CINXE.COM

<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE html> <html lang="en" dir="ltr" version="HTML+RDFa+MathML 1.1" xmlns:dc="http://purl.org/dc/terms/" xmlns:foaf="http://xmlns.com/foaf/0.1/" xmlns:og="http://ogp.me/ns#" xmlns:rdfs="http://www.w3.org/2000/01/rdf-schema#" xmlns:sioc="http://rdfs.org/sioc/ns#" xmlns:sioct="http://rdfs.org/sioc/types#" xmlns:skos="http://www.w3.org/2004/02/skos/core#" xmlns:xsd="http://www.w3.org/2001/XMLSchema#" xmlns:mml="http://www.w3.org/1998/Math/MathML"> <head profile="http://www.w3.org/1999/xhtml/vocab">  <link rel="dns-prefetch" href="//securepubads.g.doubleclick.net" /> <link rel="dns-prefetch" href="//d1bxh8uas1mnw7.cloudfront.net" /> <link rel="dns-prefetch" href="//scholar.google.com" /> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <link rel="shortcut icon" href="https://thorax.bmj.com/sites/default/themes/bmjj/favicon.ico" type="image/vnd.microsoft.icon" /> <meta name="viewport" content="width=device-width, initial-scale=1" /> <script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Bupropion and the risk of sudden death: a self-controlled case-series analysis using The Health Improvement Network","hwUrl":"https://thorax.bmj.com/content/60/10/848","hwPath":"/content/60/10/848","hwType":"journal page"},"user":{"hwMemberID":"","hwLoggedIntoInstitutionID":"","hwLoggedIntoInstitution":"","hwAccessUsageTerms":"guest","hwRegisteredUser":"no","hwHasFullTextAccess":"no","hwEntitled":"no","mail":"e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855"},"content":{"hwIssueDate":"2005-10-01","hwIssueDateTime":"2005-10-01 00:00:00","hwPublicationDate":"2022-09-01","hwPublicationDateTime":"2022-09-01 00:29:02","hwNlmArticleType":"other","hwDOI":"10.1136/thx.2005.041798","hwAuthors":"R Hubbard,S Lewis,J West,C Smith,C Godfrey,L Smeeth,P Farrington,J Britton","hwContributors":"","hwIsEarlyRelease":"no","hwEissn":"1468-3296","hwPissn":"0040-6376","hwVolume":"60","hwIssue":"10","hwArticleType":"Smoking cessation","hwTabView":"main_tab","hwViewType":"","hwAccessType":"Paywall","hwOpenAccess":"no","hwFreeAccess":"no","hwTaxonomy":"Health education|Smoking|Smoking cessation|Tobacco use","hwCorpusCode":"thoraxjnl","hwType":"article","hwSubtitle":null,"hwOverline":null,"hwPisaId":"thoraxjnl;60/10/848","hwFirstPage":"848","hwLastPage":"850","hwIsLatestVersion":"yes","hwIsCurrentIssue":"no","hwIsOpenIssue":"no","hwHasFullText":"yes","hwHasPDF":"yes","hwParentTitle":"Thorax: 60 (10)","hwElectronicPubDate":"2022-09-01","hwElectronicPubDateTime":"2022-09-01 00:29:02"}}); //--><!]]></script> <link rel="canonical" href="https://thorax.bmj.com/content/60/10/848" /> <meta name="Generator" content="Drupal 7 (http://drupal.org)" /> <link rel="alternate" type="application/pdf" title="Full Text (PDF)" href="/content/60/10/848.full.pdf" /> <link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/60/10/848.full.txt" /> <meta name="issue_cover_image" content="https://thorax.bmj.com/sites/default/files/highwire/thoraxjnl/60/10.cover.gif" /> <meta name="type" content="article" /> <meta name="category" content="other" /> <meta name="HW.identifier" content="/thoraxjnl/60/10/848.atom" /> <meta name="HW.pisa" content="thoraxjnl;60/10/848" /> <meta name="DC.Format" content="text/html" /> <meta name="DC.Language" content="en" /> <meta name="DC.Title" content="Bupropion and the risk of sudden death: a self-controlled case-series analysis using The Health Improvement Network" /> <meta name="DC.Identifier" content="10.1136/thx.2005.041798" /> <meta name="DC.Date" content="2005-10-01" /> <meta name="DC.Publisher" content="BMJ Publishing Group Ltd" /> <meta name="DC.Rights" content="Copyright 2005 Thorax" /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="Background: Bupropion is an effective smoking cessation therapy but its use in the UK has been limited by concerns that it may increase the risk of sudden death. Methods: Data for all patients prescribed bupropion within The Health Improvement Network (a computerised general practice database) were extracted and the self-controlled case-series method was used to estimate the relative incidence of death during the first 28 days of treatment. The incidence of seizures, a recognised adverse effect of bupropion, was also investigated during this period. Results: A total of 9329 individuals had been prescribed bupropion (mean age 44 years, 48% male). The total person-time after the first prescription for bupropion was 17 586 years, and during this time 121 people died. Two people died within the first 28 days of treatment, which was less than expected in comparison with the remaining observation period by an incidence ratio of 0.50 (95% confidence interval (CI) 0.12 to 2.05). Twenty eight people were recorded as having a total of 45 seizures (23 before starting bupropion, two in the first 28 days of treatment, and 20 at a later point). The relative incidence of seizures during the first 28 days of treatment was 3.62 (95% CI 0.87 to 15.09), equivalent to one additional seizure per 6219 first time bupropion users. Conclusions: Bupropion use is probably associated with an increased risk of seizures, but no evidence was found to suggest that the drug is associated with an increased risk of sudden death." /> <meta name="DC.Contributor" content="R Hubbard" /> <meta name="DC.Contributor" content="S Lewis" /> <meta name="DC.Contributor" content="J West" /> <meta name="DC.Contributor" content="C Smith" /> <meta name="DC.Contributor" content="C Godfrey" /> <meta name="DC.Contributor" content="L Smeeth" /> <meta name="DC.Contributor" content="P Farrington" /> <meta name="DC.Contributor" content="J Britton" /> <meta name="article:published_time" content="2005-10-01" /> <meta name="article:section" content="Smoking cessation" /> <meta name="citation_title" content="Bupropion and the risk of sudden death: a self-controlled case-series analysis using The Health Improvement Network" /> <meta name="citation_abstract" lang="en" content="<p><b>Background:</b> Bupropion is an effective smoking cessation therapy but its use in the UK has been limited by concerns that it may increase the risk of sudden death.</p><p><b>Methods:</b> Data for all patients prescribed bupropion within The Health Improvement Network (a computerised general practice database) were extracted and the self-controlled case-series method was used to estimate the relative incidence of death during the first 28 days of treatment. The incidence of seizures, a recognised adverse effect of bupropion, was also investigated during this period.</p><p><b>Results:</b> A total of 9329 individuals had been prescribed bupropion (mean age 44 years, 48% male). The total person-time after the first prescription for bupropion was 17 586 years, and during this time 121 people died. Two people died within the first 28 days of treatment, which was less than expected in comparison with the remaining observation period by an incidence ratio of 0.50 (95% confidence interval (CI) 0.12 to 2.05). Twenty eight people were recorded as having a total of 45 seizures (23 before starting bupropion, two in the first 28 days of treatment, and 20 at a later point). The relative incidence of seizures during the first 28 days of treatment was 3.62 (95% CI 0.87 to 15.09), equivalent to one additional seizure per 6219 first time bupropion users.</p><p><b>Conclusions:</b> Bupropion use is probably associated with an increased risk of seizures, but no evidence was found to suggest that the drug is associated with an increased risk of sudden death.</p>" /> <meta name="citation_journal_title" content="Thorax" /> <meta name="citation_publisher" content="BMJ Publishing Group Ltd" /> <meta name="citation_publication_date" content="2005/10/01" /> <meta name="citation_mjid" content="thoraxjnl;60/10/848" /> <meta name="citation_id" content="60/10/848" /> <meta name="citation_public_url" content="https://thorax.bmj.com/content/60/10/848" /> <meta name="citation_abstract_html_url" content="https://thorax.bmj.com/content/60/10/848.abstract" /> <meta name="citation_full_html_url" content="https://thorax.bmj.com/content/60/10/848.full" /> <meta name="citation_pdf_url" content="https://thorax.bmj.com/content/thoraxjnl/60/10/848.full.pdf" /> <meta name="citation_issn" content="0040-6376" /> <meta name="citation_issn" content="1468-3296" /> <meta name="citation_doi" content="10.1136/thx.2005.041798" /> <meta name="citation_pmid" content="16055620" /> <meta name="citation_volume" content="60" /> <meta name="citation_issue" content="10" /> <meta name="citation_article_type" content="Other" /> <meta name="citation_section" content="Smoking cessation" /> <meta name="citation_firstpage" content="848" /> <meta name="citation_lastpage" content="850" /> <meta name="citation_author" content="R Hubbard" /> <meta name="citation_author" content="S Lewis" /> <meta name="citation_author" content="J West" /> <meta name="citation_author" content="C Smith" /> <meta name="citation_author" content="C Godfrey" /> <meta name="citation_author" content="L Smeeth" /> <meta name="citation_author" content="P Farrington" /> <meta name="citation_author" content="J Britton" /> <meta name="citation_reference" content="citation_title=Thorax;citation_journal_abbrev=Thorax;citation_title=Smoking cessation guidelines for health professionals: an