Addictive behaviors最新文献

{"title":"Social norms modulate asymmetric effects of group opinions on cue-induced smoking craving","authors":"Woojin Jung ,&nbsp;HeeYoung Seon ,&nbsp;Sunhae Sul ,&nbsp;Dongil Chung","doi":"10.1016/j.addbeh.2026.108623","DOIUrl":"10.1016/j.addbeh.2026.108623","url":null,"abstract":"<div><div>The social environment is an important predictor of smoking behavior. However, it remains unknown if social factors shape beliefs about whether certain cues trigger their urge to smoke, known as cue-induced smoking craving. Across two studies (total N = 300), we investigated whether group opinions influence cue-induced smoking craving in current- and past-smokers. Individuals rated their level of craving for each presented image, followed by exposure to group opinions. In Study 1, we found that individuals’ smoking craving shifted in response to group opinions, with stronger conformity to lower group opinions compared with equal or higher group opinions. Study 2, a pre-registered follow-up study, replicated these findings and further demonstrated that biased social norms modulate the degree of social influence on smoking craving. Specifically, individuals conformed more to low group opinions when biased social norms favored low ratings, and to high group opinions when norms favored high ratings. Our data demonstrate that group opinions can influence cue-induced smoking craving, highlighting the pivotal role of the social environment in shaping smoking-related beliefs and, consequently, smoking behavior.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"176 ","pages":"Article 108623"},"PeriodicalIF":3.6,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146071020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal associations between fear of missing out, problematic social media use, and problematic smartphone use","authors":"Xiangling Hou ,&nbsp;Ling Xu ,&nbsp;Ningning Zhou ,&nbsp;Xinxin Zhu ,&nbsp;René Mõttus ,&nbsp;Wendy Johnson","doi":"10.1016/j.addbeh.2026.108620","DOIUrl":"10.1016/j.addbeh.2026.108620","url":null,"abstract":"<div><div>Fear of missing out (FoMO) has been linked to problematic smartphone use (PSU) and problematic social media use (PSMU), but it remains unclear whether these associations reflect stable between-person differences or dynamic within-person processes over time. To address this, we analyzed five-wave longitudinal data (<em>N</em> = 1,596, females = 1,055, <em>M</em>_age = 19.70, <em>SD</em> = 1.60) using Random-Intercept Cross-Lagged Panel Models (RI-CLPMs) to disentangle between- and within-person associations longitudinally. Our observations revealed that: (1) PSU and PSMU were strongly correlated across time, indicating substantial overlap between the two behaviors; (2) FoMO positively predicted both PSU and PSMU, and these behaviors also predicted higher subsequent FoMO, suggesting bidirectional relations; and (3) FoMO and PSU exhibited moderate temporal stability. These observations underscore a subtle but persistent interplay between FoMO, PSU, and PSMU over time.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108620"},"PeriodicalIF":3.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis use in pregnancy: Key findings from 2021-2023 National Survey on Drug Use and Health data","authors":"Christina N. Wysota ,&nbsp;Scott E. Sherman ,&nbsp;Lorien C. Abroms ,&nbsp;Akhgar Ghassabian ,&nbsp;Sasha Hernandez ,&nbsp;Kelly C. Young-Wolff ,&nbsp;Erin S. Rogers","doi":"10.1016/j.addbeh.2026.108621","DOIUrl":"10.1016/j.addbeh.2026.108621","url":null,"abstract":"<div><h3>Objective</h3><div>It is critical to understand the characteristics of people who use cannabis during pregnancy. We examined the prevalence and sociodemographic and clinical correlates of current, recent, former, and never cannabis use among pregnant individuals in the U.S.</div></div><div><h3>Methods</h3><div>We analyzed pooled data from 1,992 pregnant participants in the National Survey on Drug Use and Health (NSDUH) from 2021 to 2023. We used multinomial regression to identify correlates of cannabis use status (i.e., never use vs. current [past 30-day], recent [past 2–12-month], and former [nonuse in the past year], respectively).