Nicotine as Treatment (NEAT) Trial


Compared to the general population, people undergoing alcohol and other drug (AOD) treatment have far higher rates of tobacco use, experience more difficulty quitting tobacco, and are more likely to relapse after a quit attempt. Behavioural support and nicotine replacement therapy (NRT) have been shown to help people remain abstinent from tobacco while in residential AOD treatment, however, most resume smoking after leaving residential treatment. Thus, finding ways to help people remain abstinent from tobacco after treatment would substantially improve long-term health outcomes in this population.

NRT is an effective treatment that can help reduce withdrawal symptoms and cravings and help people quit smoking. However, the effectiveness of vapourised nicotine products (VNP) with this population has received little research attention. In an earlier pilot-RCT Quit-Nic, we demonstrated that the use of VNPs for the 12-weeks following discharge from inpatient withdrawal, combined with telephone counselling, was acceptable to participants and achieved similar smoking abstinence rates as NRT plus counselling (Bonevski et al, 2021).

The NEAT trial, funded by the NHMRC and led by Prof Billie Bonevski, at Flinders University, is a randomised controlled trial (RCT) to test the effectiveness of VNPs and Quitline telephone counselling compared to NRT and Quitline counselling in helping clients cease smoking following discharge from residential withdrawal treatment in a large sample of 363 participants. The study is being run at 6 residential and inpatient withdrawal units across three states (Qld, NSW, VIC) in Australia. In this 12-week intervention, participants are randomly assigned to receive a VNP with a 12-week supply of nicotine and Quitline Support (condition 1), or a 12-week supply of NRT and Quitline Support (condition 2), when they discharge from withdrawal treatment. Participants are contacted for 3-month and 9-month follow-up interviews following their discharge to assess tobacco abstinence and other outcomes.

Project team

Turning Point team

Professor Victoria Manning, Professor Dan Lubman, Dr Joshua Garfield, Mr Hugh Piercy, Davinia Rizzo , Rachel Petukhova and Danielle Whelan.

Project partners

Professor Billie Bonevski (Flinders University), Professor Amanda Baker (University of Newcastle), Associate Professor Coral Gartner (University of Queensland), Associate Professor Natalie Walker (University of Auckland), Dr Catherine Segan (University of Melbourne), Professor Chris Bullen (University of Auckland), Dr Christopher Oldmeadow (University of Newcastle), Professor Linda Bauld (University of Edinburgh), Professor Adrian Dunlop (Hunter New England Local Health District Drug & Alcohol Clinical Services), Dr Anthony Gill (St Vincent’s, Sydney), Rose McCrohan (Uniting ReGen) and Dr David Jacka (Monash Health).

Participating sites

Turning Point Addiction Medicine Unit, Uniting ReGen and Monash Health.

Learn more about this project

For more information about this project, please refer to the protocol available at medRxiv.

The trial is registered by the Australian New Zealand Clinical Trials Registry (ANZCTR)