update;citation_pages=987-999;citation_volume=55;citation_year=2000;citation_issue=12;citation_issn=0040-6376;citation_pmid=11083883;citation_doi=10.1136/thorax.55.12.987" /> <meta name="citation_reference" content="citation_title=Nicotine addiction in Britain;citation_year=2000" /> <meta name="citation_reference" content="citation_title=Mail on Sunday;citation_year=2001" /> <meta name="citation_reference" content="citation_title=JAMA;citation_journal_abbrev=JAMA;citation_title=Effects of Smoking Intervention and the Use of an Inhaled Anticholinergic Bronchodilator on the Rate of Decline of FEV1: The Lung Health Study;citation_pages=1497-1505;citation_volume=272;citation_year=1994;citation_issue=19;citation_issn=0002-9955;citation_pmid=7966841;citation_doi=10.1001/jama.1994.03520190043033" /> <meta name="citation_reference" content="citation_title=Informatics in primary care;citation_journal_abbrev=Inform Prim Care;citation_title=Feasibility study and methodology to create a quality-evaluated database of primary care data.;citation_pages=171-177;citation_volume=12;citation_year=2004;citation_issue=3;citation_pmid=15606990" /> <meta name="citation_reference" content="citation_title=American Journal of Epidemiology;citation_journal_abbrev=Am J Epidemiol;citation_title=Case Series Analysis of Adverse Reactions to Vaccines: A Comparative Evaluation;citation_pages=1165-1173;citation_volume=143;citation_year=1996;citation_issue=11;citation_issn=0002-9262;citation_pmid=8633607;citation_doi=10.1093/oxfordjournals.aje.a008695" /> <meta name="citation_reference" content="citation_title=Lancet;citation_journal_abbrev=Lancet;citation_title=A new method for active surveillance of adverse events from diphtheria/tetanus/pertussis and measles/mumps/rubella vaccines.;citation_pages=567-569;citation_volume=345;citation_year=1995;citation_issue=8949;citation_pmid=7619183;citation_doi=10.1016/S0140-6736(95)90471-9" /> <meta name="citation_reference" content="citation_title=American Journal of Epidemiology;citation_journal_abbrev=Am J Epidemiol;citation_title=Exposure to Tricyclic and Selective Serotonin Reuptake Inhibitor Antidepressants and the Risk of Hip Fracture;citation_pages=77-84;citation_volume=158;citation_year=2003;citation_issue=1;citation_issn=0002-9262;citation_pmid=12835289;citation_doi=10.1093/aje/kwg114" /> <meta name="citation_reference" content="citation_title=The Journal of clinical psychiatry;citation_journal_abbrev=J Clin Psychiatry;citation_title=A prospective safety surveillance study for bupropion sustained-release in the treatment of depression.;citation_pages=366-373;citation_volume=59;citation_year=1998;citation_issue=7;citation_pmid=9714265" /> <meta name="citation_reference" content="citation_title=Lancet;citation_journal_abbrev=Lancet;citation_title=The UK General Practice Research Database.;citation_pages=1097-1099;citation_volume=350;citation_year=1997;citation_issue=9084;citation_pmid=10213569;citation_doi=10.1016/S0140-6736(97)04248-7" /> <meta name="citation_reference" content="citation_title=The Journal of clinical psychiatry;citation_journal_abbrev=J Clin Psychiatry;citation_title=A 102-center prospective study of seizure in association with bupropion.;citation_pages=450-456;citation_volume=52;citation_year=1991;citation_issue=11;citation_pmid=1744061" /> <meta name="citation_reference" content="citation_title=Drug safety : an international journal of medical toxicology and drug experience;citation_journal_abbrev=Drug Saf;citation_title=Effects of psychotropic drugs on seizure threshold.;citation_pages=91-110;citation_volume=25;citation_year=2002;citation_issue=2;citation_pmid=11888352;citation_doi=10.2165/00002018-200225020-00004" /> <meta name="citation_reference" content="citation_title=Cochrane Database Syst Rev;citation_pages=CD000031;citation_year=2004" /> <meta name="citation_reference" content="citation_title=European journal of clinical pharmacology;citation_journal_abbrev=Eur J Clin Pharmacol;citation_title=Evaluation of the safety of bupropion (Zyban) for smoking cessation from experience gained in general practice use in England in 2000.;citation_pages=767-773;citation_volume=59;citation_year=2003;citation_issue=10;citation_pmid=14615857;citation_doi=10.1007/s00228-003-0693-0" /> <meta name="twitter:title" content="Bupropion and the risk of sudden death: a self-controlled case-series analysis using The Health Improvement Network" /> <meta name="twitter:card" content="summary_large_image" /> <meta name="twitter:image" content="https://thorax.bmj.com/sites/default/files/highwire/thoraxjnl/60/10.cover.gif" /> <meta name="twitter:description" content="Background: Bupropion is an effective smoking cessation therapy but its use in the UK has been limited by concerns that it may increase the risk of sudden death. Methods: Data for all patients prescribed bupropion within The Health Improvement Network (a computerised general practice database) were extracted and the self-controlled case-series method was used to estimate the relative incidence of death during the first 28 days of treatment. The incidence of seizures, a recognised adverse effect of bupropion, was also investigated during this period. Results: A total of 9329 individuals had been prescribed bupropion (mean age 44 years, 48% male). The total person-time after the first prescription for bupropion was 17 586 years, and during this time 121 people died. Two people died within the first 28 days of treatment, which was less than expected in comparison with the remaining observation period by an incidence ratio of 0.50 (95% confidence interval (CI) 0.12 to 2.05). Twenty eight people were recorded as having a total of 45 seizures (23 before starting bupropion, two in the first 28 days of treatment, and 20 at a later point). The relative incidence of seizures during the first 28 days of treatment was 3.62 (95% CI 0.87 to 15.09), equivalent to one additional seizure per 6219 first time bupropion users. Conclusions: Bupropion use is probably associated with an increased risk of seizures, but no evidence was found to suggest that the drug is associated with an increased risk of sudden death." /> <meta name="og-title" property="og:title" content="Bupropion and the risk of sudden death: a self-controlled case-series analysis using The Health Improvement Network" /> <meta name="og-url" property="og:url" content="https://thorax.bmj.com/content/60/10/848" /> <meta name="og-site-name" property="og:site_name" content="Thorax" /> <meta name="og-description" property="og:description" content="Background: Bupropion is an effective smoking cessation therapy but its use in the UK has been limited by concerns that it may increase the risk of sudden death. Methods: Data for all patients prescribed bupropion within The Health Improvement Network (a computerised general practice database) were extracted and the self-controlled case-series method was used to estimate the relative incidence of death during the first 28 days of treatment. The incidence of seizures, a recognised adverse effect of bupropion, was also investigated during this period. Results: A total of 9329 individuals had been prescribed bupropion (mean age 44 years, 48% male). The total person-time after the first prescription for bupropion was 17 586 years, and during this time 121 people died. Two people died within the first 28 days of treatment, which was less than expected in comparison with the remaining observation period by an incidence ratio of 0.50 (95% confidence interval (CI) 0.12 to 2.05). Twenty eight people were recorded as having a total of 45 seizures (23 before starting bupropion, two in the first 28 days of treatment, and 20 at a later point). The relative incidence of seizures during the first 28 days of treatment was 3.62 (95% CI 0.87 to 15.09), equivalent to one additional seizure per 6219 first time bupropion users. Conclusions: Bupropion use is probably associated with an increased risk of seizures, but no evidence was found to suggest that the drug is associated with an increased risk of sudden death." /> <meta name="og-type" property="og:type" content="article" /> <meta name="og-image" property="og:image" content="https://thorax.bmj.com/sites/default/files/highwire/thoraxjnl/60/10.cover.gif" /> <link rel="alternate" type="application/vnd.ms-powerpoint" title="Powerpoint" href="/content/60/10/848.ppt" /> <title>Bupropion and the risk of sudden death: a self-controlled case-series analysis using The Health Improvement Network | Thorax</title> <link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__QxGmTO72thjKeROM_Gj3l18NvAn--8IsCRoy1fYiu4M__XIYCORrpa1u8qww8HC0MSBX05rwK_OicLIEmHsfVRcE__UK4XtEDKdMc0Gs7HNCE9o0vU2f7Fe9vzuvoxMxYgoFA.css" media="all" />  <script src="https://cookie-cdn.cookiepro.com/scripttemplates/otSDKStub.js" type="text/javascript" charset="UTF-8" data-domain-script="565e50dd-f6e9-46d6-91cd-5c40a270264f"></script> <script type="text/javascript"> function OnetrustAdsConsent(){ if(googletag.apiReady){ //console.log("GoogleTag API ready") googletag.pubads().disableInitialLoad(); if(OptanonActiveGroups.match(/,4,/)){ googletag.pubads().setRequestNonPersonalizedAds(0); //googletag.pubads().refresh(); } else{ googletag.pubads().setRequestNonPersonalizedAds(1); googletag.pubads().refresh(); } } else{ OnetrustAdsConsent(); } } function OptanonWrapper() { OnetrustAdsConsent(); } </script>  <script