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March, 2014
Authors: Elizabeth H. Bautista, RN, MAN; Valentina M. Chilam, RN, MSN; Harwin P. Alipda;
Michael Jeric R. Sta. Maria; Vandame V. Valerio; Victoria Kristina S. Almazan; Ellyne Joyce P.
Bondot; Michal P. Dumanglig; Kim C.Fontanilla; Eldred Mae S. Manaois; Daphne R. Molina;
Charmaine B. Prado; Winzel Ann D. Tumaneng; Erika May B. Zulueta.

Background:Bupropion was originally used
as an antidepressant, but was found to be
effective in helping persons to stop smoking
by reducing cravings and other withdrawal
effects. It also improves abstinent rate in
healthy young smoking by approximately
50%.To explore the experiences of the
smokers who underwent Bupropion therapy.
Methodology: The study used qualitative
phenomenological design. Four participants
were chosen through a purposive followed
by snowballing method. They were 22 to 44
years of age and were smokers for 1 to 24
years. They also utilized Bupropion therapy
to quit smoking. Unstructured interviews
were used for data gathering from
November 2013 to January 2014.
Results:1285 statements were extracted
from the participants and 556 were
significant. The statements were categorized
into the following themes: Catching Fires of
Smoking followed by Turning Upside Down
with Smoking using Bupropion then Living
in a Kaleidoscope World. It is further
themed into three which are Encounters with
Physical Effects, Twist on Psychological
Aspect and Battling the Eye of the

Society.All their experiences leads to relapse

due to lack of will power so all participants
are still smokers.
Conclusion: The participants had varied
experiences during Bupropion therapy. They
are still smokers despite of their struggles
during Bupropion therapy. Their failure is
quitting smoking were greatly influence by
the lack of willingness to quit smoking.
Recommendations: The participants should
have the will power to cease smoking to be
able to quit. The length of Bupropion
therapy as a criterion in future researches be
Keywords: Bupropion Therapy, Struggles,
Background of the Study
Smoking is the inhalation and
exhalation of the fumes of burning plant
material, which is tobacco (MerriamWebster, 1996). It can be caused due to
external factors which are social influences,
low educational attainment, low socioeconomic status and curiosity (Horimoto, et
al., 2012; Heron, Hickman, Macleod,
&Munaf, 2011; Lim, et al., 2013), peer
pressure and delinquent behavior /violation
of law are also among the reason cited for
the development of this habit (Ghani WM,

2011). According to the World Health
Organization (WHO), tobacco kills nearly 6
million people each year. Due to the alarming
mortality caused by tobacco-related diseases,
the health sectors have created the smoking
cessation program which intends to reduce and
possibly quit cigarette smoking. Under the
program, it includes medical, psychological and
physical interventions. Bupropion under the
medical intervention was originally used as an
antidepressant, but it was found out to be
effective in helping persons to stop smoking by
reducing cravings and other withdrawal effects.
It also improves abstinent rate in healthy young
smoking by approximately 50%.
Researchers Background
Smoking is one of the most common and
dangerous vices that greatly affect human
health nowadays.
We chose this study because there are
members of our family and friends who tried to
stop smoking and caused good and bad effects
to their health.
All members of the group are nonsmokers except for one. All have vicarious
experiences of smoking and its effects from the
experiences. The group has a common
impression of smokers and smoking; that is, it
is a dangerous vice that has unhealthy
The researchers also believe that the
family and the peers are both sources of the
habit and affected by the smoking individual.
The identification of this vices are important to
prevent the contamination of data during the
data gathering; thus, ensuring that the
experiences are those at the participants.
Along the identification of the vices the
researchers would also be able to identify their
weakness in conducting this research. This is
the researchers first exposure towards the data
gathering, they admit that they are novices in

collecting and interpreting data therefore would
find it challenging to organize and manipulate
the data gathered. To compensate with this, the
researchers are currently enrolled in Nursing
Research subject which will aide them to have a
better understanding of the topic which then
will guide them through their way during the
course of the study.
Statement of the Problem
The researchers explore the experiences
of the participants who underwent Bupropion
therapy particularly on the encounter with
physical effects, twist on psychological
encounter and battling the eye of the society.
Significance of the Study
The verbalization of experiences aided
the participants in expressing their feelings
towards the effects of their experiences during
the course of Bupropion therapy. The
participants will be able to realize the reasons
why they were able or unable to quit smoking.
For our nursing education, we can
educate them on what steps or interventions can
be done in order to cease smoking. If there will
be people that will approach us and ask about
what experiences will be felt during smoking
cessation we will be able to educate them
especially on the effects of the Bupropion
therapy, smoking and ceasing smoking.
Research Design
phenomenological approach.


