Chantix: There are better ways to stop smoking

As if smokers don’t have it hard enough, it turns out that a new drug heavily advertised as a way to help smokers kick the habit poses serious health risks, ranging from aggressive behavior to suicide. And, as we reported previously, cigarette makers aren’t making quitting any easier. After years of decline, adult smoking rates have recently hit a plateau, possibly because tobacco companies have ramped up their marketing campaigns and cigarettes these days appear to have more nicotine than they used to.

The new risks, detailed in a study released on May 21st by the independent Institute for Safe Medication Practices, focus on the anti-smoking drug varenicline (Chantix). Last year Pfizer spent nearly $64 million advertising the drug directly to consumers, with considerable success. Sales of the medication reached close to $765 million in 2007. But based on the new report and other recent concerns, we think everyone taking Chantix should talk to their doctor about safer alternatives.

The Institute’s findings help clarify the risks of Chantix, which the Food and Drug Administration has previously hinted at. The new report links the medication not only to aggression and suicide but also an increased risk of falls, potentially lethal heart problems, seizures, skin reactions, psychosis, and vision problems. The Institute found that the FDA received 988 reports associated with use of the drug in the last quarter of 2007, more than with any other drug during that same time period.

Those concerns underscore several issues we’ve long emphasized:

• Smokers need safe, effective ways to quit. The smoking cessation strategy we recommend begins by talking with a doctor or a specialist counselor, and taking medications if necessary. Over-the-counter and prescription nicotine replacement products are proven to be safe. The antidepressant bupropion (Zyban and generic) also seems to help by stimulating some of the same brain chemicals as cigarettes.  Be cautious, however, if you take both drugs, since the combination can make blood pressure spike.
• View all new medications with caution. The experience with Chantix over the past year is a powerful reminder of the risks new drugs can pose when they are used by a larger and more diverse population than was possible in pre-approval studies. Stick with tried-and-true medications unless a new drug offers clear advantages.
• If you experience a drug side effect, report it to your doctor and the FDA. Call your doctor if you experience any unusual symptom soon after starting a drug. You can also report suspected adverse drug events directly to the FDA’s MedWatch program.

We think that Congress should ban consumer advertising of newly-approved drugs for the first three years in order to be more certain about their safety. Our patient-safety advocates also want the FDA to make it easier for people to report their side effects. Find out more about our Prescription for Change campaign.

Comments

[mike]

There is an acupoint on the ear, which when stimulated is supposed to help the craving for cigarettes. It is at the top of the ear just under the fold. Do this each time you want a cigarette.

[Sue]

I have been taking Chantix for a couple of months. I have not completely quit but am down to 1 to 3 cigs a day and am really trying to tell myself that those are just 'habit' smoking. I seldom think about having a smoke but often think about 'taking a walk' at work, but that walk is too closely tied to having a smoke.

I have had several problems and now that I read this I think some of my anger and irritation may be related to the drug. BUT, the side effects are almost gone after about 1 month and it is worth some side effects to quit smoking. I recomend this drug to other smokers since it has helped me so much.

[natashaclarck]

There are effective ways to stop smoking like the nicotine patch, hypnosis, cold turkey, nicotine gum, avoid caffeine and other stimulants, relaxation and exercise, avoid temptation, behavior modification, progressive quitting and eat a healthy diet.

[Dennis]

I see Costco is now selling what may well be the long sought after "safe cigarette." Maybe not better than quitting but a whole lot better than smoking.

Google: electronic cigarette

http://www.costco.com/Browse/Product.aspx?Prodid=11333096&search=cigarette&Mo=1&cm_re=1_en-_-Top_Left_Nav-_-Top_search&lang=en-US&Nr=P_CatalogName:BC&Sp=S&N=5000043&whse=BC&Dx=mode+matchallpartial&Ntk=Text_Search&Dr=P_CatalogName:BC&Ne=4000000&D=cigarette&Ntt=cigarette&No=1&Ntx=mode+matchallpartial&Nty=1&topnav=&s=1

[Sam]

I have site relate to chantix .May be chantix increase depression or suicide tendency. If yes then Government has to take action against chantix…. But still there is no action. I am not agreed. Chantix is still recommended by many Doctor. I know that each drug have certain side effect. So side effect by chantix is a not big issue.

