Achieving smoking cessation milestones in opioid treatment patients: a randomized 2 x 2 factorial trial of directly observed and long-term varenicline

PROJECT NARRATIVE Individuals with opioid use disorders use and suffer health consequences of tobacco at disproportionately high rates. Prior research suggests that opioid treatment patients can quit smoking while interventions are in place, but relapse and low medication adherence make sustained tobacco abstinence challenging. We propose to evaluate the mechanisms of two promising interventions to promote and maintain tobacco abstinence: directly observed therapy and long-term varenicline treatment. The proposed research will guide efforts to optimize medication treatment effects and reduce the burden of tobacco use among opioid treatment patients.