How many days before cessation should patients start bupropion?

• A. 1-3 days
• B. 4-7 days
• C. 10-14 days
• D. 21-28 days

Answer: (C)

Starting bupropion about 10 to 14 days before the planned quit date gives the medication time to reach therapeutic levels and begin reducing nicotine withdrawal and cravings by the time the patient stops smoking. Pharmacokinetics matter here: it takes several days to build up in the body to a level where it can effectively blunt withdrawal symptoms, so having a lead-in period helps maximize success on quit day. A typical approach is to begin with a lower dose for a few days and then increase to the full dose, so by the time cessation occurs the patient already has medication-supported relief from cravings. Starting too late wouldn’t allow enough time for the drug to work, and starting much earlier than needed doesn’t add substantial benefit.