Locale and Population

The participants of the study were
chosen using purposive method followed by
snowballing method with the criteria that the

individual utilized Bupropion Therapy, should
be 18 years old and above and should have
been smoking for 5 years or more. The study
was done in Baguio City, conducted within the
month of November 2013 until January 2014.
The researchers found 4 individuals who met
the criteria thus considering them as the
participants for the study. Researchers used
colors in identifying each participant.
Participants ages ranged from 22 to 44 years
old at the time of the study and they were
smokers for about 5 to 24 years and have
utilized Bupropion Therapy. Before the
interview, different rights of the participants
were discussed and have signed the consent to
participate. Individuals who joined this study
are not forced and are willing to share their
experiences in Bupropion Therapy.
Using purposive method, participant
Purple, was found who is an instructor, had
been smoking for 22 years and utilized
Bupropion Therapy for 2 weeks.
Second participant Green was found
by using snowballing method as referred by
Purple. Works as an instructor, had been
smoking for almost 24 years and used
Bupropion Therapy for 3 weeks.
Third participant Blue was referred by
participant Green, occupying a position in a
government office, had been smoking for
almost 20 years and used Bupropion Therapy
for 6 months.
Participant Blue have no referrals,
therefore the researchers utilized purposive
method to find another participant. Participant
Red, was chosen, a college student and is
smoking for 1 year. Used Bupropion Therapy
for 1 month.

Data Gathering Tools
Information for analysis was collected
through an unstructured interview. Researchers
informed the participants that the interview
would not be time bounded but may continue as
they want.
Data Gathering Procedure
Information was gathered in the course
of interview. The general question asked to all
the participants was, What are your
experiences with the medication during the
course of cessation? They also used an audio
recorder, video camera, pencil and papers
depending on the agreement of the participants.
They were divided into four groups, each
consisting of three members. During the data
gathering, one member conducted the
interview; another took down notes and used
the video camera or audio recorder, another
member helped the other group member to
facilitate the whole interview process.
Initially, the researchers gathered data
from the first participant with the codename,
Purple. All verbatim gathered from Purple
was transcribed, and then the researchers had a
member check. With the use of the referral
method, Purple referred our second
participant. Codename Green. Researchers
conducted the interview and gathered data.
Once data was gathered from participant
Green, researchers met at the end of the day
and made the transcription file and came up
with theming. All the information revealed by
participant Green which is not revealed by
the first participant was confirmed by going
back to Purple. Then participant Green
referred participant Blue. After interviewing
participant Blue, researchers did member



check and made the transcription file and came

up with theming then all the information
revealed by participant Green which were not
revealed by the first and second participants
were confirmed again by going back to them.
By the use of purposive method another
participant was found. The last participant,
codename Red, was interviewed and all the
previous participants data were confirmed. No
new information was gathered from the four
participants, therefore the researchers met

Data Management
Analysis of the data included the
following steps: a) reading and re-reading all
participants descriptions of the phenomenon;
b) extracting significant statements that pertain
directly to the phenomenon; c) formulating
meaning for the significant statement; d)
categorizing the formalized meaning into
clusters of themes; e) integrating the findings
into an exhaustive description of the
phenomenon; f) validating the exhaustive
description by returning to some of the
participants into the final description of the

