Conclusions
This randomized clinical trial in daily smokers from a smoking cessation clinic with medication choice and limited exclusion criteria found higher smoking abstinence rates among participants randomized to adaptive compared with those randomized to nonadaptive pharmacotherapy. Specifically, these findings provide support for the use of precessation varenicline and precessation nicotine patches in an adaptive treatment regimen in which bupropion is provided to treatment nonresponders. This study’s design provides greater generalizability to clinical populations. Our findings support an evolving body of literature on adaptive treatment.