Chantix Safe for Quitting Smoking? Alternatives?


Results from a new study of over 40,000 people suggest that the worries about side effects of Chantix may be greatly exaggerated. (Remember the debunking of concerns about MSG, that turned out to be mostly manufactured by the media and rumors?) I'm not thrilled with the idea of an antidepressant for quitting smoking, but many people have used it successfully, despite the millions that drug manufacturer Pfizer has paid out over claims against Chantix.

If you prefer an alternative, and just deciding to quit is not enough, I write about them below. 

But first, the pro-Chantix theories as to why so many people have sued deserve an airing. From the article from Psychiatric News. "When Psychiatric News asked Mann why he thinks thousands of varenicline users have reported adverse psychiatric effects, he replied, 'People who smoke have more pronounced aggressive and impulsive traits—smoking is associated with suicidal behavior and mood change—[and] sometimes the side effects or adverse effects reported are due to nicotine withdrawal or the loss of the cognitive-enhancing effects of nicotine.' Mann also noted that when any medication receives negative media attention for adverse events, clinicians are more likely to inquire about these side effects, and patients are more likely to report them. 'Some reports are due to the patient being alert to the possibility [of a side effect] and [thus] more likely to report its occurrence, and sometimes the person feels that they have the complication, but objective examination fails to confirm this,' Mann said." The article goes into more detail. For example, many people using Chantix to quit were also on a number of other medications or had mental health conditions. People with mental illnesses are a good deal more likely to smoke, and to smoke more.

However, the article also points out that there is not enough high-quality research to have the level of certainty needed about Chantix. 

Here are some alternatives to consider:

Just doing it. Many people succeed after multiple quit smoking attempts. Many of them do it on the spur of the moment. They didn't psych themselves up--they were just ready. Others make a lot of preparation. There are plenty of books and articles on that subject.

Electronic cigarettes. Since nicotine does not cause the harm (other than addiction) associated with cigarettes, you can keep the nicotine (and any psychological benefits referred to as cognitive enhancement) and even have the ritual of smoking--but without the emphasema, cancer, heart disease, diabetes, and smelly hair and clothes. Nice! They are said to be less costly than cigarettes. You probably want to use a weak or medium cartridge, though, because many people are taking in more nicotine than they intend to with full-strength cartridges.

Other nicotine sources: The patch and gum are well-known alternatives. They are more expensive and have their own pros and cons that are thoroughly discussed in articles online. 

Counseling or coaching. The research on this doesn't show long-term quit rates that are much better than just reading about quitting, calling a quit line, or talking with your doctor. This seems counter-intuitive to me--but there's too much evidence to deny. I will say though, that there is not yet a body of research on using methods such as EMDR to desensitize relapse triggers. I have reason to believe that this, at the minimum, can help with initial quitting. It probably also help long-term. A self-help form of relapse prevention that involves the same kind of desensitization provides even more help in the long run. I use this kind of approach with people that are quitting drugs, alcohol, and smoking, and I teach them to apply it to themselves. I call it shimmering, just because no one else gave it a popular type of name.

If you or a loved one is trying to quit, best of luck! Consider your options and keep experimenting. You can succeed. Electronic cigarettes are a win against smoking-related diseases, which are a far more urgent concern than addiction to nicotine. Desensitizing your relapse triggers is an option that can be used along with any and all the alternatives, including Chantix.