Concept Map















Results and Discussion
This chapter presents the results and
findings of the study on the experiences of
smokers who underwent Bupropion therapy.
There were 1285 statements that were extracted
from the participants and 556 statements were
significant. These were categorized into the
following: Catching fire which discusses the
participants smoking initiation followed by
Turning Upside Down which discusses the
introduction of the drug Bupropion, then Living
in a Kaleidoscope world which pertains to the
use of Bupropion. It is further themed into three
(3) which are Physical Effects, Psychological
Encounter and Social Battle.
Catching Fires of Smoking Habit
Catching fire is basically describing
smoking initiation among participants. The fire
signifies the start of their smoking habit where
there are several reasons for the flame to haze.
These are influences from their peers, a
smoking family member, curiosity or a persons
own choice. This was shown in one of the
verbatim of the participant.
Nakikitakosiyangnagyoyosi every day, every
time kaya nagyoyosiako. Pero most especially
iyong peer pressure, iyongmgakaibiganniyo,
one of the best motivators for smoking.
Nagyoyosisilanglahat, magyoyosi ka narin.
nakitakosamagulangko (a big factor is my
mom smokes cigarette. I see her smoke every
day, every time thats why I smoke too. But
despite that fact, peer pressure also played a
role where your friends smoke which is one of
the best motivators for smoking, so you also
tend to smoke. Still, the first stick of cigarette
that I have seen was my mothers)

The influencing factors on peers,
smoking family member or their own choice
can affect an individuals decision making. This
can be explained by Banduras Social Learning
theory, Ericksons developmental theory, and
Rogers Personality theory.
In Banduras Social Learning theory,
(Bandura, Ross, & Ross, 1961) the participants
behavior is influenced by their environment
through the process of observational learning.
Participant Greens first sight of smoking was
his mother whom he sees smoking every day.
This eventually sunk into his consciousness and
as time passed by, this was a factor why
participant Green had started his smoking habit.
According to Ericksons developmental
developmental stages mentioned the role of
their peers in influencing their life. In the study,
the participants had claimed that they were
influenced by their peers in terms of the
initiation in inhaling the fumes of tobacco.
Turning Upside Down with Smoking Using
These are the struggles of the
participants if they would really want to stop
smoking or not. They were being ambivalent on
their choice to stop smoking as evidenced by
the verbalizations of participant:
nakasisyemprekawawanamanyungmgaanak mo
ganyantapos eh doctor yungasawa nun, so
binigyanniyaakotaposnagtakeako, so kumbaga
di talaga...ahh, akoyung may gustong mag-stop
at that time nungmagstartakong mag
medication.(She said I should stop because my
children would be affected and her husband
was a doctor so she gave me the medication and
I took it. In other words it wasnt really me who
wanted to stop smoking at that time where I

started taking the medication). This verbatim
showed that it was her friend who was very
much interested for her to quit smoking.
From the verbatim of the participants it
was found out that it was not their choice that is
why they were not that determined to quit their
smoking habit. The feeling of ambivalence of
the participants was supported by a study which
found that many cigarette smokers appear to
experience ambivalence about smoking which
they defined as the simultaneous co-occurrence
of a strong desire to smoke and a strong wish to
quit smoking. (Wilson, Creswell, Sayette, &
Fiez, 2014). In another journal, it mentioned
that the participants could give up smoking if
they wanted to but they dont want to give up
(Amos, Wiltshire, Haw, & McNeill, 2005).
Ambivalence in the quitting process is
intensified by the phenomenon of addiction
(Buswell & Duncan, 2012). According to
Bandura et al (1992), behavioral change is
facilitated by a personal sense of control. If
people believe that they can take action to solve
a problem, they become inclined to do so and
feel committed to their decision. The outcome
expectancies will be based on possible
consequences of one's action.
Living in a Kaleidoscope World
Living in a Kaleidoscope describes the
experiences of the participants in this study. A
kaleidoscope, when rotated, can create different
forms and angles. This could be likened on the
experiences of the participants when they
underwent Bupropion Therapy, they have
various encounters. This is further themed into
three (3) categories which are, Encountering
Physical Effects, Twist on Psychological
Encounter, and the Battling the Eye of the
Encounters with Physical Effects
Encounters with physical effects in the
use of Bupropion Therapy were referred to as

