Kicking the habit: Reported Chantix risk shouldn't deter smokers from quitting

Our view: Reported Chantix risks are troubling, but smokers should still try to quit

July 06, 2011

News that a popular prescription medication that helps smokers kick the habit may carry an increased risk of heart attack and other cardiovascular problems shouldn't discourage tobacco users from trying to quit. The long-term health benefits of quitting are undisputed, while the dangers of continuing to puff away are both deadly and well-documented. If one method of stopping is found to be unsafe, smokers will still have a wide variety of other remedies to turn to.

The study published Monday by Johns Hopkins researcher Dr. Sonal Singh found that Chantix, an anti-smoking drug that had sales of $755 million last year, carries a statistically significant increase in the risk for a heart attack or other serious heart problems in healthy, middle-aged smokers. Since one of the chief benefits of quitting is to reduce the risk of cardiovascular disease, Dr. Singh noted, taking the drug increases smokers' risk for the very type of problems they are trying to avoid.

This isn't the first time Chantix, which works by blocking the brain's pleasure receptors from nicotine, has been criticized for possible harmful side effects. Two years ago, the federal Food and Drug Administration ordered Pfizer, the drug's manufacturer, to put labels on its product warning of possible psychiatric effects, including depression, mood swings and increased risk of suicide. But the drug has remained a best-seller because it markedly decreases users' desire to smoke, thus making quitting easier.

The latest research also underscores a finding earlier this year by the FDA that Chantix increased the risk of heart problems in smokers who already had cardiovascular disease, albeit by a smaller amount. Pfizer, the drug's manufacturer, has disputed those claims, saying the sample the study was based on was too small to be representative. The company plans to conduct a new analysis of clinical trials with the FDA on whether Chantix poses heart risks; meanwhile, officials continue to insist that their product is safe.

Some researchers have called on Pfizer to take Chantix off the market until the results of those trials are in next year. But physicians don't have to wait until then to suggest alternative therapies to their patients who want to quit, including over-the-counter nicotine patches, lozenges and gum and prescription medications such as Nicotrol and Zyban. Prevention experts say a combination therapy of counseling and medications is more effective than either drugs or counseling alone.

The worst thing that could come from this study would be for smokers to conclude that the risks of trying to quit are somehow equivalent to the risks of continuing to smoke. The long-term consequences of smoking are so serious that almost anything people can do to rid themselves of the habit is better than doing nothing — for some individuals, perhaps even accepting the higher risk of Chantix. Decisions on how to quit should be made in consultation with a doctor, but smokers should make no mistake that it is imperative that they do. The FDA estimates smoking kills 1,200 people a day, and the American Heart Association calls it the nation's No. 1 preventable cause of premature deaths. The annual toll it takes in lives and on an overstressed health care system is both unaffordable and unsustainable.

Last month, the FDA ordered cigarette manufacturers to label their products with graphic new warnings depicting smoking's gruesome long-term health effects. It's a not-so-subtle attempt to scare people straight by confronting them with what they're doing to their bodies every time they light up. That may be enough for some people, but most will need more help. Smokers need to remember that even if Chantix turns out not to be a miracle drug, there are other methods that may be just as effective.

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