type="text/javascript" src="/sites/default/files/advagg_js/js__DdxPgqGimsdUot2QWNz_pGsHzqNGpx6RMCWHpL8YWkg__c6zfK6oHHbLpTal5PdQxeQI3xGoCM8IXWtEHwIZr560__UK4XtEDKdMc0Gs7HNCE9o0vU2f7Fe9vzuvoxMxYgoFA.js"></script> <script type="text/javascript" src="https://securepubads.g.doubleclick.net/tag/js/gpt.js"></script> <script type="text/javascript" src="/sites/default/files/advagg_js/js__RplUf5n1SHvT_MHHQProZaAaHxo7a_9YZuaKWYnqVeQ__t8vznsHJmtJcTuSP5JnWJ92mdmFUGaXxtxwBatvNwmc__UK4XtEDKdMc0Gs7HNCE9o0vU2f7Fe9vzuvoxMxYgoFA.js"></script> <script type="text/javascript" src="https://d1bxh8uas1mnw7.cloudfront.net/assets/embed.js"></script> <script type="text/javascript" src="/sites/default/files/advagg_js/js__RxmsdK7-WlnwoO5NREEVy8MRi0OqO4ZhkOHaMokGNlw__IAyE4mioyYmepJfxC77gDsM0J1xDyesxXH7WjkUNmyc__UK4XtEDKdMc0Gs7HNCE9o0vU2f7Fe9vzuvoxMxYgoFA.js"></script> <script type="text/javascript" defer="defer" async="async" src="//cdn.foxycart.com/bmjpg.ecommerce.highwire.org/loader.js"></script> <script type="text/javascript" async="async" src="https://scholar.google.com/scholar_js/casa.js"></script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script>   <script> let cookies = parseCookies(); let bmj_uuid = cookies.bmj_uuid; let bmj_ppid = cookies.bmj_ppid; window.dataLayer = window.dataLayer || []; const anonMailId = 'e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855'; function checkUserLoginStatus(dataLayer) { const userMail = dataLayer.find((item) => item.user)?.user?.mail; if (!userMail) { return false; } return userMail !== anonMailId; } let nonAnonMailId = ((dataLayer.find(item => item.user)?.user)?.mail) === anonMailId ? null : (dataLayer.find(item => item.user)?.user)?.mail; let userId = ((dataLayer.find(item => item.user)?.user)?.['data-ics']) ?? ((dataLayer.find(item => item.user)?.user)?.mail && nonAnonMailId) ?? bmj_ppid ?? bmj_uuid; document.cookie = 'bmj_ppid=' + userId + '; domain=.bmj.com; path=/; max-age=31622400; SameSite=None; Secure'; googletag.cmd.push(function() { googletag.pubads().setPublisherProvidedId(userId); googletag.pubads().setTargeting("islogged", checkUserLoginStatus(dataLayer) ? "true" : "false"); googletag.enableServices(); }); window.dataLayer.push({ 'bmj_uuid': bmj_uuid }); </script> </head> <body class="html not-front not-logged-in no-sidebars page-node page-node- page-node-146297 node-type-highwire-article">  <noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-5NN54W" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript> <script type="text/javascript">(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-5NN54W');</script>  <div id="skip-link"> <a href="#main-content" class="element-invisible element-focusable">Skip to main content</a> </div> <div class="page" id="page"> <section class="container-fluid content-header"> <header role="banner" class="section section-header row"> <div class="zone zone-superheader"> <div class="region region-superheader"> <div class="region-inner region-superheader-inner"> <div class="region region-superheader"> <div id="block-panels-mini-jnl-template-bmjj-uid-strng" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_template_bmjj_uid_strng"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-dfp-pane" > <div class="pane-content"> <div id="dfp-ad-top-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-top" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-top"); }); </script> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="site-info mobile-hidden"> </div> <div class="zone zone-header row mobile-hidden"> <div class="region region-header"> <div class="region-inner region-header-inner"> </div> </div> </div> </header>  <section class="row visible-sm visible-md visible-lg header header-platform mobile-hidden"> <div class="col-narrow-3 col-normal-3 col-large-3 logo-bmj"> <div class="l-inline"> <p class="logo-bmj-journals"><a href="http://journals.bmj.com/" title="BMJ Journals"><img src="/sites/default/themes/bmjj/img/logos/logo-bmj-journals.svg" title="BMJ Journals" alt="BMJ Journals"/></a></p> </div> </div> <div class="col-narrow-9 col-normal-9 col-large-9 no-right-padding"> <div class="region region-top"> <div class="region-inner"> <div class="region region-platmenu"> <div id="block-menu-menu-platform-menu" class="block block-menu" class="block block-menu"> <div class="content"> <ul class="menu"><li class="first leaf"><a href="/subscribe" data-hide-link-title="0" class="header-subscribe-link" data-icon-position="">Subscribe</a></li> <li class="leaf"><a href="/" id="menu-login" class="drop-menu link-icon-right link-icon"><span class="title">Log In</span> <span class="icon icon-arrow-down"></span></a> <a href="# " class="menu-attach-block-drop-link external expand-on-click" data-block-id="panels_mini|challenge_opportunity_pane_dropdown" id="<front>-drop-link-728" data-icon-position="" data-hide-link-title="0">More</a><div class="menu-attach-block-wrapper"> <div id="block-panels-mini-challenge-opportunity-pane-dropdown" class="block block-panels-mini article-login bmjj-login" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-challenge_opportunity_pane_dropdown-2"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-society-logins society-logins" > <div class="pane-content"> <span class="ui-button ui-state-default ui-dialog-titlebar-close" title="close"></span><div class="shib-login-link"><a href="/login/shibboleth?subcode=bmjjournals&env=prod&uri=https%3A//thorax.bmj.com/accallback/content%25252F60%25252F10%25252F848" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via Institution</a></div><div class="openathens-login-link"><a href="https://openathens-sp.highwire.org/session/init?entityID=https%3A//idp.eduserv.org.uk/openathens&hw-shib-return-uri=https%3A//thorax.bmj.com/accallback/content%25252F60%25252F10%25252F848&subcode=bmjjournals" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via OpenAthens</a></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-opportunity-challenge" > <div class="pane-content"> <div class='opportunity-challenge-login'><h3>Log in using your username and password</h3><div class="drupal-login compact"><form action="/content/60/10/848" method="post" id="highwire-user-login--4" accept-charset="UTF-8"><div><div id="edit-customtext--4" class="form-item form-item-label-before form-type-item"> <span class="customtext">For personal accounts OR managers of institutional accounts</span> </div> <div class="form-item form-item-label-invisible form-type-textfield form-item-name"> <label class="element-invisible" for="edit-name--4">Username <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Username" type="text" id="edit-name--4" name="name" value="" size="30" maxlength="60" class="form-text required" /> </div> <div class="form-item form-item-label-invisible form-type-password form-item-pass"> <label class="element-invisible" for="edit-pass--4">Password <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Password" type="password" id="edit-pass--4" name="pass" size="30" maxlength="128" class="form-text required" /> </div> <input type="hidden" name="form_build_id" value="form-PrpKqa21Jk-Z9iTi5h6yaIjAuPZBkr-ZwWgBalfa-Ks" /> <input type="hidden" name="form_id" value="highwire_user_login" /> <div class="bmjj-reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot your log in details?</a><a href="/user/register?destination=node/146297" class="" data-icon-position="" data-hide-link-title="0">Register a new account?</a></div><div class="form-actions form-wrapper" id="edit-actions--4"><input type="submit" id="edit-submit--4" name="op" value="Log in" class="form-submit" /></div><div class="reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot</a> your user name or password?</div></div></form></div></div> </div> </div> </div> </div> </div> </div> </div> </div> </li> <li class="leaf"><a href="/cart" class="link-icon-right link-icon"><span class="title">Basket</span> <span class="icon icon-basket"></span></a></li> <li class="last leaf"><a href="/search" id="menu-search" class="drop-menu link-icon-right link-icon"><span class="title">Search</span> <span class="icon icon-search"></span></a> <a href="# " class="menu-attach-block-drop-link external expand-on-click" data-block-id="panels_mini|jnl_template_bmjj_search_box" id="search-drop-link-729" data-icon-position="" data-hide-link-title="0">More</a><div class="menu-attach-block-wrapper"> <div id="block-panels-mini-jnl-template-bmjj-search-box" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display one-layout " id="mini-panel-jnl_template_bmjj_search_box-1"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-seach-quicksearch block-search pull-left" > <div class="pane-content"> <form class="highwire-quicksearch button-style-mini button-style-mini" action="/content/60/10/848" method="post" id="highwire-search-quicksearch-form-1" accept-charset="UTF-8"><div><div class="form-item form-item-label-invisible form-type-textfield form-item-keywords"> <label class="element-invisible" for="search_rightsidebar_keywords_301088697">Search for this keyword </label> <input placeholder="search" type="text" id="search_rightsidebar_keywords_301088697" name="keywords" value="" size="60" maxlength="128" class="form-text" /> </div> <input data-icon-only="1" data-font-icon="icon-search" data-icon-position="after" type="submit" id="search_rightsidebar_submit_145877549" name="op" value="Search" class="form-submit" /><input type="hidden" name="form_build_id" value="form-7falL-IejqXgWxRIIHHUDG8gbXvsT014NMr_fNqBpAY" /> <input