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Smoking CessationBAReNikotinNCT05290025

Easy Access to Smoking Cessation for People Receiving Opioid Agonist Therapy Who Are Smoking Tobacco

A study testing Nicotine patch, Nicotine gum and Nicotine lozenge in people with Smoking Cessation and Substance-Related Disorders, run by Haukeland University Hospital at 2 sites in Norway.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Background: About 85% of those receiving opioid agonist therapy (OAT) for opioid dependence are smoking tobacco. Cigarette smoke lead to lunge diseases and cause illness and death within this group. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Nicotine patch, Nicotine gum and Nicotine lozenge
Could I receive a placebo?
No, everyone receives an active treatment
How many people
266 participants
Where
2 sitesNorway
Study dates
7 Apr 2022to Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Receiving OAT from an included outpatient clinic with weekly follow-up
  • Smoking at least one cigarette per day or seven cigarettes per week
  • Obtaining informed consent

Who cannot join

  • Allergies or prior anaphylactic reactions to medication used
  • Smoking less than three times a week

Trial locations and contacts

2 sites in 1 country.

Norway2 sites
  • Department of Addiction Medicine, Haukeland University Hospital

    Bergen, 5021

  • LAR Helse Stavanger HF

    Stavanger, 4010

Other trials in Norway

About this study

Official title: Integration of Smoking Cessation Into Standard Treatment for People Receiving Opioid Agonist Therapy Who Are Smoking Tobacco: Protocol for a Randomised Controlled Trial

Background: About 85% of those receiving opioid agonist therapy (OAT) for opioid dependence are smoking tobacco. Cigarette smoke lead to lunge diseases and cause illness and death within this group. BAReNikotin is a multicentre randomised controlled clinical trial that will test if integration of smoking cessation therapy to clinical practice at OAT-clinics will increase the rate of OAT-patients that quit smoking.

Intervention: The patients selected for the intervention arm will receive smoking cessation therapy including weekly brief behavioural interventions and prescription-free nicotine replacement products such as nicotine lozenges, patches and chewing gum for at least 16 weeks. This will be compared to a group of patients, who does not receive any help to quit smoking, apart from intial screening of smoking behaviour and advice on where to buy nicotine replacement products.

Read more

The patients will have to attend OAT outpatient clinics in Bergen and Stavanger, Norway. The main evaluation will take place 16 weeks after the start of the study.

Study population: The target group will be patients with severe opioid dependence receiving OAT from outpatient clinics in the aforementioned cities who are smoking tobacco daily.

Expected outcome: The primary goal of the study is to see how many of those patients that are offered smoking cessation treatment, that have stopped smoking or reduced the number of cigarettes smoked by at least one half by the end of the intervention. We will also investigate if quitting smoking changes the well-being, physical fitness and quality of life of the participants. If the nicotine replacement therapy is safe and efficacious, it can be considered for further scale-up.

Read the detailed description

Background: About 85% of those receiving opioid agonist therapy (OAT) for opioid dependence are smoking tobacco. Smoke-related pulmonary diseases are significant contributors to morbidity and mortality within this group. BAReNikotin is a multicentre randomised controlled clinical trial that will compare if integrated smoking cessation therapy increases the rate om smoking cessation compared to standard treatment at OAT-clinics among patients who receive OAT.

Study design: BAReNikotin is a multicentre, randomised controlled clinical trial that will recruit 266 patients receiving OAT in Bergen and Stavanger, Norway.

Intervention: The patients selected for the intervention arm will receive smoking cessation therapy including weekly brief behavioural interventions and prescription-free nicotine replacement products such as nicotine lozenges, patches and chewing gum for at least 16 weeks. This will be compared to a group of patients, who does not receive any help to quit smoking, apart from intial screening of smoking behaviour and advice on where to buy nicotine replacement products.

Study population: The target group will be patients with severe opioid dependence receiving OAT from outpatient clinics in the aforementioned cities who are smoking tobacco daily.

