Quitting cigarette addiction

Messing With Your Head

Every time I see a gaggle of smokers standing around the entrance to an office building I feel profoundly grateful that I’m not out there with them.

I used to be one of them – a slave to the habit. And without question, quitting cigarette addiction was the healthiest thing I’ve ever done. It was also one of the HARDEST things I’ve ever done. And I know I wouldn’t have succeeded without the daily support of my husband.

But my husband can’t be there to help everyone stop smoking, so I guess that’s why Pfizer developed Chantix – only the second smoking cessation drug with FDA approval that doesn’t use nicotine.

No nicotine – that’s sounds good. But after reading the details (and reading between the lines), you might wonder why any clear thinking person would choose this regimen over a non-pharmaceutical method.

The old switcheroo

Before we look at Chantix (holding it at arm’s length so we don’t get any on us), I’ll tell you a little secret about that other FDA-approved non-nicotine smoking cessation drug.

It’s called Zyban and it’s been on the market since 1997. But its active ingredient has actually been around quite a bit longer, going by the name Wellbutrin, an antidepressant that has a history of increased seizure risk when used in high doses, according to the National Alliance on Mental Illness. You have to wonder how many smokers out there are trying to quit by using Zyban, completely unaware that they’re actually taking a powerful antidepressant.

Ah, but there’s more. The Zyban information flyer warns: “Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior.” And according to the Wellbutrin web site, the “most common side effects” with Wellbutrin XL include skin rash, sweating, stomach pain, anxiety, dizziness, trouble sleeping, nausea, sore throat and fast heartbeat.

Classic! The cure might be worse than the habit.

In the pleasure center

Nicotine binds to certain brain receptors, prompting a release of dopamine in the brain’s pleasure centers. This creates the sensation that cigarette smokers chase relentlessly. Chantix binds to the same brain receptors, blocking the nicotine and the pleasant sensation. The drug also cuts cigarette cravings by slowing dopamine release.

Studies show that this method works on a little over 20 percent of smokers who take Chantix for a year. Only 16 percent of Zyban users were successful over the same test period. And Chantix was even more effective in a 12-week test, although the subjects’ long-range success in quitting for good was not monitored.

And of course, there were side effects. Chantix will launch later this year, but Pfizer has already put up a Chantix web site that lists these side effects as the most common: nausea, constipation, gas, vomiting and changes in dreaming. (I wonder if “changes in dreaming” is a sly euphemism for “nightmares.”)

But that list just gets things started. There are quite a few side effects listed as “frequent,” including diarrhea, gingivitis, chest pain, back pain, dizziness, anxiety, depression, emotional disorder, polyuria (excessive urination), menstrual disorder and hypertension.

And then there’s this intriguing note: “Fewer than 1 out of 1,000 patients reported euphoria in clinical trials with Chantix.” Euphoria? Hmm sounds like a little dopamine might be slipping through to the pleasure centers for a few blissfully happy Chantix users.

Creating an aversion

In the December 2000 HSI Members Alert, we told you about a botanical called Plantago Major. About 15 years ago, Dr. Mary Cody, a physician and researcher, found that Plantago Major creates a natural aversion to tobacco when inhaled or ingested.

In a 1992 study, 24 heavy smokers were given Plantago Major tincture in a nasal spray and then instructed to smoke. More than 80 percent of the subjects reported an aversion to tobacco shortly after receiving the dose, and the effect lasted as long as 24 hours for some of the subjects.

Dr. Cody’s Plantago Major formula was patented shortly after that trial and is now available as a product called CIG-NO, which is sprayed under the tongue and creates an almost immediate reduction in cigarette cravings, with no reported side effects. You can find more information at cigno.com.

In the e-Alert “Tool Time” (8/17/05), I told you about CIG-NO and several other methods that HSI members (including myself) have used to quit smoking. You can find that e-Alert on our web site at hsionline.com.

“FDA OKs Pfizer Anti-Smoking Pill” Associated Press, 5/11/06, ap.org