type="hidden" name="form_id" value="highwire_search_quicksearch_form_1" /> </div></form> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-6 pull-right advanced-search-link" > <div class="pane-content"> <a href="/search">Advanced search</a> </div> </div> </div> </div> </div> </div> </div> </div> </li> </ul> </div> </div> </div> </div> </div> </div> </section> <div class="row header header-journal"> <div class="col-mobile-7 col-narrow-2 col-normal-4 logo-journal"> <a href="/"><img src="https://resources.bmj.com/repository/journals-network-project/images/journal-logos/logo-thorax.svg" alt="Thorax" id="logo-img"></a> </div> <div class="col-mobile-5 col-narrow-10 col-normal-8 no-right-padding nav-journal"> <div class="region region-journmenu"> <div id="block-system-main-menu" class="block block-system mobile-hidden block-menu" class="block block-system mobile-hidden block-menu"> <div class="content"> <ul class="menu"><li class="first leaf"><a href="https://thorax.bmj.com/pages/thorax-education" class="" data-icon-position="" data-hide-link-title="0">Thorax Education</a></li> <li class="leaf"><a href="/content/early/recent" class="" data-icon-position="" data-hide-link-title="0">Latest content</a></li> <li class="leaf"><a href="/content/current" class="" data-icon-position="" data-hide-link-title="0">Current issue</a></li> <li class="leaf"><a href="/content/by/year" class="" data-icon-position="" data-hide-link-title="0">Archive</a></li> <li class="leaf"><a href="http://thorax.bmj.com/pages/authors/" class="" data-icon-position="" data-hide-link-title="0">Authors</a></li> <li class="leaf"><a href="https://thoraxbmj.podbean.com/" class="" data-icon-position="" data-hide-link-title="0">Podcasts</a></li> <li class="last leaf"><a href="http://thorax.bmj.com/pages/about/" class="" data-icon-position="" data-hide-link-title="0">About</a></li> </ul> </div> </div> <div id="block-panels-mini-mobile-slide-out-menu" class="block block-panels-mini mobile-only" class="block block-panels-mini mobile-only"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-mobile_slide_out_menu"> <div class="panel-panel panel-col"> <div><div id="" class="highwire-responsive-toggle-group"><div class="panel-pane pane-panels-mini pane-jnl-template-bmjj-search-box" > <h2 class="pane-title"><span class="icon-search"></span></h2> <div class="pane-content"> <div class="panel-display one-layout " id="mini-panel-jnl_template_bmjj_search_box"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-seach-quicksearch block-search pull-left" > <div class="pane-content"> <form class="highwire-quicksearch button-style-mini button-style-mini" action="/content/60/10/848" method="post" id="highwire-search-quicksearch-form-0" accept-charset="UTF-8"><div><div class="form-item form-item-label-invisible form-type-textfield form-item-keywords"> <label class="element-invisible" for="search_rightsidebar_keywords_1008631920">Search for this keyword </label> <input placeholder="search" type="text" id="search_rightsidebar_keywords_1008631920" name="keywords" value="" size="60" maxlength="128" class="form-text" /> </div> <input data-icon-only="1" data-font-icon="icon-search" data-icon-position="after" type="submit" id="search_rightsidebar_submit_461885005" name="op" value="Search" class="form-submit" /><input type="hidden" name="form_build_id" value="form-nyQxolEMrw8MMeO7vXfE3gAEi9fXHyVihAlQtWstj6E" /> <input type="hidden" name="form_id" value="highwire_search_quicksearch_form_0" /> </div></form> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-5 pull-right advanced-search-link" > <div class="pane-content"> <a href="/search">Advanced search</a> </div> </div> </div> </div> </div> </div> </div> <div class="panel-pane pane-block pane-menu-menu-mobile-slideout-menu pane-menu" > <h2 class="pane-title"><span class="icon-menu"></span></h2> <div class="pane-content"> <ul class="menu"><li class="first leaf"><a href="/" class="menu-close link-icon-only link-icon"><span class="icon icon-close"></span> <span class="title element-invisible">Close</span></a> <a href="# " class="menu-attach-block-drop-link external expand-on-click" data-block-id="panels_mini|mobile_slide_out_autobot_menu" id="<front>-drop-link-781" data-icon-position="" data-hide-link-title="0">More</a><div class="menu-attach-block-wrapper"> <div id="block-panels-mini-mobile-slide-out-autobot-menu" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display one-layout " id="mini-panel-mobile_slide_out_autobot_menu"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-menu-tree pane-main-menu" > <h2 class="pane-title">Main menu</h2> <div class="pane-content"> <div class="menu-block-wrapper menu-block-ctools-main-menu-1 menu-name-main-menu parent-mlid-main-menu:0 menu-level-1"> <ul class="menu"><li class="first leaf menu-mlid-14793"><a href="https://thorax.bmj.com/pages/thorax-education" class="" data-icon-position="" data-hide-link-title="0">Thorax Education</a></li> <li class="leaf menu-mlid-14794"><a href="/content/early/recent" class="" data-icon-position="" data-hide-link-title="0">Latest content</a></li> <li class="leaf menu-mlid-14795"><a href="/content/current" class="" data-icon-position="" data-hide-link-title="0">Current issue</a></li> <li class="leaf menu-mlid-14796"><a href="/content/by/year" class="" data-icon-position="" data-hide-link-title="0">Archive</a></li> <li class="leaf menu-mlid-14797"><a href="http://thorax.bmj.com/pages/authors/" class="" data-icon-position="" data-hide-link-title="0">Authors</a></li> <li class="leaf menu-mlid-14798"><a href="https://thoraxbmj.podbean.com/" class="" data-icon-position="" data-hide-link-title="0">Podcasts</a></li> <li class="last leaf menu-mlid-14799"><a href="http://thorax.bmj.com/pages/about/" class="" data-icon-position="" data-hide-link-title="0">About</a></li> </ul></div> </div> </div> </div> </div> </div> </div> </div> </div> </li> <li class="leaf"><a href="/subscribe" data-hide-link-title="0" class="callout-link" data-icon-position="">Subscribe</a></li> <li class="leaf"><a href="/" class="mobile-drop-down callout-link link-icon-right link-icon"><span class="title">Log in</span> <span class="icon icon-plus"></span></a> <a href="# " class="menu-attach-block-drop-link external expand-on-click" data-block-id="panels_mini|jnl_template_bmjj_login" id="<front>-drop-link-780" data-icon-position="" data-hide-link-title="0">More</a><div class="menu-attach-block-wrapper"> <div id="block-panels-mini-jnl-template-bmjj-login" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_template_bmjj_login"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-society-logins society-logins opportunity-challenge-login" > <div class="pane-content"> <span class="ui-button ui-state-default ui-dialog-titlebar-close" title="close"></span><div class="shib-login-link"><a href="/login/shibboleth?subcode=bmjjournals&env=prod&uri=https%3A//thorax.bmj.com/accallback/content%25252F60%25252F10%25252F848" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via Institution</a></div><div class="openathens-login-link"><a href="https://openathens-sp.highwire.org/session/init?entityID=https%3A//idp.eduserv.org.uk/openathens&hw-shib-return-uri=https%3A//thorax.bmj.com/accallback/content%25252F60%25252F10%25252F848&subcode=bmjjournals" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via OpenAthens</a></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-opportunity-challenge" > <div class="pane-content"> <div class='opportunity-challenge-login'><h3>Log in using your username and password</h3><div class="drupal-login compact"><form action="/content/60/10/848" method="post" id="highwire-user-login--3" accept-charset="UTF-8"><div><div id="edit-customtext--3" class="form-item form-item-label-before form-type-item"> <span class="customtext">For personal accounts OR managers of institutional accounts</span> </div> <div class="form-item form-item-label-invisible form-type-textfield form-item-name"> <label class="element-invisible" for="edit-name--3">Username <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Username" type="text" id="edit-name--3" name="name" value="" size="30" maxlength="60" class="form-text required" /> </div> <div class="form-item form-item-label-invisible form-type-password form-item-pass"> <label class="element-invisible" for="edit-pass--3">Password <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Password" type="password" id="edit-pass--3" name="pass" size="30" maxlength="128" class="form-text required" /> </div> <input type="hidden" name="form_build_id" value="form-89VKW4q5HM5tzafsGw-iPX4TyEIDBu6xFHI8dTI4m3E" /> <input type="hidden" name="form_id" value="highwire_user_login" /> <div class="bmjj-reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot your log in details?</a><a href="/user/register?destination=node/146297" class="" data-icon-position="" data-hide-link-title="0">Register a new account?</a></div><div class="form-actions form-wrapper" id="edit-actions--3"><input type="submit" id="edit-submit--3" name="op" value="Log in" class="form-submit" /></div><div class="reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot</a> your user name or password?