</div></div><div><h3>Results</h3><div>Overall, nearly 7% of pregnant participants reported current cannabis use. Among current users, 31% reported any doctor-recommended cannabis use in the past year and 52% bought their cannabis from a dispensary. Compared to never users, current cannabis use was more likely among those aged 18–25 (vs. 26+; Relative Risk Ratio [RRR] = 2.08, 95% CI: 1.04–4.18), unmarried (vs. married; RRR = 2.54, 95% CI: 1.05–6.14), with greater education (vs. &lt; high school; RRR = 2.97, 95% CI: 1.42–6.23), past 30-day cigarette use (RRR = 2.57, 95% CI: 1.11–5.94), alcohol use (RRR = 7.24, 95% CI: 1.52–34.49), e-cigarette use (RRR = 4.92, 95% CI: 1.71–14.10), or serious psychological distress (RRR = 6.25, 95% CI: 2.46–15.85); current use was less likely among those perceiving some risk of weekly cannabis use (vs. no risk; RRR = 0.07, 95% CI: 0.03–0.14). Recent use (vs. never use) was less likely in states where cannabis was illegal (RRR = 0.45, 95% CI: 0.22–0.95).</div></div><div><h3>Conclusion</h3><div>Cannabis use during pregnancy remains high among certain subgroups. Future research should develop tailored interventions targeting motivations of cannabis use during pregnancy, such as risk perceptions and polysubstance use, which negatively impact maternal and fetal health.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"176 ","pages":"Article 108621"},"PeriodicalIF":3.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CBD, cannabis, or both? Examining use patterns and associated factors among U.S. youth and adults","authors":"Hongying Daisy Dai ,&nbsp;Troy B. Puga","doi":"10.1016/j.addbeh.2026.108622","DOIUrl":"10.1016/j.addbeh.2026.108622","url":null,"abstract":"<div><h3>Background</h3><div>Cannabis and cannabidiol (CBD) use have grown recently among U.S. adults, yet little is known about their exclusive or combined use at the population level. This study sought to assess the prevalence and contributing factors of distinct use patterns.</div></div><div><h3>Methods</h3><div>Data from the 2023 National Survey of Drug Use and Health study were analyzed for adolescents (12–17,n = 11,572) and adults (18+,n = 45,133). Past-month cannabis and CBD use over the past 30 days, including patterns (non-use, exclusive, and dual-use), were reported and associated factors were examined by multinomial regressions.</div></div><div><h3>Results</h3><div>In 2023, 15.4% and 9.8% of participants reported past-month cannabis and CBD use, respectively; while 8.9, 3.4%, and 6.4% reported exclusive cannabis use, exclusive CBD use, and dual-use, respectively. Cannabis and CBD use were most common among individuals aged 18–34, while dual use was highest in 18–25-year-olds (10.8%). Exclusive cannabis use peaked in 26–34-year-olds (14.8%), and exclusive CBD use was most prevalent in adults 65+ (5.0%). Youth females (vs. males) and those living above the poverty line (vs. in poverty) were more likely to report exclusive CBD use. Adolescents with fair or poor health (vs. excellent/good) were more likely to report exclusive cannabis (AOR = 3.2,p &lt; 0.001), exclusive CBD (AOR = 3.0,p = 0.002), and dual-use (AOR = 3.0, p &lt; 0.001). Based on adolescent regression results, state medical cannabis legalization was associated with higher exclusive cannabis use(AOR = 1.8,p = 0.01). Based on adult regression results, state medical cannabis legalization was associated with higher exclusive cannabis use (AOR = 1.5, p &lt; 0.001) and dual-use (AOR = 1.5, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Cannabis and CBD use exhibited distinct usage patterns. As cannabis legalization policies continue to evolve, public health professionals should focus on tailored interventions to mitigate potential side effects associated with complex cannabis use.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"176 ","pages":"Article 108622"},"PeriodicalIF":3.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between intimate partner violence victimization and smoking initiation and cessation among married adults in Korea","authors":"Seong-Uk Baek ,&nbsp;Jin-Ha Yoon","doi":"10.1016/j.addbeh.2026.108619","DOIUrl":"10.1016/j.addbeh.2026.108619","url":null,"abstract":"<div><h3>Background</h3><div>Intimate partner violence (IPV) is a global public health concern. Although some studies have identified cross-sectional associations between IPV victimization and smoking, longitudinal research remains limited. This study investigated the association between IPV victimization and smoking initiation and cessation among Korean adults.</div></div><div><h3>Methods</h3><div>This study included adult participants from the Korean Welfare Panel Study 2009–2023 (n = 13,450; observations = 108,932). Experiences of non-physical and overt physical IPV within the past year were assessed. The outcome measure was the incidence of smoking initiation and cessation in the following year. Generalized estimating equations were used to account for repeated measures. Odds ratios and 95% confidence intervals (CIs) were calculated to represent the associations.