FAQ - Anti-smoking medication
About varenicline (Champix®)
Question: After trying to quit several times, I would like to speak to my doctor about Champix®. It seems to work well. My boyfriend is very supportive and wants to marry me, but he would like his wife and the future mother of his children to be a non-smoker. I already find it so hard to spend an evening with friends or have a drink without smoking. How can Champix® help me, how does it work, and what are the main pros and cons? Also, how much does it cost?
Response: Champix® can certainly be a useful medicine, especially if you do not suffer from depressive tendencies. It costs the same as smoking 1 packet of 20 cigarettes every day for 3 months.
In the first week, you increase the dose progressively. You stop smoking on the 8th day and you continue to take Champix® every morning and evening for 2 to 6 months.
Champix® contains varenicline, a molecule which resembles nicotine, which attaches itself to the same receptor in the limbic system and which blocks this receptor without producing a pleasurable feeling like nicotine does. In addition, the nicotine from cigarettes no longer produces pleasure either, so you can get over your addiction...
The side effects are predominantly feelings of nausea, which should disappear over the course of the first week, and abnormal dreams (not nightmares). You seem to have well thought-out reasons for wanting to use Champix®, so you just need to take the plunge to see whether it suits you. You will be surprised to see that cigarettes are no longer such an important part of your life. The enjoyment you gain from smoking is a pleasure on demand - artificial and short-lived - which will soon be replaced by more real and interesting forms of enjoyment. But don't just take our word for it - try it for yourself! Being prepared to eliminate the artificial enjoyment of smoking from your life is the best thing you can do for your physical and mental health.
Question: Why does Zyban® need to be taken for between 8 and 9 weeks? What happens if you stop taking it before then?
Response: It was established that Zyban® treatment should last 8-9 weeks after numerous studies showed that this period covered the time required for physical withdrawal from nicotine and its consolidation.
Disrupted sleep, i.e. waking up and falling straight back to sleep frequently during the night, is a known side effect of Zyban®. To reduce this effect, you are advised to take the second tablet early on in the afternoon and not in the evening, provided there is at least an 8-hour interval between the first and second tablet of the day.
You are advised not to drink alcohol while taking Zyban® because Zyban® accentuates its effects. In other words, you will become inebriated after drinking a smaller quantity of alcohol than usual.
Lastly, if you decide to reduce your dosage of Zyban® to 1 tablet per day, you will notice that the side effects diminish considerably. It can be a good idea to reduce your dosage of Zyban® in certain cases, and don't worry - the treatment will still be just as effective. In the worst case scenario, if you continue to be tempted to smoke cigarettes and find that you can barely resist lighting up again, it can be possible to prolong your treatment period a little.
Question: Can bupropion (Zyban®) be dangerous?
Response: In the past, certain information about Zyban® in the media has given rise to public concern. Regarding the different results and controversies reported in the press, Dr. J.-P. Humair gives the following opinion:
The recent announcement of the death risks caused by Zyban® in the UK is a typical example of the type of distortion of information concerning health that often occurs in the press. In this case, the statistic "57 deaths during or after taking Zyban®" was changed into a more catchy "57 deaths due to Zyban®".
Having examined the sources of the statistics by reviewing the available data regarding Zyban®, I would like to offer the following clarifications:
The 57 deaths were only reports of the deaths of people who were taking or had recently taken this medication received by the British regulatory agency for medicines
Such reports are part of the normal procedure regarding the regulation of medicines, and more of them are always received following the introduction of a new medicine.
These deaths are the subject of an investigation which has so far demonstrated no causality between Zyban® and these deaths
Most of the deceased already had an illness which explains their death, a high number of which were due to smoking
Even people who had stopped smoking (with or without Zyban®) may have developed a new disease due to smoking, because the risks diminish only gradually over a number of years
None of the studies carried out so far have revealed a difference between the number of deaths occurring among those taking Zyban® and those taking a placebo
This medication has been used to aid smoking cessation in the USA and Canada for at least 5 years without ever having been proven to have caused a death. The same applies to Wellbutrin®, which contains a higher dose of the same substance and is used to treat depression
Even if these deaths were attributable to Zyban® (which is not at all the case), the risk of death would still be negligible (57/400,000 ie. 0.014%) in comparison with the enormous risk of death from smoking, which stands at 50%!
Lastly, it is worth pointing out that the media are often more concerned about selling their information than they are about public health, even if this means throwing the public into a panic. In addition, the impartiality of the press on the subject of smoking is highly questionable given that they are financially dependent on the tobacco industry thanks to the revenue they receive from advertising.
Question: I would like to know, is Clonidine effective for smoking cessation?
Clonidine is used first and foremost as a hypotensor (for lowering blood pressure).
There are some existing studies that show Clonidine to be effective for smoking cessation. However, the rate of effectiveness is comparable to that of other methods, i.e. nicotine replacements and buproprion.
Clonidine can produce considerable side effects, such as dizziness with high blood pressure, a dry mouth and sleeplessness. Furthermore, it is not a recognized means for quitting smoking, at least not in Switzerland and probably not anywhere in Europe. In conclusion, Clonidine has the same efficacy rate as other methods but it is blighted by several side effects and should not be used for smoking cessation except as a last resort, when all other methods have proved ineffective. Even then, Clonidine should only be taken if you are otherwise in good health and if your doctor agrees to prescribe it for this particular purpose.