Thursday, May 8, 2008

New Smoking Cessation Guidelines

Yesterday, the 2008 smoking cessation guidelines were released. A companion piece in JAMA reviews some of the highlights. Though this is the first update in 8 years for treating the single leading cause of preventable death in the United States, the media has been pretty quiet. The few mentions concern the recommendations to use Chantix despite recent warnings about the drug, as well as the guideline's author's previous ties to Pfizer who happens to make Chantix.

I have blogged previously about the recent Chantix warnings and media hype surrounding this. The drug was not initially studied in patient with mental health disorders. These patients were excluded from initial studies, especially since Chantix was compared in these studies to bupropion, which is also used to treat depression. After the drug came to maker, there were reports of changes in behavior, agitation, depressed mood, suicidal ideation, and suicidal behavior. These things also happen when you stop smoking, so the link between Chantix and neuropsychiatric symptoms is not clear. The warning is appropriate, but mostly for people who have mental health disorders or who may be at risk. The benefit of Chanitx seems to outweigh any of these concerns.

With regards to the author's finacial ties to the industry, it should be noted that Dr. Fiore is one of the leading experts on smoking cessation, and wrote the previous 2000 guideline, well before Chantix was even being developed (he cut ties with Pfizer several years ago).
The real news is not Chantix side effects or conflict of interest, but there is more and more evidence that treatments for smoking cessation work!

Things you should know if you smoke:
1. Chantix has been shown to be the most effective agent for smoking cessation.
2. Quit lines have been proven to be beneficial. They are completely free!!! Call 1-800-QUITNOW
3. The guideline offers more treatment options then before, especially in regards to combination of medications. There were two things shown to be better than the patch alone: Chantix and patch plus as needed gum or spray.

1 comment:

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