</div></div><div><h3>Results</h3><div>Among the overall sample, individuals exposed to non-physical or physical IPV had 1.36-fold (95% CI: 1.18–1.56) and 2.69-fold (95% CI: 1.77–4.08) higher odds of smoking initiation, respectively, compared to those not exposed to IPV. Furthermore, verbal IPV, threats of physical IPV, and physical IPV were associated with 1.43-fold (95% CI: 1.24–1.63), 1.74-fold (95% CI: 1.26–2.39), and 2.44-fold (95% CI: 1.60–3.72) increased odds of smoking initiation, respectively. These associations were observed in both men and women. However, no clear association was found between IPV and smoking cessation in the subsequent years.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that individuals who experienced IPV had an increased likelihood of smoking initiation one year after exposure. Consequently, policy interventions aimed at preventing IPV are warranted.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"176 ","pages":"Article 108619"},"PeriodicalIF":3.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of past 30-day vaping abstinence among young e-cigarette users: Machine learning analysis of a longitudinal cohort","authors":"Anasua Kundu ,&nbsp;Peter Selby ,&nbsp;Daniel Felsky ,&nbsp;Theo J Moraes ,&nbsp;Michael Chaiton","doi":"10.1016/j.addbeh.2026.108617","DOIUrl":"10.1016/j.addbeh.2026.108617","url":null,"abstract":"<div><h3>Introduction</h3><div>Our existing knowledge on factors influencing vaping abstinence are still limited. The objective of this study was to build a machine learning (ML)-based model to predict past 30-day vaping abstinence and identify predictors among young e-cigarette users.</div></div><div><h3>Methods</h3><div>Data was taken from a Canadian past 30-day e-cigarette users aged 16–25 (n = 1,659), who were followed-up from 2020 to 2023 across 9 waves. For each outcome, predictors were taken from the immediately preceding wave, resulting in a dataset of 6,435 observations. This dataset was split into a training and testing set in 4:1 ratio and three ML models- random forest, gradient boosting machine, extreme gradient boosting were built on the training set to predict past 30-day vaping abstinence. Model performance was evaluated on the testing set and the best performing model was selected for further Shapley Additive ExPlanations analysis.</div></div><div><h3>Results</h3><div>The random forest model achieved the highest performance (AUC 0.737), and sensitivity analysis showed the robustness of the model. The topmost key predictors of past 30-day vaping abstinence were past month frequency of vaping and different measures of e-cigarette dependence. In addition, product characteristics (i.e., nicotine strength, flavor), intention to quit, and harm perception of nicotine vaping emerged as important predictors across different models. The model was used to estimate individual probability of abstinence and identify the barriers of successful cessation for each individual user.</div></div><div><h3>Conclusion</h3><div>While these findings can inform targeted vaping cessation strategies for young people, further research is needed to develop a more generalizable and higher-performing model.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108617"},"PeriodicalIF":3.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-specific risk factors for gambling-related suicidal ideation: Evidence from a help-seeking population","authors":"Virve Marionneau ,&nbsp;Sara Havuaho ,&nbsp;Håkan Wall","doi":"10.1016/j.addbeh.2026.108616","DOIUrl":"10.1016/j.addbeh.2026.108616","url":null,"abstract":"<div><div>People suffering from gambling problems are at a heightened risk of suicidal behaviours and ideations. Emerging evidence suggests that gambling-related suicidality may be more common amongst women, those with gambling-related debt and those gambling with fast-paced products such as electronic gambling machines. This study aims to investigate associations between gambling-related suicidal ideations and risk factors using logistic regression analysis. The analyses are conducted separately for women and men.</div><div>The data consisted of questionnaire responses from 2,800 help-seekers (1,746 men, 1,054 women), who enrolled in a Finnish online help service for gambling problems during 2019–2024. The survey focused on the following questionnaire measures: self-reported suicidal ideation (MARDS), problematic gambling products, gambling-related debt, at-risk alcohol use (AUDIT-C), problem gambling (NODS) and social support.