Testing a Full Substitution Therapy Approach As Treatment of Tobacco Dependence

Inclusion Criteria:

• Meet DSM-IV criteria for nicotine dependence with FTND score > 5.
• Smoke at least 15 cigarettes (3/4 pack) daily (averaged over 1 week, in the past 1 month).
• At the time of initial evaluation, are motivated to quit smoking in the next 30 days.
• Have made at least one unsuccessful attempt to quit smoking in the past year.
• At baseline, have expired breath CO level > 10.
• Are between ages 18-70 years old.
• Weigh at least 100 lbs (45.5 kg, selegiline dose < 0.22 mg/kg).
• No previous use of nicotine replacement products in the one month prior to randomization.
• Have the capacity to give informed consent, and are English-speaking.

Exclusion Criteria:

• Have present or past diagnoses of schizophrenia, bipolar disorder, PTSD, BPD or major depressive illness.
• Have abused alcohol or other drugs of abuse (cocaine, opiates, benzodiazepines, etc) in 6 months prior to randomization into the trial (based on clinical evaluation including self-report, and confirmed by positive urine).
• Demonstrate serious medical conditions (i.e. abnormal liver function [as evidenced by AST, ALT or bilirubin values 2x ULN], unstable cardiovascular disease, significant blood abnormalities).
• Exhibit or have history of clinical hypertension.
• Exhibit active peptic ulcer disease.
• Are pregnant, are trying to become pregnant, or are currently breastfeeding.
• Are on current medication regimes that include antidepressants, or sympathomimetic agents, or meperidine and other meperidine-opioids which may have interactions with selegiline.
• Known hypersensitivity to selegiline or NRT.
• Are from the same household as another study participant.