Tobacco Treatment Optimization and Preferences During Concurrent Cancer Treatment

Varenicline therapy will be 12-week course. On days 1-3 participants will receive 0.5mg once daily; days 4-7 receive 0.5mg twice daily and day 8 until the end of treatment receive 1mg twice daily.

Patients will begin with a dose of 150 mg every morning for 3 days. Then dosage will increase to 150 mg twice daily (morning and evening), for a total daily dose of 300 mg, for 7 to 12 weeks.

Nicotine replacement therapy (NRT) patches will be used daily from 1-10 weeks depending on participant's smoking history.

A study coordinator or a member of the treatment team will provide a minimum level of initial counseling, approximately 10-20 minutes in length.

A counselor will provide eight sessions in the first 8 weeks of the study. Up to three follow up sessions over the next 4 months of study will be encouraged, but not required.

Participants in this group will not receive per required need nicotine replacement therapy.

Participants in this group will receive per required need nicotine replacement therapy.