Effectiveness of Combination Varenicline and Oral Nicotine Replacement Therapy (COMBO)

All participants will be offered a 13-week course of varenicline (including a 1 week titration period). Dosage and administration per manufacturer: 0.5mg once daily for days 1-3 and 0.5mg twice daily for days 4-7 encompass the titration period, then 1mg twice daily for 12 weeks. An additional 12 weeks of treatment is recommended for long-term abstinence.

Half of study participants will be randomly assigned to receive oral nicotine replacement therapy (4mg gum or 4mg lozenge, depending on preference; to be used every 1-2 hours as urges occur) in addition to varenicline.

Half of study participants will be randomly assigned to receive automated medication reminders via their smartphones.

All participants will be offered 6 weekly tobacco cessation counseling sessions with a Tobacco Treatment Specialist.