A Pilot Study to Determine the Feasibility and Utility of Implementing of the Full Scale TOM Trial

The protocol is a small scale pilot of the full-scale TOM trial, and it will utilize a placebo design and incorporates 4 treatment arms. In the Vanguard Protocol all participants are to complete a 4 week run-in with Advair 100/50, followed by randomization to 1 of 4 arms of study treatment. The 4 drug treatment combinations are (2 inhalers, 2 pills): * Advair 250/50, Placebo, Placebo, Placebo * Advair 100/50 and montelukast, Placebo, Placebo * Advair 100/50 and theophylline, Placebo, Placebo * Advair 100/50 and ipratropium, Placebo, Placebo The 24 week treatment phase will be followed by a 4 week washout period on Advair 100/50. There is no crossover.