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01.12.2015 | Study protocol | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Examination of the mechanism of action of two pre-quit pharmacotherapies for smoking cessation

BMC Public Health > Ausgabe 1/2015
Stuart G. Ferguson, Julia A. E. Walters, Wenying Lu, Gudrun P. Wells, Natalie Schüz
Wichtige Hinweise

Competing interests

SGF has worked as a consultant for pharmaceutical companies on matters relating to smoking cessation. This project is supported by a researcher-initiated project grant from Pfizer (through the GRAND initiative) awarded to SGF.

Authors’ contributions

SGF conceived the study. SGF, JAEW and NS were involved in the initial discussions that led to the grant application, writing of the study protocol and participated in the study design. SGF devised the statistical analysis plan. WL designed the urine analyses. All authors contributed to the draft of the manuscript. All authors read and approved the final version of the manuscript.



There is substantial scope for improvement in the current arsenal of smoking cessation methods and techniques: even when front-line cessation treatments are utilized, smokers are still more likely to fail than to succeed. Studies testing the incremental benefit of using nicotine patch for 1–4 weeks prior to quitting have shown pre-quit nicotine patch use produces a robust incremental improvement over standard post-quit patch treatment. The primary objective of the current study is to test the mechanism of action of two pre-quit smoking cessation medications—varenicline and nicotine patch—in order to learn how best to optimize these pre-quit treatments.


The study is a three group, randomized, open-label controlled clinical trial. Participants (n = 216 interested quitters) will be randomized to receive standard patch treatment (10 weeks of patch starting from a designated quit day), pre-quit patch treatment (two weeks of patch treatment prior to a quit day, followed by 10 weeks post-quit treatment) or varenicline (starting two weeks prior to quit day followed by 10 weeks post-quit). Participants will use study-specific modified smart-phones to monitor their smoking, withdrawal symptoms, craving, mood and social situations in near real-time over four weeks; two weeks prior to an assigned quit date and two weeks after this date. Smoking and abstinence will be assessed at regular study visits and biochemically verified.


Understanding how nicotine patches and varenicline influence abstinence may allow for better tailoring of these treatments to individual smokers.

Trial registration

Australian New Zealand Clinical Trials Registry, ACTRN12614000329​662 (Registered: 27 March 2014).
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