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Tobacco smoking is the most important risk factor for lung cancer, with a 100-fold increase in risk for smokers compared to never smokers, and continued smoking is the most important factor in sustaining a large proportion of patients with advanced lung cancer. While many studies have identified the most common risk factors for lung cancer, much less is known about how to best approach tobacco cessation counseling and treatment. We hypothesize that 1) clinically significant adverse effects are likely to be more common when attempting to quit tobacco with evidence-based pharmacotherapy (e.g., varenicline, nicotine replacement therapy, and bupropion) compared to standard behavioral therapy (e.g., counseling and nicotine replacement therapy), and 2) efficacy of pharmacotherapy will be improved with the use of adjunctive behavioral therapy. We propose a randomized trial comparing standard behavioral therapy alone with standard behavioral therapy plus either evidence-based pharmacotherapy (e.g., varenicline, bupropion) or nicotine replacement therapy. The two groups will be compared for a) the occurrence of adverse effects during the entire treatment period, b) the time to and c) the sustained abstinence rate (i.e., at the end of the entire treatment period) of smoking, and d) the relative efficacy of various medications in sustaining abstinence from smoking. Our study population will consist of current smokers at high risk for developing lung cancer (i.e., previous or present smokers who have a positive family history of lung cancer). We will enroll 200 such current smokers into this study. In each subject, the treatment will consist of a 1-month treatment phase (first randomization) followed by a 12-month follow-up period. During the initial 1-month treatment phase, the subjects will be randomized into one of three groups: 1) 5 mg/d varenicline, 2) 150 mg/d bupropion, 3) 2 mg/d transdermal nicotine patches. The efficacy and side effect profile of each medication will be assessed, and patients will be switched to the next group of medications if their condition does not improve. During the follow-up period, each subject will be followed every three months for signs of recurrence of tobacco use and assessed for adverse effects. The primary outcome of this study will be abstinence from tobacco use, and we will also assess other efficacy parameters, including time to and sustained abstinence rate of smoking.In recent years, there has been proposed a liquid crystal display device that includes a gate-line driving circuit. In the liquid 0b46394aab
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