</div></div></form></div></div> </div> </div> </div> </div> </div> </div> </div> </div> </li> <li class="last leaf"><a href="http://journals.bmj.com/" data-hide-link-title="0" class="bmj-link" data-icon-position="">BMJ Journals</a></li> </ul> </div> </div> </div></div> </div> </div> </div> </div> </div> </div> </div> </section> <section role="main" class="section section-content container-fluid"> <div class="crumb-navigation"> <div class="row"> <div class="col-mobile-12 col-narrow-9 col-normal-9 col-wide-10 breadcrumbs"> <h2 class="element-invisible">You are here</h2><div class="item-list"><ul class="breadcrumb"><li class="first"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Home</a></li> <li><a href="/content/by/year" class="" data-icon-position="" data-hide-link-title="0">Archive</a></li> <li><a href="/content/60/10" class="" data-icon-position="" data-hide-link-title="0">Volume 60, Issue 10 </a></li> <li class="last"><span class="active">Bupropion and the risk of sudden death: a self-controlled case-series analysis using The Health Improvement Network</span></li> </ul></div> </div> <div class="mobile-hidden col-narrow-3 col-normal-3 col-wide-2 email-alerts"> <span> <a href="https://myaccount.bmj.com/myaccount/signup.html?regService=etoc-alerts&corpusCode=thoraxjnl&fwdUrl=https://thorax.bmj.com/" class="email-alerts-label"><i class="icon icon-article-alerts"></i>Email alerts</a> </span> </div> </div> </div> <div class="container"> <div class="zone zone-content row"> <div class="region region-content col-narrow-12"> <div class="region-inner region-content-inner"> <a id="main-content"></a> <div class="region region-content"> <div id="block-system-main" class="block block-system" class="block block-system"> <div class="content"> <div class="panel-display two-layout " > <div class="panel-row-wrapper panel-row-first row"> <div class="top-wrapper col-narrow-12"> <div class="panel-panel panel-region-top"> <div class="inside"><div class="panel-pane pane-panels-mini pane-article-tabset-mobile mobile-only" id="mobile-article-tab-container"> <div class="pane-content"> <div class="panel-display two-layout " id="mini-panel-article_tabset_mobile_"> <div class="panel-row-wrapper row"> <div class="left-wrapper col-mobile-6"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane pane-bmjj-mob-tab-title" id="mobile-tab-title"> <div class="pane-content"> <p><span class="icon-article-text"></span>Article Text</p> </div> </div> </div> </div> </div> <div class="right-wrapper col-mobile-6"> <div class="panel-panel panel-region-right"> <div class="inside"><div class="panel-pane pane-bmjj-mobile-article-menu" > <div class="pane-content"> <a href="#block-system-main" class="mobile-article-tab" data-icon-position="" data-hide-link-title="0">Article menu <span class="icon-plus icon-toggle"></span></a><div class="mobile-art-drop-down"></div> </div> </div> </div> </div> </div> </div>  </div> </div> </div> </div> </div> </div> </div>  <div class="panel-row-wrapper row relative" id="article-top"> <div class="left-wrapper col-narrow-2 col-normal-1 col-wide-1 tab-pane"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane pane-highwire-panel-tabs pane-panels-ajax-tab-tabs nav nav-tabs nav-stacked articleToolbar mobile-hidden" id="nav-tabs"> <div class="pane-content"> <div class="item-list"><ul class="tabs inline panels-ajax-tab"><li class="active first"><a href="/content/60/10/848" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_tab_art" data-target-id="highwire_article_tabs" data-entity-context="node:146297" data-trigger="" data-url-enabled="1"><span class="icon-article-text"></span>Article <br/>Text</a><a href="/panels_ajax_tab/jnl_template_bmjj_tab_art/node:146297/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/60/10/848.info" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_art_info" data-target-id="highwire_article_tabs" data-entity-context="node:146297" data-trigger="info" data-url-enabled="1"><span class="icon-article-info"></span>Article <br/>info</a><a href="/panels_ajax_tab/jnl_template_bmjj_art_info/node:146297/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/60/10/848.citation-tools" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_cite_tool" data-target-id="highwire_article_tabs" data-entity-context="node:146297" data-trigger="citation-tools" data-url-enabled="1"><span class="icon-citation-tools"></span>Citation <br/>Tools</a><a href="/panels_ajax_tab/jnl_template_bmjj_cite_tool/node:146297/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/60/10/848.share" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_share" data-target-id="highwire_article_tabs" data-entity-context="node:146297" data-trigger="share" data-url-enabled="1"><span class="icon-share"></span>Share</a><a href="/panels_ajax_tab/jnl_template_bmjj_share/node:146297/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/60/10/848.responses" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_tab_elets" data-target-id="highwire_article_tabs" data-entity-context="node:146297" data-trigger="responses" data-url-enabled="1"><span class="icon-responses"></span>Rapid Responses</a><a href="/panels_ajax_tab/jnl_template_bmjj_tab_elets/node:146297/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/60/10/848.altmetrics" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_tab_altmetrics" data-target-id="highwire_article_tabs" data-entity-context="node:146297" data-trigger="altmetrics" data-url-enabled="1"><span class="icon-article-stats"></span>Article <br/>metrics</a><a href="/panels_ajax_tab/jnl_template_bmjj_tab_altmetrics/node:146297/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=" last"><a href="/content/60/10/848.alerts" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_art_alert" data-target-id="highwire_article_tabs" data-entity-context="node:146297" data-trigger="alerts" data-url-enabled="1"><span class="icon-article-alerts"></span>Alerts</a><a href="/panels_ajax_tab/jnl_template_bmjj_art_alert/node:146297/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> </ul></div> </div> </div> </div> </div> </div> <div class="right-wrapper col-narrow-9 col-normal-10 col-wide-10 article-pane panel-region-main"> <div class="panel-panel panel-region-right"> <div class="inside"><div class="panel-pane pane-bmjj-challenge-modal col-mobile-2 col-narrow-1 pull-right " > <div class="pane-content"> <a href="" class="" data-icon-position="" data-hide-link-title="0"><a href="#" id="chal-modal" class="article-pdf-download"><img alt="Download PDF" src="/sites/default/themes/bmjj/img/icon-pdf.png" /><strong>PDF</strong></a></a> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-entity-field pane-node-field-highwire-article-cat article-category col-narrow-9 col-normal-10" > <div class="pane-content"> <div class="field field-name-field-highwire-article-cat field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Smoking cessation</div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-article-citation col-mobile-10 col-narrow-10 col-normal-11 article-title" > <div class="pane-content"> <div class="highwire-article-citation highwire-citation-type-highwire-article node146297" data-node-nid="146297" id="node-146297--2608415146" data-pisa="thoraxjnl;60/10/848" data-pisa-master="thoraxjnl;thx.2005.041798" data-apath="/thoraxjnl/60/10/848.atom"><cite class="highwire-cite highwire-cite-highwire-article highwire-citation-bmjj-title clearfix"> <div class="highwire-cite-title">Bupropion and the risk of sudden death: a self-controlled case-series analysis using The Health Improvement Network</div> <span class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="thoraxjnl;thx.2005.041798" data-atom-uri="/thoraxjnl/60/10/848.atom" data-request-view="full"></span></span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container col-narrow-12 clear" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="jnl_template_bmjj_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://thorax.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_template_bmjj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup author-affiliates col-narrow-12 author-affiliates-corresp article" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li id="contrib-1"><span class="name">R Hubbard</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">1</a>, </li><li id="contrib-2"><span class="name">S Lewis</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">2</a>, </li><li id="contrib-3"><span class="name">J West</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">1</a>, </li><li id="contrib-4"><span class="name">C Smith</span><a id="xref-aff-2-2" class="xref-aff" href="#aff-2">2</a>, </li><li id="contrib-5"><span class="name">C Godfrey</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">3</a>, </li><li id="contrib-6"><span class="name">L Smeeth</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">4</a>, </li><li id="contrib-7"><span class="name">P Farrington</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">5</a>, </li><li id="contrib-8"><span class="name">J Britton</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1">1</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>1</sup>Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>2</sup>Division of Respiratory Medicine, University of Nottingham, Nottingham, UK</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>3</sup>Centre for Health Economics, University of York, York, UK</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>4</sup>Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>5</sup>Department of Statistics, Open University, Milton Keynes, UK</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="corresp-label"></span>Correspondence to:<br/> Dr R Hubbard<br/> Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK; <span class="em-link" title="Richard.Hubbard@Nottingham.ac.uk"><span class="em-addr">Richard.HubbardNottingham.ac.uk</span></span></li></ol></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup abstract-with-bc" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" id="content-block" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view"><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2> <p id="p-1"><strong>Background:</strong> Bupropion is an effective smoking cessation therapy but its use in the UK has been limited by concerns that it may increase the risk of sudden death.