Anyone who's been listening to our podcast or reading our blog for any length of time (even just last week's post on the use of texting to help people quit the smoking habit) knows I'm rabidly anti-smoking. So what gives with the headline? Turns out a medication marketed as "Chantix," chemical name varenicline, actually increases the risk of cardiovascular events when taken to assist cigarette smoking cessation efforts. Yikes. Just when you thought you were doing something good for your body as well as those around you.
This study, published in the Canadian Medical Association Journal, is a meta-analysis of 14 of our favorite type of clinical trial (double-blind, placebo controlled, prospective, randomized), where study participants who smoked or used smokeless tobacco either used Chantix to assist their quitting attempt or not. The studies contained data on cardiovascular events, including ischemia, arrhythmia, congestive heart failure, sudden death, or cardiovascular-related death.
The study concluded that use of Chantix for variable lengths of time ranging from 7 weeks to 52 weeks resulted in a 72% increased risk for a serious cardiovascular event or complication. Hmmmm. Rick attempts to be balanced in his interpretation of the data by admitting that we don't know how the quitting attempt impacts on cardiovascular disease risk related to not smoking anymore, but that's provided the quit attempt is both successful and durable. Big ifs, as anyone who's witnessed smoking cessation efforts will attest. Recidivism is high amongst smokers, with the majority continuing to smoke or returning to the practice in short order. My guess is that the aggregate benefit of stopping smoking may not balance against the real and immediate risk of Chantix.
I argue that previous research we've covered over the years establishes the efficacy of a multifaceted approach to smoking cessation. Cognitive behavioral therapy, support groups, nicotine replacement, and perhaps use of a medication are known to offer the best chance for successful quitting. Last week's post also describes another ingenious insertion to this constellation of strategies with utilization of texting to support and encourage those attempting to stop smoking. In view of the demonstrated risks of Chantix, why not make a quit attempt by harnessing all the horses and leaving this particular medication by the wayside? There are other, although admittedly less effective medication choices, but my own predilection is if a serious, comprehensive approach is taken to stop smoking, success without this particular drug is likely.
Genuflecting to both Rick and one of the study's authors who is here at Johns Hopkins, Sonal Singh, I must reveal that both of them say this data doesn't absolutely close the door on Chantix. Rather, they agree, people who chose to use Chantix should be apprised of the risks and benefits and allowed to make their own choices. Clearly, continuing to smoke is the most dangerous choice of all.
Other topics this week include (speaking of choices) what women can do to reduce their risk of sudden cardiac death, the appropriateness of stent placement, and the dangers of rural hospitals, all in JAMA. Until next week, y'all live well.
It Might be Dangerous to Quit Smoking,4 Comments