</div><div>19.8 percent of all respondents reported suicidal ideation (25.5% of women, 16.4% of men). Both genders reported online EGMs, online casino products and land-based EGMs as causing most harm. However, we found no statistically significant associations between gambling products and suicidal ideation. Gambling-related debt was a significant risk factor for suicidal ideation for both genders. At-risk alcohol use was a risk factor for suicidality amongst women. Lack of social support was a risk factor for both genders.</div><div>In conclusion, we found that some risk factors for gambling-related suicidal ideation can differ across genders. Gambling-related debt can increase the risk of suicidality for both genders. Policy action is needed to prevent significant financial harm from gambling.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108616"},"PeriodicalIF":3.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metacognitive beliefs and addictions: A systematic review and meta-analysis with emphasis on the mediating role of desire thinking","authors":"Mehdi Akbari ,&nbsp;Minoo Rahmani ,&nbsp;Mahsa Sadat Navab Safiadin ,&nbsp;Roya Forootan ,&nbsp;Giovanni Mansueto","doi":"10.1016/j.addbeh.2026.108613","DOIUrl":"10.1016/j.addbeh.2026.108613","url":null,"abstract":"<div><div>The Self-Regulatory Executive Function model and the Elaborated Intrusion Theory of desire highlight how dysfunctional metacognitions and desire thinking sustain addictive behaviors. Although some evidence suggests that desire thinking may act as a bridge linking metacognitive beliefs to addictive behaviors, no <em>meta</em>-analysis has investigated the potential mediating role of desire thinking in this relationship. To address this, we conducted a systematic review and <em>meta</em>-analysis in line with PRISMA guidelines. Searches across seven databases through May 2025 identified 156,312 records; after screening and eligibility checks, 14 studies (N = 7,093, male = 51.90%, mean age = 32.08, SD = 12.43) met inclusion criteria. Metacognitions showed robust positive associations with addictive behaviors (<em>r</em> = 0.29–.74), strongest for negative metacognitions about desire thinking and problematic smartphone/social media use. Positive metacognitions also correlated significantly, though effect sizes were smaller. Metacognitions were strongly related to desire thinking (<em>r</em> up to 0.62), particularly between negative metacognitions and verbal perseveration. Desire thinking itself was moderately to strongly associated with addictive behaviors (<em>r</em> = 0.34–.67), with imaginal prefiguration strongly predicting smartphone overuse (<em>r</em> = 0.63). Mediation analyses confirmed that both verbal perseveration and imaginal prefiguration transmitted effects of metacognitions onto addictive behaviors, with imagery-based pathways especially relevant for smartphone use. Moderator analyses revealed age, sex, and population type as significant moderators in selected models, highlighting stronger effects for females and general population samples. Findings highlight desire thinking as a process closely associated with various forms of addictive behaviors, underscoring its clinical relevance. Focusing on this association can enhance metacognitive interventions and deepen our understanding of addictive behaviors across different domains.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108613"},"PeriodicalIF":3.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute effects of subjective alcohol effects and negative alcohol consequences on next-day positive alcohol expectancies","authors":"Jack T. Waddell ,&nbsp;Samuel F. Acuff ,&nbsp;Megan E. Schultz ,&nbsp;Christine M. Lee","doi":"10.1016/j.addbeh.2026.108615","DOIUrl":"10.1016/j.addbeh.2026.108615","url":null,"abstract":"<div><h3>Background</h3><div>Acute subjective alcohol effects are theorized to impact next-day alcohol expectancies and future drinking likelihood. However, little research has focused on the acute impact of distinct subjective alcohol-related effects (i.e., high-arousal-positive/stimulation vs. low-arousal-positive/relaxation) on next-day expectancies and drinking likelihood, despite the two having divergent alcohol outcomes. Further, such relations may be dampened when simultaneously experiencing negative alcohol consequences. The current study fills these voids in the literature.