</p> <p id="p-2"><strong>Methods:</strong> Data for all patients prescribed bupropion within The Health Improvement Network (a computerised general practice database) were extracted and the self-controlled case-series method was used to estimate the relative incidence of death during the first 28 days of treatment. The incidence of seizures, a recognised adverse effect of bupropion, was also investigated during this period.</p> <p id="p-3"><strong>Results:</strong> A total of 9329 individuals had been prescribed bupropion (mean age 44 years, 48% male). The total person-time after the first prescription for bupropion was 17 586 years, and during this time 121 people died. Two people died within the first 28 days of treatment, which was less than expected in comparison with the remaining observation period by an incidence ratio of 0.50 (95% confidence interval (CI) 0.12 to 2.05). Twenty eight people were recorded as having a total of 45 seizures (23 before starting bupropion, two in the first 28 days of treatment, and 20 at a later point). The relative incidence of seizures during the first 28 days of treatment was 3.62 (95% CI 0.87 to 15.09), equivalent to one additional seizure per 6219 first time bupropion users.</p> <p id="p-4"><strong>Conclusions:</strong> Bupropion use is probably associated with an increased risk of seizures, but no evidence was found to suggest that the drug is associated with an increased risk of sudden death.</p> </div><ul class="kwd-group KWD"><li class="kwd">bupropion</li><li class="kwd">smoking cessation</li><li class="kwd">seizures</li><li class="kwd">sudden death</li><li class="kwd">post-marketing surveillance</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-dfp-pane oas-ads oas-ads-mid pull-right" > <div class="pane-content"> <div id="dfp-ad-mpu-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-mpu" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-mpu"); }); </script> </div> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-1" > <div class="pane-content"> <p><a href="https://doi.org/10.1136/thx.2005.041798" target="_new">https://doi.org/10.1136/thx.2005.041798</a></p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-altmetrics" > <h2 class="pane-title">Statistics from Altmetric.com</h2> <div class="pane-content"> <div data-badge-details="right" data-badge-type="medium-donut" data-doi="10.1136/thx.2005.041798" data-hide-no-mentions="true" class="altmetric-embed"></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmjj-jumplinks" > <div class="pane-content"> <div class="highwire-list-wrapper"><div class="highwire-list"><ul></ul></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-2 permissions-box" > <h2 class="pane-title">Request Permissions</h2> <div class="pane-content"> <p>If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.</p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-ajax-pane-content permissions-box pane-highwire-permission-link" id="request-permissions"> <h2 class="pane-title"><span class='panels-ajax-pane-title' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></span></h2> <div class="pane-content"> <div class='panels-ajax-pane panels-ajax-pane-new-70fd4c70-563e-4b94-ae3b-2a97f3980c13' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view"><span class="highwire-journal-article-marker-start"></span><ul class="kwd-group KWD"><li class="kwd"><a href="/keyword/bupropion" class="hw-term hw-article-keyword hw-article-keyword-bupropion" rel="nofollow">bupropion</a></li><li class="kwd"><a href="/keyword/smoking-cessation" class="hw-term hw-article-keyword hw-article-keyword-smoking-cessation" rel="nofollow">smoking cessation</a></li><li class="kwd"><a href="/search/%20text_abstract_title%3Aseizures%20text_abstract_title_flags%3Amatch-phrase%20sort%3Apublication-date" class="hw-term hw-article-keyword hw-article-keyword-seizures" rel="nofollow">seizures</a></li><li class="kwd"><a href="/search/%20text_abstract_title%3Asudden%2Bdeath%20text_abstract_title_flags%3Amatch-phrase%20sort%3Apublication-date" class="hw-term hw-article-keyword hw-article-keyword-sudden-death" rel="nofollow">sudden death</a></li><li class="kwd"><a href="/search/%20text_abstract_title%3Apost-marketing%2Bsurveillance%20text_abstract_title_flags%3Amatch-phrase%20sort%3Apublication-date" class="hw-term hw-article-keyword hw-article-keyword-post-marketing-surveillance" rel="nofollow">post-marketing surveillance</a></li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="https://thorax.bmj.com/content/60/10/848.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup footnotes" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section fn-group" id="fn-group-1"><h2>Footnotes</h2><ul><li class="fn" id="fn-1"> <p id="p-22"> <strong>Published Online First 29 July 2005</strong> </p> </li><li class="fn" id="fn-2"> <p id="p-23">This project was funded by the British Lung Foundation and the Wellcome Trust.</p> </li><li class="fn" id="fn-3"> <p id="p-24">Competing interests: RH is a member of The Health Improvement Network (THIN) advisory group. JB has received an honorarium from a third party organisation but originating from GlaxoSmithKline (the producers of bupropion) for speaking at an invited conference on smoking cessation management guidelines in 2002, and also received consulting fees from the manufacturers of nicotine replacement therapy and other novel smoking cessation therapies.</p> </li><li class="fn" id="fn-4"> <p id="p-25">RH, JB and LS were responsible for the main study hypothesis and RH, SL, CS, CG, LS, PF and JB were responsible for the detailed study design and were applicants on the British Lung Foundation grant. The analysis was performed by RH, JW, SL, PF and CS. All authors contributed to the writing of the paper and all authors have had access to all of the data in the study.</p> <p id="p-26">Work attributed to Division of Epidemiology and Public Health, Nottingham University.</p> </li></ul></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-atom bmjj-linked-articles" id="linked-articles"> <h2 class="pane-title">Linked Articles</h2> <div class="pane-content"> <div class="highwire-atom-data-bmjj-linked-articles field field-highwire-atom-data field-label-hidden clearfix"><div class="field-items"><div class="highwire-list highwire-atom-data-list"><ul><li class="first last odd">Airwaves<div class = "highwire-article-citation bmjj-article-citation"><div class="highwire-cite"><div class="highwire-cite-title"><a href="/content/60/10/793.2" class="bmjj-linked-article" data-icon-position="" data-hide-link-title="0">Airwaves</a></div> <div class = "highwire-cite-authors"><div class="highwire-citation-authors"><span class="highwire-citation-author">Wisia Wedzicha</span> </div></div><div class="highwire-cite-metadata bmjj-citation-metadata"><span class="highwire-cite-metadata-journal highwire-cite-metadata">Thorax </span><span class="highwire-cite-metadata-year highwire-cite-metadata">2005; </span><span class="highwire-cite-metadata-volume highwire-cite-metadata">60 </span><span class="highwire-cite-metadata-pages highwire-cite-metadata">793-793 </span><span class="highwire-cite-metadata-date highwire-cite-metadata"><span class="label"> Published Online First:</span> 28 Sep 2005. </span></div></div></div></li></ul></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-template-bmjj-challenge article-login" > <h2 class="pane-title">Read the full text or download the PDF:</h2> <div class="pane-content"> <div class="panel-display three-layout " id="mini-panel-jnl_template_bmjj_challenge"> <div class="panel-row-wrapper row"> <div class="left-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane pane-add-to-cart" > <div class="pane-content"> <span class="highwire-foxycart-add-to-cart-ahah highwire-foxycart-add-to-cart-ahah" data-text="Buy this article (%short-price)" data-apath="/thoraxjnl/60/10/848.atom" data-type="link" data-font-icon="" data-parent-id="136040"></span> </div> </div> </div> </div> </div> <div class="middle-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-middle"> <div class="inside"><div class="panel-pane pane-bmjj-article-subscribe-button" > <div class="pane-content"> <a href="/subscribe" class="btn btn-default btn-lg" data-icon-position="" data-hide-link-title="0">Subscribe</a> </div> </div> </div> </div> </div> <div class="right-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-right article-login"> <div class="inside"><div class="panel-pane pane-custom pane-3" > <div class="pane-content"> <button type="submit" class="btn btn-default btn-lg" id="sign-in" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false" aria-hidden="true">Log