the bodily response experienced by the
participants which alter the bodys functioning.
These are further subtheme into side effects
either positive or negative and withdrawal
symptoms leading to battling the wicked.
A. Positive & Negative Side effects of
Bupropion Therapy
The participants encountered different
effects of the medication during the Bupropion
Therapy. Positive side effect among the
participants includes sleepiness since he
experienced falling asleep in the absence of
nicotine. Therefore in its absence, he can sleep
easily with the help of bupropion because he
believed that nicotine also keeps him awake.
This is verbalized by participant Blue:
madalinaakongantukin. Kasi yang nicotine
yungparangpagiistay ka nyanggising. Kaya
nungnawala mas mabilisnaakongantukin.
(and when theres no cigarette anymore, I can
easily get sleepy. Because nicotine seems to
make you stay awake. Therefore in its absence I
can easily get sleepy.)
On the other hand, negative side effects
verbalized by the participants include sleep
disturbances, vivid dreams, palpitation,
salivation, headache, and cough. According to
Maslows hierarchy of needs, our actions are
motivated in order to achieve certain needs. In
the case of participant Green, his sleep
disturbance was an intermittent insomnia
wherein he is awakened at dawn. This is
evidenced by participant Green:
Oo, nunghindi pa akonagtatakenggamot.
motakotasmagigisingnamannaakomga alas dos
alas tres. (Yes, when Im still not taking
medication. I can sleep continuously. When I



was already medicating then Ill be awaken at

around 2am 3am.)

seems like you are salivating, and I cant sleep,

moreover I am palpitating, there.)

Another negative experience of the

participants during their sleep was vivid
dreams. According to Sigmund Freuds concept
of dreams, dreams are a secret outlet for
repressed fears and desires. Freud said dreams
are a way to express the unconscious emotions
arising from the Id. Both participants Purple
and Green had this experience of vivid dreams.
This is supported by participants Purples

Headache is commonly reported as a

side effect related to Bupropion therapy. This is
supported by participant Greens statement:

Oo, everyday naganun (smiles) feeling

mongnahuhulog ka kunwari. Talagang may
fear of heights pa namanakotaposyung
(chuckles) nahuhulogkangganuntaposalam mo
talagangpaggising mo yungpakiramdam mo
damankonagumanuntalagasapusokoyung ay,
bala (Holds her chest) di maganda (Laughs).
Kaya nag-stop ako.(Yes, everyday its like
that. You feel like falling. I really have this fear
of heights then youre falling like that and you
know that when you woke up you dont feel
good. Theres also this dream that I was gun
shot then I really felt the bullet through my
heart. Its not good. So I stopped.)
During the medication, participant
Purple experienced palpitation which is her
main reason why she quit the medication. She
feared for death, though not at the dying itself,
but for those she will be leaving behind.
experienced by participant Purple was
salivation. This is verbalized by participant
On the third day nanagtitakeakonyan,
o, yun. (on the third day that I am taking it, it

factors nanagaagravatenamagpropromoteng
headache mo. Hanggangngayon may ganyan
pa rinakoyungbiglangsasakit.. (Sudden onset.
My head will suddenly ache. There are no
factors that agravates the promotion of your
headache. Until now I still have that sudden
onset of pain.)
Lastly, one participant manifested the
side effect of cough during the course of the
medication. This is verbalized by participant
Siguromgacouple of days, sabinila symptoms
kasinganasanayyungkatawankona may nicotine
hindi pa nawala, siguronagaadjust. (Maybe
for a couple of days, they said its a symptom
because the body is adjusting, because my body
is used to the presence of nicotine that was not
remove, maybe its adjusting.)
Battling the Wicked Effects
Battling the wicked refers to the
participants way of alleviating the side effects
and withdrawal symptoms they have
encountered during the bupropion therapy.
These include use of food, holding cigarette
without lighting and use of sleeping pills. These
are exemplified by the verbatim. Participant
Blue mentioned:
I started to gain weight mas tumabaako
naghanapnaakongpagkain, o di kaya lagiakong

