Please select the eligibility criteria that correspond to the clinical trial below.
Title: An Examination of the Efficacy, Safety, and Gender Differences in Using Varenicline as an Aid to Smoking Cessation in a Population of Methadone Maintained Opioid Dependent Patients (Pilot Trial)
Brief Summary: The main hypotheses guiding the study are:

1. Stable methadone maintenance patients receiving varenicline will be more likely to maintain abstinence than patients receiving placebo
2. There will be no differences in the type and number of symptoms reported between stable methadone maintenance patients receiving varenicline and placebo
3. There will be no changes in methadone dosage between abstinent and non-abstinent smokers
4. There will be no differences in efficacy, withdrawal symptoms, and safety of varenicline between male and female participants


Options:
A: Inclusion Criteria:

* Aged 18 to 65 years old
* Smoking 20 or more cigarettes per day
* Wants to stop smoking(seeking treatment)
* No period of smoking abstinence longer than 3 months in the past year
* Be able to give informed consent to participate
* Complete the study questionnaires
* Female smokers will be eligible providing they are not breastfeeding, pregnant (negative pregnancy test) or at risk of becoming pregnant

Exclusion Criteria:

* Previous use of nicotine transdermal patches or varenicline (VRN) in the last 6 months
* Cigar, pipe and oral tobacco users who do not smoke 20 or more cigarettes per day
* Those who meet the criteria contra-indicating nicotine patches or VRN use, as described in the Summaries Product Characteristics
* Those with previous severe adverse reactions to nicotine patch or to VRN
* Those currently taking either medication for smoking cessation that they are unwilling to stop or taking medication with a known influence on smoking cessation that they should not stop (e.g. nortriptyline for depression)
* Those who are non-Spanish neither Catalan speakers
* Those deemed unsuitable for the study by their smoking cessation physicians; -- Unstable diseases within the previous 6 months
* Diagnoses of or treatment for major depression last 6 months or psychotic disorder; or drug or alcohol dependence within the previous 12 months
* Skin disorders that cause a difficulty of nicotine absorption by patches as Psoriases as well as general dermatitis
* Clinically significant renal or hepatic impairment or dysfunction
* Pregnant or breast-feeding women
* women who do not use neither want to use any effective anticonceptive method.
B: Inclusion Criteria:

* Smoke 10 or more cigarettes per day
* Expired carbon monoxide (CO) level greater than 9 parts per million (ppm)
* Motivated to quit smoking (score of 3 on 4-point self-report scale)
* Willing to fulfill study requirements

Exclusion Criteria:

* Carbon monoxide breath test score below 9 ppm
* Serious psychopathology (bipolar disorder, psychosis)
* Center for Epidemiologic Studies Depression Scale CES-D)score over 16
* Contraindications for use of bupropion
* History of seizure disorder
* History of eating disorder
* Current heavy drinking
* Risk of pregnancy
* Current breastfeeding
C: Inclusion Criteria:

* Stable on methadone maintenance (an individual is considered 'stable' if they have had a 4 week constant/fixed dose of methadone by self report and verified by B.C. Pharmanet review)
* Subjects must have smoked at least 10 cigarettes per day during the past year and over the month prior to the screening visit, with no period of abstinence greater than 3 months in the past year
* Ages 19 to 75 years (inclusive) and motivated to quit smoking
* Should read and understand English
* For female subjects:

  * instructed and agrees to avoid pregnancy through 30 days after the last dose of study medication
  * has a negative urine pregnancy test at screening
  * agrees to use birth control method(s) for duration of the study
* Should be available by telephone

Exclusion Criteria:

* Subjects who have used varenicline previously or are currently on other Nicotine Replacement Therapy or pharmacotherapy for smoking cessation (e.g., nicotine patch, zyban or wellbutrin)
* Subjects who have a prior or current history of depression, bipolar affective disorder or a prior or current history of psychotic episodes or suicidal ideation (on the basis of self-report augmented by medical chart review where appropriate and/or corroborating history with previous or current health care provider)
* Subjects who have not reached a stable dose of methadone in their methadone maintenance therapy (4 weeks at a constant/fixed dose of methadone by self-report and verified by B.C. Pharmanet review)
* Pregnancy or currently nursing
D: Inclusion Criteria:

* males and females
* over age 18
* used smokeless tobacco every day for the past year (confirmed with urinary cotinine)
* residing within 100km of New Dehli for the next 4 months
* interested in quitting use of smokeless tobacco.

Exclusion Criteria:

* currently enrolled or plan to enroll in another tobacco cessation program in the next 4 months
* plan to use other smoking cessation treatments in the next 4 months
* smoke cigarettes
* have current substance abuse (e.g., opioids, cocaine, marijuana) verified by urine drug screen
* have current (last 6-months) alcohol consumption that exceeds 25 standard drinks/week (if past abuse, must be symptom free for ≥ the past 12 months)
* Current use or discontinuation within last 14 days of:

  1. smoking cessation medications (bupropion, Varenicline, NRT);
  2. antipsychotics, atypicals, mood-stabilizers, anti-depressants (tricyclics, SSRIs, MAOIs), anti-panic agents, anti-obsessive agents, anti-anxiety agents, stimulants;
  3. Anti-coagulants;
  4. Daily medication for asthma or diabetes (eligible with physician approval);
* are pregnant, planning a pregnancy, or lactating
* have a history or current diagnosis of psychosis, general anxiety disorder,bipolar disorder, or schizophrenia
* have a current diagnosis of depression (if past diagnosis, must be symptom free for ≥ the past 12 months)
* have an allergy to Varenicline
* ever contemplated or attempted suicide
* have serious/unstable disease within the past 6 months (e.g., cancer \[but melanoma\], heart disease, HIV/AIDS)
* have a history of epilepsy or seizure disorder
* have a history or diagnosis within the last 6 months of abnormal rhythms and/or tachycardia (\>100 beats/minute)
* have a history or current diagnosis of COPD; cardiovascular disease (stroke, angina); heart attack in the last 6 months; and/or uncontrolled hypertension (SBP\>150 or DBP\>90)16)
* have a history of kidney or liver failure
* have any medical condition or medication that could compromise safety as determined by a study physician
* cannot provide informed consent or complete the study tasks as determined by the Principal Investigator or study physician.

Answer: C