Smoking Alternative Blog

Antismoking drugs go up in smoke

Anti-smoking treatments claim to offer a way to help smokers kick the habit, but how effective are they really?

For millions of frustrated smokers, drug makers promise to help them quit with a little pill. But studies from the companies themselves don’t show very promising results. “The drugs are approved because they’ve shown in FDA studies that they’re better than placebo,” said Dr. Edward Levin, a psychopharmacological researcher at Duke University Medical Center in Raleigh, N.C. “But being better than placebo doesn’t take a whole lot, so there really is room for improvement.”

Pfizer’s Chantix is said to be the most effective therapy in quitting smoking, according to test results from a company-funded study conducted by Dr. Douglas Jorenby of the University of Wisconsin School of Medicine and Public Health. During the 12 weeks that patients were on the drug, less than half were able to quit smoking.

The long view

But a more important figure to look at is Chantix’s success rate when the patient stops using it after 12 weeks, according to Pfizer’s recommended dosage. The number of smokers who have still quit after a year falls by half to roughly one in four, compared with one in ten who were on a placebo.

“The patient may have to go through this quitting process many times,” said Dr. Martina Flammer of Pfizer, senior medical director of the Chantix global medical team. “It is inherent of the nature of nicotine addiction that the patient may actually relapse.”

Dr, Jorenby’s study, published in 2006 in The Journal of the American Medical Association, found that Chantix is better than Zyban, which had a weaker success rate: 14.6% of smokers had still quit after one year compared with 10.3% for placebo. “Most people in the field would agree that there is room for improving,” says Jorenby.

Risks and side-effects

Anti-smoking drugs carry serious health risks of their own. The Food and Drug Administration safety labels for Chantix and Zyban both carry warnings related to suicide. Chantix’s label was updated in January to include a warning of “suicidal ideation and suicidal behavior” associated with the drug. Zyban is the same drug as Glaxo Smith Kline’s Wellbutrin, an antidepressant. Like other antidepressants, it carries a warning of “suicidal thinking and behavior” in children, adolescents and young adults.

The market for these drugs is growing, despite the risks and skepticism about their effectiveness and safety. Research firm Datamonitor projects that the prescription market for anti-smoking therapies, worth $213 million in 2006, will balloon to $4.6 billion by 2016. This is in addition to the $2 billion market for nicotine replacement therapies, like inhalers and gum.

Smokers quit an average of eight to 11 times, according to the American Legacy Foundation, an anti-smoking group. Chantix appears to be the best quit smoking drug, even though the odds of quitting permanently are still stacked against them.

According to Dr. David Gonzales, co-director of the Smoking Cessation Center at the Oregon Health & Science Center in Portland; Smokers shouldn’t have “false expectations” about Chantix and other drugs, which aren’t completely effective because they address only the physiological parts of the addiction, not the behavioral, according to Gonzales.  “There’s nothing out there now that you can take that will make you not smoke,” said Gonzales, “That’s what people think these drugs do, but they don’t do that. The drugs do a reasonable job with suppressing withdrawal, but they don’t teach people how not to smoke.”

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