may candy.(I started to gain weight because I
have to find an alternative way to stop smoking
and I find that eating is a management where
made me had excessive eating or candy)
The participants utilized strategies to
cope up with these side effects. Participant
Blue, exchange smoking to eating which made
him gain weight.
mouth konalang, kasi part nangangbuhay mo
e.(Im holding and putting in my mouth the
cigarette but not lighting it because its part of
my life)
Psychosocial development theory in the oral
stage, these may involve the mouth where they
find to put something to receive oral pleasure. It
is a psychological way to stop smoking by
placing a cigarette in his mouth and its a kind
of replacement.
I had a sleep disturbance without taking
sleeping pills I couldnt sleep at all.
Interventions used for sleep disturbance
are follows; avoid caffeinated food and drinks.
Opponent-Process Theory, states that people go
into drug withdrawal because the bodys
response to drugs lasts longer, pushing people
into the opposite reaction that the drug causes
and driving them to use the drug more.
Twist on Psychological Aspect
Twist on psychological aspect of the
participants happen as to how they had
perceived the drug affecting them, which
causes change in their perception of self. Twist
on psychological aspect is further themed into
mood swings and loss of satisfaction.
A. Mood Swings

Mood swings are emotional reactions or
changes in demeanor out of proportion with
what could be called a normal reaction to an
event or circumstance. This is evidenced by
their following verbatim:
Participant Red mentioned,
Irritable in the sense that like how my angers
triggered, uhmm..certain small things.Im
really have the type played around it so base on
that pranks that they did like small pranks just
like little things that okay should be actually
namanpero since your irritable you find it very
irritating talaga you dont do that again . Its
not to the extent that I dont understand myself
but more on the sense of still trying to find
myself at that time. I had a hard time actually
trying to figure out what my objectives were.
My goals in life.My feelings were actually
mixed. The way I wild up. The angry they
actually see it in my face. They could tell that
when they use to come and visit um diba Im
quietly neat freak but due to all those mood
changes and stuff like that my case will actually
portray the mood that Im feeling."
Studies show that one of the side effects
of Bupropion therapy is irritability or mood
swings. But according to some this mood
changes happen when you reach your puberty
age, however when this teen becomes young
adult and their hormones goes back to a more
stable mood swings would normally disappear,
B. Loss of Satisfaction
In this study, the participants claimed
that when they tried to smoke, they no longer
have satisfaction, which they had when they
were still smoking before the medication

effect sa akin. Datikasi when I smoke very

pleasurable eh, relax ka ganun ka.., ah but
when I was taking that medicine and then
parangibanarinyungepektosayo.(The urge to
smoke is there but it is different for me. In the
past, when I smoke, it feels pleasurable and
relaxing.. But when I was taking that medicine
and then tried to smoke a cigarette, the pleasure
is gone and its effect to you is different).
Blue and Green verbalized that before
undergoing the Bupropion therapy they still
experienced satisfaction derived from smoking.
However; when they tried to smoke during start
of the medication therapy, they claimed that
they did not experience any satisfaction. As an
aid to smoking cessation, this implies that the
medication reduces the urge to smoke.
Battling the Eye of the Society
This refers to how the participants
accept the obstacles surrounding their life. It
will either serve as a guide or an obstacle to be
faced by the participants during the course of
Bupropion. Battling the eye of the society is
further categorized into social status and lack of
support system.
A.Social Status
Social Status as an effect on the use of
bupropion therapy, it is further themed into
influence from family, peers, friends and
support system. In the study the participants
were influenced by their family and friends to
stop smoking but they relapsed because of the
influence of their friends and lack of social
support system. This supported by the
following verbatim:
Actually, parangsyemprepag college ka di
bamedyo may mgabarkadakangnagssmoke,