Expected outcome: The primary outcomes are smoking cessation verified by carbon monoxide (CO)-levels or at least a 50 % reduction in the number of cigarettes smoked. The study will assess changes in psychological well-being, impact of smoking cessation and reduction on inflammation, changes in physical health relative, quality of life and fatigue. If the integraded approach increases the number of successful cessation attempts this would be a strong argument for including smoking cessation therapy into regulart OAT-treatment.

Being tested
Nicotine patch, Nicotine gum, Nicotine lozenge, Smoking cessation counselling, Screening for use of tobacco products
Keywords
Tobacco Use Cessation Devices, Smoking Cessation, Opioid-Related Disorders, Opiate Substitution Treatment
Medical subject headings
Smoking Cessation, Substance-Related Disorders, Opioid-Related Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Nicotine patchDrug

    > 20 cigarettes per day: 21 mg nicotine/ 24 hours 10-20 cigarettes per day: 14 mg nicotine/ 24 hours 5-10 cigarettes per day: 7 mg nicotine/ 24 hours

  • Nicotine gumDrug

    Nicotine chewing gum will be available in 1 and 2 mg strengths. Patients may individually choose which strength to use. Maximum 12 chewing gums per day

  • Nicotine lozengeDrug

    Nicotine lozenges will be available in 1 and 2 mg strengths. Patients may individually choose which strength to use. Maximum 12 lozenges per day

  • Smoking cessation counsellingBehavioural

    Once a week patients are asked about progress in cessation attempt. Sigaretts smoked the last week are recorded. Goal is set for the next week. Information on typical nicotine withdrawal symptoms and ameliorating techniques.

  • Screening for use of tobacco productsOther

    At the initiation of the trial screening questions about cigarett use for the last day and week.

  • Screening for interest in smoking cessationOther

    At the initiation of the trial all smoking participants are asked if the are interested in changing their smoking habits. They are given three alternatives: will make cessation attempt; will make reduction attempt; not certain.

Study groups in NCT05290025
Study groupRoleWhat they receive
InterventionExperimentalPatients will be offered brief weekly behavioural interventions for smoking cessation and prescription-free nicotine replacement products in addidition standard opioid replacement therapy.
Receives: Drug: Nicotine patch; Drug: Nicotine gum; Drug: Nicotine lozenge; Behavioral: Smoking cessation counselling; Other: Screening for use of tobacco products; Other: Screening for interest in smoking cessation
Intitial screening onlyOtherParticipants will receive standard opioid replacement therapy. At the start of the intervention number of cigarettes smoked during the past week will be recorded. Smokers will be adviced to make a cessation or reduction attempt. Advice that nicotine replacement products ( patches, lozenges or gum) may be bought over the counter in grocery-stores and pharmacies and information about goverment home-pages giving cessation advice.
Receives: Other: Screening for use of tobacco products; Other: Screening for interest in smoking cessation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Smoking cessation

    Smoking cessation verified by CO-levels below 6 at the end of the intervention

    Measured: Mid of the intervention period 16 weeks after initiation

  2. Smoking reduction

    at least 50% reduction in number of cigarettes smoked by week 16 of the intervention

    Measured: Mid of the intervention period 16 weeks after initiation

Secondary outcomes (9)
  1. impact on inflammation -CRP

    Impact of smoking cessation/ reduction on inflammation measured with C-reactive protein in serum

    Measured: Mid of the intervention period 16 weeks after initiation

  2. impact on inflammation - leukocytes

    Impact of smoking cessation/ reduction on inflammation measured with total leukocyte count in blood

    Measured: Mid of the intervention period 16 weeks after initiation

  3. Number of cigarettes smoked

    If primary outcomes are not reached the daily number of cigarettes smoked is recorded

