Tailoring Varenicline to Individual Needs (TVIN Study)
Tailoring Varenicline to Individual Needs (TVIN Study)
Varenicline is a partial nicotinic agonist which acts on alpha4 beta2 nicotinic receptors. It
 is presumed to alleviate withdrawal discomfort, but also to diminish rewarding effects of
 cigarettes. The standard varenicline dosing has been formulated to avoid adverse reactions
 (primarily nausea) in sensitive clients. The downside of this cautious approach is that a
 substantial proportion of clients may be under-dosed. A blanket dose increase would
 inevitably increase the incidence of side effects, but it is likely that tailoring
 varenicline dosing to clients' needs would be safe and may further increase varenicline's
 efficacy.

 This study will recruit 200 smokers who report little change to their enjoyment of cigarettes
 and no nausea, during the first week of varenicline use. These smokers will be randomised to
 receive the standard dose plus placebo or plus individualised varenicline dose up to 5mg,
 titrated over the next week prior to their target quit day. Urges to smoke, and other
 withdrawal symptoms, experienced during the study period will be compared between groups to
 see if the tailored therapy may be useful.
Inclusion Criteria:

 -  Smoker seeking treatment

 -  Aged 18 and over

 -  Consenting to take part

 -  Report little or no change in enjoyment of cigarettes and/or nausea

 Exclusion Criteria:

 -  Pregnant or breastfeeding

 -  Have severe kidney disease

 -  Have severe heart problems

 -  Have a current psychiatric illness

 -  Are unable to fill in questionnaires in English

 -  Have an allergy to varenicline

 -  Are currently involved in another clinical trial