Effects of Smoking Environments on Craving and Smoking (CameraCue2.0)
Condition: Cigarette Smoking
Study type: Interventional

Summary: 
      The goal of this study is to evaluate the effects of varenicline versus nicotine replacement
      versus placebo on personal smoking environment cue (PSE) reactivity. The results of this
      study will inform whether first-line pharmacotherapies for nicotine dependence (e.g. nicotine
      patch, varenicline) alter reactivity to environment cues. The investigators propose to
      identify 120 regular cigarette smokers who will complete 10 visits (1 screening visit, 1
      training visit, 1 camera turn-in 2 cue exposure sessions and 4 post-quit medication check
      sessions). Smokers will be randomized to one of three medication conditions: placebo (PLAC;
      n=40), transdermal nicotine patch (NRT; n=40) or varenicline (VAR; n=40) in a double blind,
      double-dummy design. Reactivity variables (craving, latency to smoke, and smoke intake) will
      be entered into 3 (Medication: NRT, VAR, PLAC) x 2 (Environment: smoking, nonsmoking)
      repeated measures ANOVAs with random-effects. The investigators hypothesize that personal
      smoking, as compared to nonsmoking environments, will be associated with greater reactivity
      (i.e. increased craving and smoke intake; decreased latency to smoke). A Medication x
      Environment interaction will be characterized by decreased reactivity to smoking as compared
      to nonsmoking environments in the VAR and NRT groups as compared to the PLAC group.
    


Intervention name(s): Nicotine Patch; Varenicline; Placebo Nicotine Patch; Placebo Capsule
Intervention type(s): Drug; Drug; Drug; Drug
Intervention description(s): Participants will wear 21mg/day patches for days 1-14. After day 14, participants will make a quit attempt continue to wear the 21mg/d patches for 6 weeks, then step down to 14mg/d patches for 2 weeks and finally step down 7mg/d for the last 2 weeks of treatment. Participants will also take a placebo capsule. During days 8-14, participants will undergo 2 cue-exposure sessions.; Varenicline (VAR) will be administered by titrating to steady state levels over a 7 day induction period (.5 mg once daily in Days 1-3; .5 mg twice daily on Days 4-7 and 1 mg twice daily on Days 8-14). Participants will continue on 1mg twice daily until the end of treatment (days 15-84). Participants will also wear a placebo patch. During days 8-14, participants will undergo 2 cue-exposure sessions.; In the PLAC group, participants will receive placebo patches and placebo capsules for 14 days prior to quitting smoking. They will then switch to wearing a nicotine patch the morning of their quit day in order to provide them with the minimum standard of care. During days 8-14, participants will undergo 2 cue-exposure sessions.
In the VAR group, participants will wear a placebo patch while taking varenicline.; In the PLAC group, participants will receive placebo patches and placebo capsules for 14 days prior to quitting smoking. They will then switch to wearing a nicotine patch the morning of their quit day in order to provide them with the minimum standard of care. During days 8-14, participants will undergo 2 cue-exposure sessions.
In the NRT group, participants will take a placebo capsule while wearing nicotine patches.
Other intervention name(s): NicoDerm CQ; Chantix
Intervention MeSH terms: Nicotine; Varenicline
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Basic Science