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Chantix: Stop-smoking medication to help you quit

Does Chantix work?

While only a few studies have been performed, results show Chantix works better than a sugar pill (placebo) at helping smokers quit. Researchers found more people were able to remain smoke-free with Chantix. Participants reported reduced withdrawal signs and symptoms and reduced pleasure from smoking. In addition to medication, participants in the studies also received weekly counseling to help them quit.

Treatment with Chantix for 12 weeks also appears to work better than bupropion, though longer term results have been mixed. One study found that Chantix worked better than bupropion for the first 24 weeks. Another study found Chantix worked better than bupropion or a placebo for up to a year after participants quit smoking. In addition, researchers have found that Chantix was more effective than the nicotine patch in helping smokers stop smoking.

Chantix hasn't been compared with other nicotine replacement products, such as the nicotine nasal spray, lozenge or gum, in research studies.

While these results sound promising, keep in mind that the majority of participants taking Chantix in studies didn't quit smoking. About 44 percent remained smoke-free for the first 12 weeks of the studies. The percentage of smokers who were smoke-free a year after quitting with Chantix was about 23 percent in the largest clinical trials.

It's also important to remember that the people participating in these research studies received counseling from trained health professionals in addition to medication. Such counseling improves the likelihood of quitting smoking over just taking medication.

What side effects have been reported with Chantix?

Participants in clinical trials reported side effects, including:

  • Nausea
  • Headache
  • Vomiting
  • Gas
  • Insomnia
  • Vivid, abnormal dreams
  • Changes in the way food tastes

Most side effects may lessen as your body adjusts to the medication and the withdrawal of nicotine. Taking Chantix after eating and with a full glass of water may reduce the risk of nausea.

The Food and Drug Administration (FDA) issued an advisory in 2008 that health care professionals, those taking Chantix, and the families of those taking Chantix should be alert to and monitor for changes in mood and behavior in people taking Chantix. Signs and symptoms may include anxiety, nervousness, tension, depressed mood, unusual behaviors, and thinking about or attempting suicide. To date, no evidence of a direct connection between taking varenicline and these symptoms has been shown. However, if you're taking the medication, you and your family need to remain alert for these signs and symptoms. People taking Chantix should report changes in mood and behavior to their doctor immediately.

The FDA also advises that people taking Chantix may experience impaired ability to drive or operate heavy machinery. Because of this the Federal Aviation Administration has added Chantix to its list of prohibited drugs for pilots and air-traffic controllers.

Don't take Chantix if you are pregnant or are planning to become pregnant, or if you're breast-feeding. Chantix hasn't been studied in these situations, so it isn't clear if it's safe for these women.

People with kidney problems and those on dialysis may need to have a lower dose of Chantix, so discuss this with your doctor.

Quitting smoking may alter the effects of certain medications and supplements on your body. Tell your doctor about all the medications and supplements you're taking, especially if you're taking asthma medicines or blood thinners.

Should you consider Chantix?

For your best chance at quitting smoking with Chantix, you must be committed to your goal. Chantix and other stop-smoking aids do increase the likelihood that you'll quit smoking, but they don't make quitting easy. Most smokers try many times to quit. Most try many different medications and other strategies, such as counseling, before they finally succeed. Counseling can play a key role in your effort to stop smoking. Telephone quit lines have been shown to provide effective counseling for those trying to quit smoking and are provided as a free service in every state in the United States. Calling 800-QUIT-NOW (800-784-8669) will connect you with a telephone counselor in your state.

Quitting smoking is very difficult and requires planning and persistence, but it can be done. Talk to your doctor about your many options for quitting smoking, including counseling. Together you can decide what stop-smoking medication or strategy might be best for you.

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References
  1. Chantix (prescribing information). New York, N.Y.: Pfizer Labs; 2008. http://media.pfizer.com/files/products/uspi_chantix.pdf. Accessed Dec. 11, 2008.
  2. Treating tobacco use and dependence: 2008 update. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat2.chapter.28163. Accessed Dec. 10, 2008.
  3. Gonzales D, et al. Varenicline an alfa-one-beta-two nicotinic acetylcholine receptor partial agonist, vs. sustained-release bupropion and placebo for smoking cessation. Journal of the American Medical Association. 2006;296:47.
  4. Jorenby DE, et al. Efficacy of varenicline, an alfa-four-beta-two nicotinic acetylcholine receptor partial agonist, vs. placebo or sustained-release bupropion for smoking cessation. Journal of the American Medical Association. 2006;296:56.
  5. Tonstad S, et al. Effect of maintenance therapy with varenicline on smoking cessation. Journal of the American Medical Association. 2006;296:64.
  6. Nides M, et al. Varenicline versus buproprion SR or placebo for smoking cessation: A pooled analysis. American Journal of Health Behavior. 2008;32:664.
  7. Aubin H-J, et al. Varenicline versus transdermal nicotine patch for smoking cessation: Results from a randomized open-label trial. Thorax. 2008;63:717.
  8. Information for healthcare professionals: Varenicline (marketed as Chantix). U.S. Food and Drug Administration. http://www.fda.gov/CDER/Drug/InfoSheets/HCP/vareniclineHCP.htm. Accessed Dec. 11, 2008.
  9. Public health advisory: Important information on Chantix (varenicline). U.S. Food and Drug Administration. http://www.fda.gov/CDER/Drug/advisory/varenicline.htm. Accessed Dec. 11, 2008.
  10. Anti-smoking medicine Chantix banned. Federal Aviation Administration. http://www.faa.gov/news/updates/?newsId=56363. Accessed Dec. 11, 2008.
  11. Hays JT, et al. Varenicline for tobacco dependence. The New England Journal of Medicine. 2008;359:2018.
  12. Hays JT, et al. Efficacy and safety of varenicline for smoking cessation. The American Journal of Medicine. 2008;121:S32.
  13. Halperin AC, et al. Impact of symptoms experienced by varenicline users on tobacco treatment in a real world setting. Journal of Substance Abuse Treatment. 2008;9:1.
  14. Hays JT. The risk-benefit balance of varenicline for smoking cessation. Journal of Thoracic Oncology. 2008;3:949.
  15. Dale LC (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 19, 2008.

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Jan. 6, 2009

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