Breaking free from nicotine: a randomised three-arm trial

Many people who smoke tobacco also use other nicotine products, like vapes, but want support to stop or reduce use of all nicotine products, especially the most harmful ones. However, we don't have any evidence about the best forms of treatment and support to assist them to do so. We aim to identify the most effective treatments for supporting people dependent on nicotine, regardless of the nicotine source. We will invite people who smoke cigarettes daily and use one or more other forms of nicotine (vapes, heated tobacco, or pouches) daily to take part in a trial comparing three different treatments: two are medications (varenicline and cytisine), and the third is tapering nicotine. Everyone will be randomly allocated to one of the three treatments and have access to additional behavioural support. The trial focus is on preventing disease, using treatments to support people to ultimately become both tobacco- and nicotine-free.