Varenicline in Drug Treatment

Drinking alcohol and cigarette smoking are closely associated and use of one often leads to the use of the other. Also, since tobacco-related illness is the number one cause of death among recovered alcoholics it is imperative that we provide strong evidence-based treatment options for this population. Since smoking can be a strong trigger to drink in those who are dependent on both alcohol and tobacco, treating both at the same time may result in better treatment outcomes. This study will examine the efficacy of starting smoking cessation treatment while patients are in residential treatment for alcohol dependence, or outpatient in the Alcohol Research and Treatment Clinic. It will compare the effectiveness of varenicline, the most effective medication for smoking cessation with placebo. Both groups will receive weekly cessation counselling and support by a trained research analyst. We will measure abstinence from smoking at the end of the 12-week treatment period and again after 6-months to determine longer-term smoking cessation.

Inclusion criteria

• current daily smokers enrolled in residential treatment or outpatient in Alcohol Treatment and Research Clinic for Alcohol Use Disorder at CAMH
• smoke minimum of 10 cigarettes per day
• Fagerstrom Test of Nicotine Dependence score > 3
• able to provide written informed consent
• able and willing to attend weekly appointments at the NDC following discharge

Exclusion criteria

• any serious medical condition requiring immediate investigation or treatment
• pregnancy or lactation
• current DSM-IV Axis I psychiatric disorder
• any know contraindication to using varenicline