The work adapts interventions that have been successful in the general populations, and tailors them to chronic smokers, who may have numerous previous smoking treatment failures. If successful it will: (1) make available a treatment intervention that produces hight long term abstinence rates; (2) provide information on variables that predicts success and failure in this population of smokers; (3) examine the cost-effectiveness of more intensive, longer term treatments.
Subjects (N=400) will be men and women (50%) over the age of 18 who smoke at least 10 cigarettes per day and answers yes to the question "Do you smoke within 30 minutes of arising?" Inclusion Criteria: -Subjects are age 18 and over, currently smoking 10 or more cigarettes per day, and report a smoking history of at least 5 years in response to the question "How long have you been a regular smoker?" Exclusion Criteria: * History of seizure or head injury resulting in unconsciousness * Any condition that might predispose to seizures (brain tumor or stroke) * A current or history of anorexia nervosa or bulimia * Any disease acutely life-threatening or so severe that the patient is judged unable to comply with the protocol * Use of a protease inhibitor of MAO inhibitor within the last two week * Current use of psychiatric drugs that would interfere with interpretation of study results, including antidepressants * Treatment for alcohol dependence during the last year, or evidence of alcohol abuse so severe that the patient is judged potentially unable to comply with the protocol * Patients who know they are leaving the Bay Area within the study period and non-English speakers will be excluded * Suicidal or homicidal ideation * Current major depression * History of bipolar disorder * Recent (within twelve months) myocardial infarction * Any other medical condition that would contraindicate use of NRT or bupropion * Physical limitation so severe that participation in a program of moderate exercise is not possible * Pregnancy or lactation
are designated in this study
of being blinded to the placebo group