CI = 1.421 -  
    Output:
    
There is modest evidence to support the assumption that lack of adherence to nicotine replacement therapy regimens undermines effectiveness in clinical studies