Planning to quit smoking with Chantix

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We are currently approaching the peak “New Year” season for quitting smoking – also a time when people are very busy finishing off their year-end work and participating in the holiday season. As Chantix is the newest medication designed to help people quit, and will likely be heavily advertised by Pfizer – its manufacturer, I expect hundreds of thousand of people will use it for the first time over the coming months.

However, as we have discussed at length on this forum, some concerns have emerged regarding potential adverse events relating to use of this medicine: depressive or suicidal thoughts, aggressive or erratic behavior and drowsiness.
See link for prior discussions: http://www.healthline.com/blogs/smoking_cessation/2007/11/chantix-varenicline-safety-being.html

So is this a good drug that may help save your life or a dangerous drug that may harm you? As we’ve discussed before, the evidence is clear that Chantix is effective at helping smokers quit and is typically accompanied by fairly mild side-effects (e.g. mild nausea). The concerns are over the possibility that a very small minority of Chantix users (perhaps between 0.1 and 1%) may experience the more serious side-effects mentioned above. At the moment the FDA is investigating this, but so far there is no conclusive evidence that these side effects are caused by Chantix (rather than being rarely occurring effects of stopping smoking). I therefore recommend that smokers interested in quitting should not be scared to try Chantix as the drug really does help smokers quit. But I strongly recommend that smokers planning to use Chantix should ensure that they have organized a proper quit plan, utilizing a number of support networks (e.g. telephone quitline, family etc) but very much involving the family doctor also. By this I mean that rather than simply calling in to the doctor for a prescription (or ordering it on a website), you arrange an appointment with your doctor to discuss the use of the medicine, and its potential side-effects, and that you also arrange at least one follow-up appointment with him/her within the first two weeks of starting on the medicine. If a doctor who knows you and your medical history is supporting your quit attempt and monitoring your progress it is far less likely you will be seriously affected by these potential side effects, and more likely you will succeed in quitting.

This model of quitting smoking is also precisely what is recommended by the Clinical Pratice Guideline your doctor should be following (advising doctors on the “5 As”: Ask, Advise, Assess, Assist, Arrange)
http://www.tobaccoteacher.com/5As.html

So my recommendation for people thinking of trying Chantix in the near future is that you should start planning now. This would involve making an initial appointment to see your doctor, planning a target quit date (just over a week after your doctors appointment) AND arranging an additional follow-up appointment shortly after your quit date, so your doctor can monitor progress and give advice. These steps should be taken in addition to using other assistance such as telephone quitlines and internet sites for smoking cessation, enlisting the support of family and friends, and taking other sensible behavioral steps (e.g. throwing out all your remaining tobacco the night before your quit date).

Best of luck, and have a great holiday season.
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About the Author


MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.

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