in <svg class="icon icon-white icon-arrow-down"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/sites/default/themes/bmjj/img/defs.svg#icon-arrow-down"></use></svg></button> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-challenge-opportunity-pane-dropdown" > <div class="pane-content"> <div class="panel-display panel-1col clearfix" id="mini-panel-challenge_opportunity_pane_dropdown"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-society-logins society-logins" > <div class="pane-content"> <span class="ui-button ui-state-default ui-dialog-titlebar-close" title="close"></span><div class="shib-login-link"><a href="/login/shibboleth?subcode=bmjjournals&env=prod&uri=https%3A//thorax.bmj.com/accallback/content%25252F60%25252F10%25252F848" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via Institution</a></div><div class="openathens-login-link"><a href="https://openathens-sp.highwire.org/session/init?entityID=https%3A//idp.eduserv.org.uk/openathens&hw-shib-return-uri=https%3A//thorax.bmj.com/accallback/content%25252F60%25252F10%25252F848&subcode=bmjjournals" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via OpenAthens</a></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-opportunity-challenge" > <div class="pane-content"> <div class='opportunity-challenge-login'><h3>Log in using your username and password</h3><div class="drupal-login compact"><form action="/content/60/10/848" method="post" id="highwire-user-login" accept-charset="UTF-8"><div><div id="edit-customtext" class="form-item form-item-label-before form-type-item"> <span class="customtext">For personal accounts OR managers of institutional accounts</span> </div> <div class="form-item form-item-label-invisible form-type-textfield form-item-name"> <label class="element-invisible" for="edit-name">Username <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Username" type="text" id="edit-name" name="name" value="" size="30" maxlength="60" class="form-text required" /> </div> <div class="form-item form-item-label-invisible form-type-password form-item-pass"> <label class="element-invisible" for="edit-pass">Password <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Password" type="password" id="edit-pass" name="pass" size="30" maxlength="128" class="form-text required" /> </div> <input type="hidden" name="form_build_id" value="form-LTJJGdm0DdyG82zkmFGry4MOUNtbRhaQS2s8KJuymu4" /> <input type="hidden" name="form_id" value="highwire_user_login" /> <div class="bmjj-reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot your log in details?</a><a href="/user/register?destination=node/146297" class="" data-icon-position="" data-hide-link-title="0">Register a new account?</a></div><div class="form-actions form-wrapper" id="edit-actions"><input type="submit" id="edit-submit" name="op" value="Log in" class="form-submit" /></div><div class="reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot</a> your user name or password?</div></div></form></div></div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div>  </div> </div> </div> </div> </div> </div> </div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-template-bmjj-challenge article-login col-narrow-12 clear hidden" > <h2 class="pane-title">Read the full text or download the PDF:</h2> <div class="pane-content"> <div class="panel-display three-layout " id="mini-panel-jnl_template_bmjj_challenge-1"> <div class="panel-row-wrapper row"> <div class="left-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane pane-add-to-cart" > <div class="pane-content"> <span class="highwire-foxycart-add-to-cart-ahah highwire-foxycart-add-to-cart-ahah" data-text="Buy this article (%short-price)" data-apath="/thoraxjnl/60/10/848.atom" data-type="link" data-font-icon="" data-parent-id="136040"></span> </div> </div> </div> </div> </div> <div class="middle-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-middle"> <div class="inside"><div class="panel-pane pane-bmjj-article-subscribe-button" > <div class="pane-content"> <a href="/subscribe" class="btn btn-default btn-lg" data-icon-position="" data-hide-link-title="0">Subscribe</a> </div> </div> </div> </div> </div> <div class="right-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-right article-login"> <div class="inside"><div class="panel-pane pane-custom pane-4" > <div class="pane-content"> <button type="submit" class="btn btn-default btn-lg" id="sign-in" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false" aria-hidden="true">Log in <svg class="icon icon-white icon-arrow-down"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/sites/default/themes/bmjj/img/defs.svg#icon-arrow-down"></use></svg></button> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-challenge-opportunity-pane-dropdown" > <div class="pane-content"> <div class="panel-display panel-1col clearfix" id="mini-panel-challenge_opportunity_pane_dropdown-1"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-society-logins society-logins" > <div class="pane-content"> <span class="ui-button ui-state-default ui-dialog-titlebar-close" title="close"></span><div class="shib-login-link"><a href="/login/shibboleth?subcode=bmjjournals&env=prod&uri=https%3A//thorax.bmj.com/accallback/content%25252F60%25252F10%25252F848" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via Institution</a></div><div class="openathens-login-link"><a href="https://openathens-sp.highwire.org/session/init?entityID=https%3A//idp.eduserv.org.uk/openathens&hw-shib-return-uri=https%3A//thorax.bmj.com/accallback/content%25252F60%25252F10%25252F848&subcode=bmjjournals" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via OpenAthens</a></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-opportunity-challenge" > <div class="pane-content"> <div class='opportunity-challenge-login'><h3>Log in using your username and password</h3><div class="drupal-login compact"><form action="/content/60/10/848" method="post" id="highwire-user-login--2" accept-charset="UTF-8"><div><div id="edit-customtext--2" class="form-item form-item-label-before form-type-item"> <span class="customtext">For personal accounts OR managers of institutional accounts</span> </div> <div class="form-item form-item-label-invisible form-type-textfield form-item-name"> <label class="element-invisible" for="edit-name--2">Username <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Username" type="text" id="edit-name--2" name="name" value="" size="30" maxlength="60" class="form-text required" /> </div> <div class="form-item form-item-label-invisible form-type-password form-item-pass"> <label class="element-invisible" for="edit-pass--2">Password <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Password" type="password" id="edit-pass--2" name="pass" size="30" maxlength="128" class="form-text required" /> </div> <input type="hidden" name="form_build_id" value="form-zdzuzhHhC1rtCOMh7h2d3qXFTUVDcKaVGjtjx8bdJGE" /> <input type="hidden" name="form_id" value="highwire_user_login" /> <div class="bmjj-reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot your log in details?</a><a href="/user/register?destination=node/146297" class="" data-icon-position="" data-hide-link-title="0">Register a new account?</a></div><div class="form-actions form-wrapper" id="edit-actions--2"><input type="submit" id="edit-submit--2" name="op" value="Log in" class="form-submit" /></div><div class="reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot</a> your user name or password?</div></div></form></div></div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div>  </div> </div> </div> </div> </div> <a href="#" id="article-bottom"></a> </div> <div class="col-narrow-1 mobile-hidden back-top" id="back-top"> <div class="panel-panel panel-region-left"> <div class="inside" id="back-top-inner"><div class="panel-pane pane-bmjj-back-to-top article-go-to-top" > <div class="pane-content"> <a href="#block-system-main" class="back-to-top" data-icon-position="" data-hide-link-title="0"><svg class="icon-article icon-arrow-up-top" aria-hidden="true"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/sites/default/themes/bmjj/img/defs.svg#icon-arrow-up"></use></svg></a><a href="#article-bottom" class="back-to-top back-to-bottom" data-icon-position="" data-hide-link-title="0"><svg class="icon-article icon-arrow-up-top" aria-hidden="true"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/sites/default/themes/bmjj/img/defs.svg#icon-arrow-down"></use></svg></a> </div> </div> </div> </div> </div> </div>  <div class="panel-row-wrapper panel-row-last row" id="article-bottom-row"> <div class="bottom-wrapper col-narrow-12"> <div class="panel-panel panel-region-bottom"> <div class="inside"><div class="panel-pane pane-snippet pane-footer-marketing-slots" > <div class="pane-content"> <div class="snippet footer-marketing-slots" id="footer-marketing-slots"> <div class="snippet-content"> <iframe data-src="https://jobs.bmj.com/widget/bootstrap/job/#i=191" class="optanon-category-3" id="mdgxWidgetiFrame" title="careers widget"></iframe> <script type="text/javascript" src="//trendmd.s3.amazonaws.com/trendmd.min.js"></script> <script type="text/plain" class="optanon-category-4">TrendMD.register( {journal_id: 42811, element: '#trendmd-suggestions', track_id: null} );</script> <div id="trendmd-suggestions"></div> </div> </div> </div> </div> </div> </div> </div> </div>  </div> </div> </div> </div> </div> </div> </div> </div> </section>  </div>  <footer role="contentinfo" class="section section-footer container-fluid" id="footer"> <section class="zone zone-footer row footer-journal-societies"> <div class="region region-footer col-narrow-12"> <div class="region-inner region-footer-inner"> <div class="region region-footersoc"> <div id="block-panels-mini-footer-society-images" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-footer_society_images"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-societies-logos" > <div class="pane-content"> <ul><li><a href="http://www.brit-thoracic.org.uk/"><img src="https://resources.bmj.com/repository/journals-network-project/images/society-logos/society-logo-bts.png" alt="British Thoracic Society" /></a></li></ul> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </section> <section role="contentinfo" class="section section-footer"> <div class="zone zone-footer footer-links"> <nav class="row"> <div class="region region-footerlinks1"> <div id="block-menu-block-1" class="block block-menu-block" class="block block-menu-block"> <div class="content"> <div class="menu-block-wrapper menu-block-1 menu-name-menu-footer-menu-1 parent-mlid-0 menu-level-1"> <ul class="menu"><li class="first expanded menu-mlid-14800 col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Content</a><ul class="menu"><li class="first leaf menu-mlid-14801"><a href="/content/early/recent" class="" data-icon-position="" data-hide-link-title="0">Latest content</a></li> <li class="leaf menu-mlid-14802"><a href="/content/current" class="" data-icon-position="" data-hide-link-title="0">Current issue</a></li> <li class="leaf menu-mlid-14803"><a href="/content/by/year" class="" data-icon-position="" data-hide-link-title="0">Archive</a></li> <li class="leaf menu-mlid-14804"><a href="http://thorax.bmj.com/pages/browse-by-topic/" class="" data-icon-position="" data-hide-link-title="0">Browse by collection</a></li> <li class="leaf menu-mlid-14805"><a href="https://thorax.bmj.com/pages/VISUAL-ABSTRACTS" class="" data-icon-position="" data-hide-link-title="0">Visual Abstracts</a></li> <li class="leaf menu-mlid-14806"><a href="http://thorax.bmj.com/pages/most-read-articles/" class="" data-icon-position="" data-hide-link-title="0">Most read articles</a></li> <li class="leaf menu-mlid-14807"><a href="http://thorax.bmj.com/pages/top-cited-articles/" class="" data-icon-position="" data-hide-link-title="0">Top cited articles</a></li> <li class="last leaf menu-mlid-14808"><a href="http://thorax.bmj.com/eletters" class="" data-icon-position="" data-hide-link-title="0">Responses</a></li> </ul></li> <li class="expanded menu-mlid-14809 col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Journal</a><ul class="menu"><li class="first leaf menu-mlid-14810"><a href="http://thorax.bmj.com/pages/about/" class="" data-icon-position="" data-hide-link-title="0">About</a></li> <li class="leaf menu-mlid-14811"><a href="http://thorax.bmj.com/pages/editorial-board/" class="" data-icon-position="" data-hide-link-title="0">Editorial board</a></li> <li class="leaf menu-mlid-14812"><a href="https://myaccount.bmj.com/myaccount/signup.html?regService=etoc-alerts&corpusCode=thoraxjnl&fwdUrl=https://thorax.bmj.com/" class="" data-icon-position="" data-hide-link-title="0">Sign up for email alerts</a></li> <li class="leaf menu-mlid-14813"><a href="http://journals.bmj.com/site/subscribe/?thorax" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Subscribe</a></li> <li class="last leaf menu-mlid-14814"><a href="http://thorax.bmj.com/pages/thank-you-to-our-reviewers/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Thank you to our reviewers</a></li> </ul></li> <li class="expanded menu-mlid-14815 col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Authors</a><ul class="menu"><li class="first leaf menu-mlid-14816"><a href="http://thorax.bmj.com/pages/authors/" class="" data-icon-position="" data-hide-link-title="0">Instructions for authors</a></li> <li class="leaf menu-mlid-14817"><a href="http://mc.manuscriptcentral.com/thorax" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Submit an article</a></li> <li class="leaf menu-mlid-14818"><a href="http://authors.bmj.com/policies/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Editorial policies</a></li> <li class="leaf menu-mlid-14819"><a href="http://openaccess.bmj.com/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Open Access at BMJ</a></li> <li class="last leaf menu-mlid-14820"><a href="http://authors.bmj.com/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">BMJ Author Hub</a></li> </ul></li> <li class="last expanded menu-mlid-14821 col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Help</a><ul class="menu"><li class="first leaf menu-mlid-14822"><a href="http://thorax.bmj.com/pages/contact-us/" class="" data-icon-position="" data-hide-link-title="0">Contact us</a></li> <li class="leaf menu-mlid-14823"><a href="http://journals.bmj.com/cgi/reprintform" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Reprints</a></li> <li class="leaf menu-mlid-14824"><a href="http://www.bmj.com/company/products-services/rights-and-licensing/permissions" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Permissions</a></li> <li class="leaf menu-mlid-14825"><a href="http://www.bmj.com/company/contact-us/advertising-sponsorship/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Advertising</a></li> <li class="last leaf menu-mlid-14826"><a href="http://myaccount.bmj.com/myaccount/customerservice/salesforce-form.html" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Feedback form</a></li> </ul></li> </ul></div> </div> </div> </div> </nav> <div class="row"> <nav class="col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"> <div class="region region-footersocial"> <div id="block-panels-mini-social-icons" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-social_icons"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-social-icons" > <div class="pane-content"> <ul class="menu"><li class="leaf"><a href="http://thorax.bmj.com/pages/rss-feeds" class="link-icon-only link-icon"><span class="icon icon-rss"></span><span class="title element-invisible"> RSS</span></a></li><li class="leaf"><a href="http://twitter.com/ThoraxBMJ" class="link-icon-only link-icon"><span class="icon icon-twitter"></span><span class="title element-invisible"> Twitter</span></a></li><li class="leaf"><a href="http://www.facebook.com/Thorax.BMJ" class="link-icon-only link-icon"><span class="icon icon-facebook"></span><span class="title element-invisible"> Facebook</span></a></li><li class="leaf"><a href="http://blogs.bmj.com/thorax" class="link-icon-only link-icon"><span class="icon icon-blog"></span><span class="title element-invisible"> Blog</span></a></li><li class="leaf"><a href="https://thoraxbmj.podbean.com/" class="link-icon-only link-icon"><span class="icon icon-soundcloud"></span><span class="title element-invisible"> Soundcloud</span></a></li></ul> </div> </div> </div> </div> </div> </div> </div> </div> </nav> </div> </div> </section> <section class="row footer-platform"> <div class="col-mobile-12 col-narrow-4 logoBMJ"> <a href="http://www.bmj.com/company"><svg class="logo-bmj-svg" aria-hidden="true"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#logo-bmj"></use><svg></svg></svg></a> </div> <div class="col-mobile-12 col-narrow-8 legal"> <div class="legal-inner"> <ul> <li><a href="http://www.bmj.com/company/legal-information/">Website Terms & Conditions</a></li> <li><a href="http://www.bmj.com/company/your-privacy/">Privacy & Cookies</a></li> <li><a href="http://www.bmj.com/company/contact-us/">Contact BMJ</a></li> </ul>  <button id="ot-sdk-btn" class="ot-sdk-show-settings">Cookie Settings</button>  <p><small><span class="online-issn issn">Online ISSN: 1468-3296</span><span class="print-issn issn">Print ISSN: 0040-6376</span></small><br /> <small>Copyright 漏 2024 BMJ Publishing Group Ltd & British Thoracic Society. All rights reserved.</small></p> </div> </div> </section> <div class="region region-absolute-bottom"> <div class="region-inner region-absolute-bottom-inner"> <div class="region region-absolute-bottom"> <div id="block-panels-mini-bottom-ad" class="block block-panels-mini text-center" class="block block-panels-mini text-center"> <div class="content"> <div class="panel-display one-layout " id="mini-panel-bottom_ad"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-dfp-pane" > <div class="pane-content"> <div id="dfp-ad-bottom-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-bottom" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-bottom"); }); </script> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </footer> <script type="text/javascript" src="/sites/default/files/advagg_js/js__xcXbPzItgCxLeD5Uy3L62U87U9ne3iv4g12sHKvzY80__MQ39WNLMHbEWS9SH5grYUB74j6iCxSoGMz9-a66u8_E__UK4XtEDKdMc0Gs7HNCE9o0vU2f7Fe9vzuvoxMxYgoFA.js"></script> <script type="text/javascript" src="/sites/default/files/advagg_js/js__Jd5dsvNznZMdglFu8sSni1wCsUfzvQbApHPAZwt5TY4__65Mqa1DMRwcSvPxjJEn6BXgMm-ckF3oOvkUTG9HRADI__UK4XtEDKdMc0Gs7HNCE9o0vU2f7Fe9vzuvoxMxYgoFA.js" defer="defer"></script> <script type="text/javascript" src="/sites/default/files/advagg_js/js__3YMnGGenZXx95e2d4w4qdZ8l2Nb4ScWnb6eRd_RG1Rk__bLDjtRazOW5NHwJqxd6XFtHApU0Yj0Keahi0hcnwqJ4__UK4XtEDKdMc0Gs7HNCE9o0vU2f7Fe9vzuvoxMxYgoFA.js"></script> </body> </html>