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Sofia Kosmetatos / The Detroit News Jo Ann Ritch nursed a smoking habit for 45 years before quitting last month. She kicked her two-pack-a-day addiction five days after she started taking Chantix, Pfizer's new prescription medicine to help smokers quit. "I was totally amazed," Ritch, 61, of St. Clair Shores said of the power of Chantix to cut her cigarette cravings. She's since been spreading the word to her smoking friends and co-workers. The "wonder drug," as Ritch calls it, offers new hope for thousands of longtime smokers who have struggled to break free from one of the strongest addictions known to medicine. With more cities and counties banning smoking in public places, more private businesses implementing smoke-free campuses, more employers charging smokers extra for health insurance and with the price of cigarettes climbing, the pressure is on for smokers to give up their cigarettes. And Chantix, which went on the market last summer after approval by the Food and Drug Administration in May, appears to give many of them more of a fighting chance to succeed. Existing anti-smoking aides -- such as the nicotine patch and gum, and even an antidepressant sold as Zyban -- have been helping smokers quit for years, but research indicates Chantix works better. The drug's early success among Metro Detroit smokers also suggests it's a winner, local doctors and coordinators of stop-smoking programs said. They say while Chantix won't work for everyone, it could be the answer for many smokers, especially those who have tried to quit. "We're very excited about having this medication," said Dr. Ayman Soubani, a pulmonologist who practices at the Karmanos Cancer Institute and DMC Harper University Hospital in Detroit. "For the first time in a long time, (we have) a new medication that is promising." Pill among slew of options For years, the only aids to help smokers quit were those that aimed at replacing the nicotine in cigarettes, such as the patch, gum or lozenges. Those options are widely available over the counter and also come in prescription-only inhalers and nasal sprays. In 1997, the FDA approved another type of aid -- the antidepressant bupropion, already sold as Wellbutrin but rebranded as Zyban. It works not only by replacing nicotine, but also by altering the brain's chemistry in a way that helps some people stop smoking. Then last year, the FDA approved varenicline, sold in the United States under the brand name Chantix. It works by targeting specific receptors in the brain that, when exposed to the nicotine in cigarette smoke, trigger the brain's release of dopamine, a chemical that causes feelings of pleasure. Those good feelings are one reason smokers have a tough time quitting. Chantix works in two ways: It blocks nicotine from stimulating these receptors, so cigarettes don't deliver the same pleasure, and stimulates the release of lower levels of dopamine to help decrease nicotine cravings and withdrawal. It's usually taken for 12 weeks. Study: Chantix more effective With hardcore smokers, "just using any kind of product would double your chances of quitting," said Linda Thomas, manager of the University of Michigan Health System's Tobacco Consultation Service. But studies suggest that Chantix is more effective than going at it alone or with Zyban. A study published in the Journal of the American Medical Association in July showed that after 12 weeks of treatment, 44 percent of people taking Chantix quit, versus 29.5 percent of those taking Zyban and 17.7 percent of those taking placebos. "Those are awesome numbers," Thomas said. A year later, 21.4 percent of participants who took Chantix were still not smoking, compared to 16.1 percent for those who took Zyban and 8.4 percent for those who took a placebo. Around town, smokers eager to quit are asking their doctors about Chantix. And many are finding success. "This is working for people who've tried all the other stuff," Thomas said. Rosemary Marino, 47, a smoker since she was 13, had tried several times to quit. She almost made it with the patch, but finally succeeded on Chantix. The former one-pack-a-day smoker from Harper Woods has been smoke-free since Feb. 12. "I feel great," she said. "If you do want to quit, this is the way to go." Alex Reich, a paramedic from Waterford, smoked for 15 years and has tried to quit numerous times using the patch, gum and Zyban. His insurance didn't cover Chantix, but Reich didn't mind shelling out more than $120 a month for it. "I was paying $300 a month for cigarettes anyway," he said. Unlike with previous attempts, Reich said he can't recall exactly when he stopped smoking while using Chantix. "I just did," he said. Drug comes with side effects Chantix users are supposed to start taking the drug seven days before they quit. The dose ramps up in the first week, and then again in the second for the duration of the 12-week treatment. The drug's most common side effect is nausea, which is why Delia Penny of White Lake stopped taking it after a few days. "It wasn't worth it to me," said Penny, 59. She gave Chantix a second shot, but stopped taking it again after experiencing the same side effect. Among the other possible side effects are increased appetite, a tired feeling and headaches. Doctors say the aids to help smokers quit vary, just as their reasons for smoking. For people with oral fixations, gum may be the answer. For others who like the feeling of cigarettes in their hands, an inhaler might do the trick. The cost of treatment also could play a role in what method smokers try. Many insurance plans don't cover Chantix, though more are starting to. Most insurers also don't cover over-the-counter smoking cessation aides. Blue Cross Blue Shield of Michigan, the state's largest insurer, covers Chantix through its prescription plan. The Blue Cross HMO, Blue Care Network, also covers Chantix, although to get the cheapest co-pay, those customers must be enrolled in a smoking cessation program that comes with phone support from nurses. Support that helps smokers modify their behavior can increase success rates, which is why Pfizer also offers its own network, called GETQUIT, free of charge for people taking Chantix. Chantix is no magic pill Ultimately, for smokers to quit successfully, they have to really want it, no matter what aid they choose, experts agree. "If you don't have that motivation … nothing is going to work," said Dorothy Molitor, coordinator of the smoking intervention program at Henry Ford Health System. "There is no magic pill," said Dr. Mark Richter, a family physician in White Lake. But, "this will be another tool -- a very strong tool -- that we have in their hands when we talk to our patients and offer them options to stop smoking," Soubani said. You can reach Sofia Kosmetatos at (313) 222-2401 or skosmetatos@detnews.com
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