    Measured: Mid of the intervention period 16 weeks after initiation

  4. CO-levels in exhaled air

    If primary outcomes are not reached the CO levels in the exhaled air is recorded

    Measured: Mid of the intervention period 16 weeks after initiation

  5. Psychological distress

    Changes in psychological well-being will be assessed with the Norwegian validated translation ten item version of Hopkins Symptom Checklist (SCL-10)

    Measured: Mid of the intervention period 16 weeks after initiation

  6. Fatigue Symptom Scale

    Changes in fatigue will be assessed with the Fatigue Symptom Scale (FSS-3)

    Measured: Mid of the intervention period 16 weeks after initiation

  7. Physical functioning

    Physical functioning assessed with 4-minute step-test measuring number of steps climbed in period

    Measured: Mid of the intervention period 16 weeks after initiation

  8. Health-related quality of life

    Changes in health-related quality of life will be assessed with EuroQoL EQ-5D-5L

    Measured: Mid of the intervention period 16 weeks after initiation

  9. Health-related quality of life

    Changes in health-related quality of life will be assessed with self-reported question on happiness on a 0 to 10 scale

    Measured: Mid of the intervention period 16 weeks after initiation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Mar 2022
  2. Study start7 Apr 2022
  3. Primary completion31 Oct 2023
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants randomised to the intervention arm will receive an individually tailored plan for smoking cessation or reduction of number of cigarettes smoked. Smoking cessation treamtent consist of brief behavoiural interventions and provision of prescription-free nicotin patches, nicotine lozenges or nicotine gum. Participants will collect the medication for smoking cessation once a week in parallel with delivery of OAT medication. Medication is individually packed for each patient and one week's use. Staff handing out the medication will give the patients a brief intervention asking about how they are progressing in their smoking cessation attempt, how much the patient smoked the day before and if they took the medication as planned. At mid of the intervention period around week 16 (12-20 weeks after intervention initiation), treatment effect measures will be collected
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
266 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05290025
Sponsor's protocol ID
155386/ REK-B
Acronym
BAReNikotin
Status last verified
Jun 2024
First submitted
31 Jan 2022
Last updated
28 Jun 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Druckrey-Fiskaaen KT, Madebo T, Daltveit JT, Vold JH, Furulund E, Chalabianloo F, Gilje Lid T, Fadnes LT. Integrated Nicotine Replacement and Behavioral Support to Reduce Smoking in Opioid Agonist Therapy: A Randomized Clinical Trial. JAMA Psychiatry. 2025 Apr 1;82(4):406-414. doi: 10.1001/jamapsychiatry.2024.4801.

    PubMed 39937506
  • Druckrey-Fiskaaen KT, Madebo T, Daltveit JT, Vold JH, Furulund E, Lid TG, Fadnes LT. Update of statistical analysis plan for: Integration of smoking cessation into standard treatment for patients receiving opioid agonist therapy who are smoking tobacco: protocol for a randomised controlled trial (ATLAS4LAR). Trials. 2024 Jan 6;25(1):29. doi: 10.1186/s13063-023-07894-w.

    PubMed 38184633
  • Druckrey-Fiskaaen KT, Furulund E, Daltveit JT, Vold JH, Lid TG, Madebo T, Fadnes LT; ATLAS4LAR Study Group. Integration of smoking cessation into standard treatment for patients receiving opioid agonist therapy who are smoking tobacco: protocol for a randomised controlled trial (ATLAS4LAR). Trials. 2022 Aug 17;23(1):663. doi: 10.1186/s13063-022-06560-x.

    PubMed 35978355

Questions about this trial

What is this clinical trial studying?

A study testing Nicotine patch, Nicotine gum and Nicotine lozenge in people with Smoking Cessation and Substance-Related Disorders, run by Haukeland University Hospital at 2 sites in Norway.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 28 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Smoking cessation (time frame: Mid of the intervention period 16 weeks after initiation). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05290025, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jun 2024; AzTrials last refreshed its copy on 7 Nov 2026.

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