Smoking Cessation Trial in Recurrent Acute Pancreatitis and Chronic Pancreatitis

Exclusion Criteria

• •Age \< 18 years
• •Ongoing acute pancreatitis or prior episode of pancreatitis in previous 30 days
• •No desire to quit smoking
• •Currently undergoing smoking cessation intervention (i.e. nicotine replacement therapy, varenicline, counseling, bupropion).
• •Known allergic reactions to varenicline or bupropion SR
• •History of seizures
• •History of an eating disorder (anorexia or bulimia)
• •Closed head trauma with any loss of consciousness or amnesia in the last 5 year
• •Ever history of closed head trauma with \> 30 minutes of loss of consciousness or amnesia or resulting in skull fracture or subdural hematoma/brain contusion
• •Ever history of alcohol withdrawal
• •Ever history of chronic kidney disease (creatine clearance \< 30 mL/minute)
• •Liver impairment (i.e. history of cirrhosis) with aminotransferase elevation ≥ 2 times the upper limit of normal and/or alkaline phosphatase elevation ≥ 2 times the upper limit of normal.
• •History of bipolar disorder or psychosis
• •Ongoing or recent use (prior 14 days) of any monoamine oxidase inhibitors (isocarboxazid, phenelzine, tranylcypromine, selegiline).
• •Regular use of potent CYP2B6 inhibitors (i.e. clopidogrel, ticlopidine)
• •Regular use of CYP2D6 substrates with narrow therapeutic indices (e.g. flecainide, propafenone, tricyclic antidepressants such as nortriptyline, thioridazine, vinblastine)
• •History of acute angle closure glaucoma
• •Meet criteria for depression as assessed by the Center for Epidemiologic Studies - Depression (CES-D) with a score of 16 or higher.
• •Psychiatric hospitalization within 1 year of screening
• •Participants who have a score of 3 or higher on the Columbus-Suicide Severity Rating Scale (C-SSRS) at enrollment or during any of the study assessments will be excluded
• •Unable to provide consent for self Incarcerated
• •Pregnant females. All female patients of childbearing potential must have a negative pregnancy test and must agree to use highly effective (failure rate \<1%) contraception during participation in the study.