[Eileen]

I used Chantix to quit 5 months ago. I had tried everything but this worked. I had to take it on a full stomach and I did have vivid dreams, but certainly not nightmares. I think some folks may be more sensitive to drugs in general. At any rate, I would hate to see anyone discouraged from at least trying it as it can be a successful tool to quit. I like it because it is non-nicotine to begin with, unlike patches and gum that end up keeping the cravings going.

[shayna]

I have used Chantix and had side effects of nausea (which helped me not smoke, even though it was annoying), gas, weird dreams, aggression and depression. But all of these things were worth going through to quit smoking. I smoke two packs per day and felt like crap---and I'll be lucky if I dont have to use an oxygen tank (or worse) at some point in my life. So, everyone is different....but I'd hate for a few folks that unfortunately had to experience the extreme spectrum of side effects...to have their stories trumped up in a way that scares others from trying a medication that could save their lives.

[Stephanie]

I have been using Chantix now for 1 month and have gone from 1 1/2 pack per day smoker to an occasional cig. At this point, I have no doubt that I will completely quit. But, I will stay on the Chantix for a little while longer to be sure.
I have had none of the side effects mentioned. As Gene mentions, perhaps people with aggressive tendancies, or tendancies toward depression already, might be affected by the drug...?
I have tried Wellbutrin. Have tried patch and gum. This is the best so far - by far.

[gene branam]

I used Chantax for 4 months to quit my 43 year smoking smoking habit. I did not commit or entertain suicide or start falling down. I already had heart problems from smoking. I did not become depressed from using this. I most likely would still be smoking if I had not used this drug. Maybe these other people already have this problems before using the drug.

[Jesme]

RE:

"And, as we reported previously, cigarette makers aren’t making quitting any easier. After years of decline, adult smoking rates have recently hit a plateau, possibly because ... cigarettes these days appear to have more nicotine than they used to."

Not having seen the previous report, I will guess that the rise in nicotine in cigarettes "recently" was treated as a mystery at best, and as a plot by "tobacco" at worst.

In case anyone is interested, the reason for this is because in the year 2000 or so the industry began using a modified process to cure tobacco which has cut down by about 80% the most carcinogenic components of tobacco smoke (the tobacco specific nitrosamines [TSNAs], mostly NNK and NNN).

These substances are made by bacteria which, during the curing process, convert some of the nicotine in the tobacco to the (cancer causing) nitrosamines. Because that conversion has been arrested by modifying the curing process, little of the conversion takes place now ... so 80% of the nicotine that used to get converted to nitrosamines is now left in the cured leaf.

So... SUPRISE! A bit more nicotine in this case is good news ... and unavoidable. Truth be known, it has been reduced nicotine due to "light" and other cigarette modifications that may have much increased the mortality due to cancer in the last 4 decades ... because to get the same amount of nicotine smokers had to smoke a lot more cigarettes ... and it's the smoke components (principally the nitrosamines) that cause cancer ... not nicotine.

There is a lot of truth about tobacco hidden from the public, both by pro- and anti-tobacco interests. There is currently a big patent battle going on in the U.S. Court of Appeals for the Federal Circuit. The story from this aspect (“more nicotine”) is told in the court documents on this case. A small company , Star Scientific, claims patent priority on aspects of this process. See Star Scientific v. R. J. Reynolds in that court.

If Consumer Reports is truly interested in informing the public about the truth, this is a most interesting subject … and no one else will touch it. An easier way to find out details would be to contact Star Scientific ... I think they would be glad to explain this complex situation. Note: I do not work for either company.

I will be proud of Consumer Reports if they will report on what should be a noticeable, and perhaps very significant decrease in cancer deaths from smoking that will likely come over the next decade or so due to this change. I’ll also be proud if they print this sentence, and/or investigate to find the truth in what I just said. Go ahead and edit out this paragraph if you feel you must (I expect it) … the information above it is too important to sacrifice for the sake of this paragraph.

Jesme