The Tipping Point: How Little Things Can Make a Big Difference

by Malcolm Gladwell

Bupropion does two things. It increases your dopamine, so smokers don’t have the desire to smoke, then it replaces some of the norepinephrine, so they don’t have the agitation, the withdrawal symptoms.” Glaxo Wellcome has tested the drug—now marketed under the name Zyban—in heavily addicted smokers (more than 15 cigarettes a day) and found remarkable effects. In the study, 23 percent of smokers given a course of anti-smoking counseling and a placebo quit after four weeks. Of those given counseling and the nicotine patch, 36 percent had quit after four weeks. The same figure for Zyban, though, was 49 percent, and of those heavily addicted smokers given both Zyban and the patch, 58 percent had quit after a month. Interestingly, Zoloft and Prozac—the serotonin drugs—don’t seem to help smokers to quit. It’s not enough to lift mood, in other words; you have to lift mood in precisely the same way that nicotine does, and only Zyban does that.