akoperonoong nag woworknaako (Hums)
Recovery Room. Ang Recovery Room namin is
one wing, malakisya, tapos all the
anesthesiologist, all the doctors, all the nurses
akolanganghindinagssmoke.(Actually when I
was in college you have friends that smoking,
sometimes I tried and then I graduate and I was
working in recovery room and our recovery
room is one wing, narrow, and all the
anaesthesiologists, doctors, nurses were
smoking and I am the only one not smoking)
Stages of Change Model Action theory:
The individual has changed their behavior.
Friends, family and social networks are
important aspects of a persons life. There is
little doubt that the number of friends one
maintains in his or her social network has a
significant impact on a number of aspects of a
persons life, including happiness, good health
and satisfaction.
B. Lack of Support System
Stopping smoking is one of the most
difficult but also one of the most important
health related changes an individual can make.
A lot of factors affect this action and one of
these is social support system. As we go along
with our study having the perspectives of our
participants, theres a big factor in failing their
willingness to quit smoking and that is Lack of
Support System.
On this thing, yungparangminsannapakainsensitive
yunyungasaisip mo. Kaya kung minsan,
imbisna effort ka ulit, wala, lalabas ka nalang,
maninigarilyo ka nalangsabwisit mo
kasiimbisnatulungan ka nila, hindi ka
nilatinutulungan.(On this thing, its like
sometimes they are insensitive, thats what you
think. Thats why sometimes, instead of giving
effort again, nothing, youll just go outside,
youll just smoke because of your madness
because, instead of helping you, theyre not.)

Partner support was driven by an in the
influence of expected support on the
effectiveness of received support. Although
there were indications of expectations
influencing the effectiveness of received
support, none of the critical analyses reached
performance of positive behavior such as those
reinforcement for the quitting attempt, were
associated with abstinence 1, 3, and 6 months
post treatment.
Inception of Relapse
Basically, with all the experiences the
participants had, there was still a relapse on
smoking habit. After some time, all participants
relapsed back to their smoking habit. The lack
of will power which was identified by the
participants should be present in order to
completely cease in smoking.
Lack of Will Power
Lack of will power is the inability of the
participants to control themselves from
cessation of their smoking habit. The
participants in the study who undergone
Bupropion therapy mentioned that they could
have stopped smoking despite of its side effect
if they have the will power as verbalized by
participant Green.
Ready to quit ng smoking yun I think
patalagaako ready mag-quit ng smoking.
Perosige, subukankong mag stop, pero di ko
kaya eh kaya nagyosinaulitakoyun, di namansa
physical symptoms kasi the physical symptoms
you can deal with that eh, you can overcome, if
in my heart, in my mind I want to quit smoking,
I will. Yung kaya kongi-overcome yungmga
physical symptoms, yungmga side effects niya,
nightmares for example, perodahilngahindi pa

| 10
ako ready mag-quit, nag yosiulitako. (Ready
to quit smoking is I think the strong reason, Im
not ready to quit smoking. But okay, Ill try to
stop but I cannot so I go back to smoking, its
not the physical symptoms because the physical
symptoms you can deal with that, you can
overcome, if in my heart, in my mind I want to
quit smoking, I will. I can overcome the
physical symptoms, the side effects, nightmares
for example, but because Im not ready to quit,
I smoked again.)
The verbalization of the participant
shows the lack of self-control, leading them to
continue smoking. The consequences are
explained by the Trans theoretical Model
(Prochaska et al., 1983) of behavior change.
According to this Model, there are stages of
change in smoking cessation under the
Temporal Dimension which includes precontemplation, contemplation, preparation,
action and maintenance (Delinda Woody,
The participant underwent these five
stages but due to the lack of willpower he
relapsed and went back to the contemplation
stage and stuck at this stage this is because of
his ambivalence between the pros and cons of
change which keeps them immobilized in this
stage. Contemplation stage is a stage wherein
consideration is being given to smoking
cessation within a 6-month future time frame;
he become aware of their desire to change a
particular behavior, it means that our
participants are still thinking about ceasing
smoking. Hes aware of the benefits of quitting
smoking but is also apprehensive about the
process of change; its also weighing the pros
and cons of changing his behavior. In order to
help the participant move to the next stage
resolving the ambivalence, patient education
and support can be given.

Various effects of the medication were
experienced by each participant. Even with the
aid of various interventions done by the
participants to counter these effects and
struggles, they still relapsed to smoking.
Failures of the participants were greatly
influenced by their lack of will power to quit
The researchers recommend future
researchers to include the length of Bupropion
therapy. The length of Bupropion therapy may
affect the variety of experiences an individual
may encounter.Since the researchers have a
limited time allotment in conducting the
research, it is recommended that in future
researches, an in- depth and longitudinal
approach will be used.
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