</div></div><div><h3>Methods</h3><div>Young adults (N = 131) completed 21 days of ecological momentary assessments, reporting (1) subjective effects during user-initiated drink reports and (2) expectancies and use behavior during next-day reports. Two-level multilevel mediation models tested whether subjective effects and negative consequences experienced from past-day drinking episodes indirectly predicted changes in next-day drinking likelihood via changes in next-day expectancies, and whether negative consequences experienced moderated such links.</div></div><div><h3>Results</h3><div>Past-day high- and low-arousal-positive subjective effects predicted increased next-day high- and low-arousal-positive expectancies, respectively. Further, past-day experiences of negative alcohol consequences predicted decreased next-day high (but not low) arousal positive expectancies. Thus, high-arousal-positive effects indirectly predicted higher likelihood of next-day drinking via increased next-day high-arousal-positive expectancies, whereas negative consequences predicted lower likelihood of next-day drinking via dampened next-day high-arousal-positive expectancies. Negative consequences moderated relations between low (but not high) arousal positive subjective effects and next-day expectancies, wherein past-day low-arousal-positive effects translated into stronger next-day low-arousal-positive expectancies when, surprisingly, experiencing higher-than-average (vs. lower-than-average) negative consequences.</div></div><div><h3>Conclusions</h3><div>Subjective effect-to-expectancy relations were present for both high- and low-arousal-positive effects, but negative consequences only served a “teachable moment” in terms of modifying next-day high arousal positive expectancies.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108615"},"PeriodicalIF":3.6,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of combined nicotine replacement therapy (NRT) and bupropion compared to bupropion alone for smoking cessation: a systematic review and meta-analysis","authors":"Min Wang ,&nbsp;Zhao Liu ,&nbsp;Xinmei Zhou ,&nbsp;Yuxin Shi ,&nbsp;Tingfen Ji ,&nbsp;Jiahui He ,&nbsp;Anqi Cheng ,&nbsp;Liang Zhao ,&nbsp;Dan Xiao ,&nbsp;Chen Wang","doi":"10.1016/j.addbeh.2026.108614","DOIUrl":"10.1016/j.addbeh.2026.108614","url":null,"abstract":"<div><h3>Introduction</h3><div>Smoking is a major preventable cause of morbidity and premature death worldwide. Both bupropion and NRT help achieve smoking cessation. However, evidence on whether the combination of bupropion and NRT is more effective than bupropion alone remains uncertain. The aim of this study was to compare the efficacy and safety of bupropion combined with NRT with bupropion monotherapy.</div></div><div><h3>Methods</h3><div>The Cochrane Library, Embase, PubMed, and Web of Science were systematically searched for original articles published in English. Randomized controlled trials (RCTs) that compared bupropion plus NRT therapy with bupropion were included. Qualitative and quantitative analyses were conducted and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool.</div></div><div><h3>Results</h3><div>Nine RCTs involving 4005 participants (53.8% female) were included in this study. The mean age across studies ranged from 27 to 55 years. The risk of bias results showed that two RCTs were rated as high, one was low, and six were unclear. Pooled analysis indicated that bupropion combined with NRT significantly improved biochemically validated 7-day point prevalence abstinence at the end of treatment [risk ratio (RR) = 1.35, 95% confidence interval (CI): 1.22–1.50, I² = 21%]. At long-term follow-up (≥6 months), bupropion plus NRT showed a non-significant benefit over bupropion monotherapy (RR = 1.10, 95% CI: 0.90–1.34, I² = 52%). Adverse events were generally comparable between groups, except for a higher incidence of nausea in the combination therapy group (10.9% vs. 7.3%; RR = 1.42, 95% CI 1.04–1.94, I² = 0%). No significant subgroup differences were found based on the types of NRT (nicotine patch, gum, or lozenge) (χ² = 0.89, p = 0.64).</div></div><div><h3>Conclusion</h3><div>Combination therapy of bupropion and NRT was associated with superior short-term smoking cessation outcome compared with bupropion alone, with a comparable safety profile except for increased risk of nausea. However, the long-term benefit of combination therapy over bupropion monotherapy was attenuated and non-significant. Further high-quality RCTs with adequate long-term follow- up are needed to confirm these findings.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108614"},"PeriodicalIF":3.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}