The new guidelines from the US Public Health Service arrive only a few months after the Chantix label was updated to reflectwarnings about suicidal thoughts and behavior. Althlough the guidelines mention the psychiatric risks, they also say the Pfizer drug is the most effective at helping people get off cigarettes, the Associated Press writes.
The guidelines mention other options, and recommend combined counseling and medication, but docs are encouraged to tell smokers who want to quit about trying the pill. Consumer advocates cautioned the Chantix safety picture is incomplete because it's only been available since 2006. "It is somewhat better than other therapies; on the other hand, it appears to have more risk," Sidney Wolfe of Public Citizen tells the AP. "That part of the risk-benefit equation is missing, and it's changing rapidly."
Another issue with the quit-smoking guidelines is the lead author's past connections with Pfizer. Michael Fiore, an expert on smoking and health issues, was a consultant to Pfizer, although he says he cut those ties in 2005. Three of 24 panelists who wrote the guidelines reported "significant financial interests" in the pharmaceutical industry, including speaking fees and stock ownership, the AP writes.
Fiore's views are shaped by his past ties to the drug industry, and those ties still pose a conflict, according to one consumer advocate. John Polito, a smoking cessation educator who runs the WhyQuit.com site advocating quitting "cold turkey," calls the revised guidelines "a sales pitch" for pharma.
The task force overlooked research showing that quitting cold turkey works, Polito tells the AP, and studies showing Chantix is superior don't reflect how it's used "in the real world...People are quitting smoking to save their lives," he says, adding that iff Chantix's risks outweigh its benefits, "then it's insane for people to risk their lives" by using it.
The guidelines are based on an extensive review of scientific evidence, were reviewed by 90 independent experts and endorsed by 60 public health entities, according to Fiore, who adds that his past financial ties to pharma had no influence. "Independent reviewers of it came to the conclusion that this is a document that reflects the science, and that's what we were charged to do," he tells the AP.
The guideline authors analyzed 83 studies and found that Chantix helped 33 percent stay off tobacco for six months after quitting, compared with a nearly 14 percent abstinence rate for dummy pills, the AP writes. The guidelines recommend combining counseling and medication as the most effective way to kick the tobacco habit, stating "both counseling and medication should be provided to patients trying to quit smoking."
Meds haven't been shown to be effective in certain groups, according to the guidelines. Those groups include pregnant women, smokeless tobacco users, light smokers and adolescents. The guidelines do say doc should consider asking about their patients' psychiatric history before prescribing Chantix, and should also monitor patients for changes in mood and behavior while on the drug.
Lois Biener, a researcher of tobacco use and control efforts at the University of Massachusetts in Boston, said most people who quit do so without smoking-cessation drugs. There's little evidence that these drugs are superior in the long run to quitting without help, and while a few studies have shown some benefit, it's "way less than what is claimed" by medication advocates, Biener tells the AP.