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Moderation by major depressive disorder history (MDD) and adherence were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Double\u2010blind double\u2010placebo\u2010controlled randomized design, stratifying by MDD, gender and nicotine dependence, with 3 and 6\u00a0months follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University offices in Rhode Island, USA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adult smokers (<jats:italic>n<\/jats:italic>\u00a0=\u00a0137), in SUD treatment, substance abstinent &lt;12\u00a0months (<jats:italic>n<\/jats:italic>\u00a0=\u00a077 varenicline, 60 NRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention and comparator<\/jats:title><jats:p>Twelve\u00a0weeks of varenicline (2\u00a0mg\/day, after 1\u2010week dose run\u2010up) or NRT (21\u00a0mg\/day decreasing to 7\u00a0mg\/day).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Primary: point\u2010prevalence smoking abstinence (7\u2010day, confirmed) at 3\u00a0months. Secondary: point\u2010prevalence abstinence at 6\u00a0months, quantity and frequency of smoking and substance use at 3 and 6\u00a0months, and within\u2010treatment abstinence, medication adherence and depressive symptoms. Smoking outcome analyses were repeated controlling for adherence and investigating adherence as a moderator.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Effects on 3\u2010month abstinence were <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.065 without a covariate (Bayes factor 3.35, supporting the effect strongly) and differed significantly when controlling for baseline smoking [varenicline: 13%, NRT: 3%; odds ratio (OR)\u00a0=\u00a04.81, 95% confidence interval (CI) 1.00, 23.13, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05]. The threefold difference at 6\u00a0months was not significant. Medication effect on abstinence across time was significant (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05) covarying adherence and baseline smoking (OR\u00a0=\u00a06.40, 95% CI\u00a0=\u00a01.00, 40.93). Medication differences in 3\u2010month abstinence occurred among participants with \u2265\u00a077% adherence (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.02). No significant medication effects on heavy drinking, drug use or depressive symptoms were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Varenicline appears to improve the chances of achieving at least 3\u00a0months of smoking abstinence in smokers with substance use disorders trying to stop, compared with transdermal nicotine patches, the effect being independent of history of depressive disorder.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.13861","type":"journal-article","created":{"date-parts":[[2017,5,12]],"date-time":"2017-05-12T14:26:58Z","timestamp":1494599218000},"page":"1808-1820","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Varenicline versus nicotine patch with brief advice for smokers with substance use disorders with or without depression: effects on smoking, substance use and depressive symptoms"],"prefix":"10.1111","volume":"112","author":[{"given":"Damaris J.","family":"Rohsenow","sequence":"first","affiliation":[{"name":"Providence Veterans Affairs Medical Center  Providence RI USA"},{"name":"Center for Alcohol and Addiction Studies Brown University School of Public Health  Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer W.","family":"Tidey","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies Brown University School of Public Health  Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemarie A.","family":"Martin","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies Brown University School of Public Health  Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne M.","family":"Colby","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies Brown University School of Public Health  Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Swift","sequence":"additional","affiliation":[{"name":"Providence Veterans Affairs Medical Center  Providence RI USA"},{"name":"Center for Alcohol and Addiction Studies Brown University School of Public Health  Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Leggio","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies Brown University School of Public Health  Providence RI USA"},{"name":"Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse  Bethesda MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter M.","family":"Monti","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies Brown University School of Public Health  Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/0-306-47939-7_23"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03530380039029"},{"key":"e_1_2_5_4_1","first-page":"205","volume-title":"Recent Developments in Alcoholism: Volume 8. 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