Wednesday, October 8, 2008

Quit smoking - permanently

Chantix is a smoking cessation drug manufactured by Pfizer, the world’s biggest drug manufacturer. Launched in August 2006, and available by prescription only, it has been touted as the most effective drug of its kind on the market. Over 6 million people have been prescribed Chantix in the US, with sales totaling $883 million in 2007.

The main ingredient of the drug is varenicline tartrate which works by blocking nicotine receptors to the brain and reducing the pleasure which comes from smoking..

But in February, less than two years after giving the drug approval, the US Food and Drug Administration (FDA) issued an alert suggesting that serious neuropsychiatric symptoms had occurred in patients taking Chantix. Causing the most concern was the prospect the drug contributed to suicidal ideation in some users, which may have been responsible for a number of suicides and attempted suicides.

Pfizer responded by strengthening its Chantix labeling to include stronger warnings about neuropsychiatric symptoms. In May, it revised the warning again, advising physicians to discontinue Chantix immediately if patients become agitated, depressed or suicidal.

In June, Health Canada warned that Chantix, sold in Canada as Champix, had caused “unusual feelings of agitation, depressed mood, hostility, changes in behavior or impulsive or disturbing thoughts, such as ideas of self-harm or of harming others, in some users.” Health Canada noted that in the year following its approval, 226 Canadian cases of adverse neuropsychiatric events had been reported in patients taking the anti-smoking medication.

And, in addition to warnings from health authorities in both Canada and the US, the US Federal Aviation Administration (FAA) banned pilots and air traffic controllers from using the drug. It has also been banned for use by commercial drivers.

In June, Pfizer began a massive public relations campaign to combat growing concerns that their smoking cessation pills were dangerous because of links to suicides, seizures, and traffic accidents.

Shannon Pettypiece, in an article on Bloomberg.com, quotes company spokesman Ray Kerins: “When there is confusion in the marketplace related to one of our products we want to make sure the right information is out there. We can't lose sight of the benefit of this product; the public health benefit is clear.''

The health benefit Kerins is talking about is the alleged effectiveness of the drug in getting people to quit smoking. However, some experts on smoking cessation have suggested that the benefits of drugs, including Chantix, are over-stated. And, rival drug company GlaxoSmithKline, claims Chantix is no better at helping patients quit smoking than their products which include Nicoderm and Nicorettes.

The first lawsuit against Pfizer alleging adverse reactions to Chantix was launched in July 2008. Now there are several hundred, with a thousand or more cases being investigated.

Yet, despite the openly stated public health concerns of the US FDA, Health Canada and others, and multiple pending lawsuits, the drug has been allowed to remain on the market and is being widely advertised on television in the US.

And, allegations that the drug may be hazardous to a user’s health might also prove embarrassing to some supporters of the drug.

In May of 2008, a panel of experts, convened by the Agency for Healthcare Research and Quality (AHRQ), made a recommendation to physicians across the US that every patient wanting to quit should be advised to use smoking cessation products such as Nicoderm, Nicorettes, etc.

Also among the drugs recommended by the panel in their Clinical Practices Guideline was Chantix.

What may be even more embarrassing is that Dr. Michael Fiore, the chair of the panel, was believed to have a substantial, undeclared conflict of interest and had received a good deal of money from the pharmaceutical industry, most notably GlaxoSmithKline. Eight other members of the panel had similar conflicts which were apparently reported.

It is the drug companies which stand to benefit most from the sales of nicotine replacement and smoking cessation drugs recommended by the panel of experts. Although many experts consider “cold turkey” to be the most effective means of giving up smoking, the majority of anti-smoker organizations recommend smoking cessation drugs or nicotine replacement therapy.

The pharmaceutical industry, including the Robert Wood Johnson Foundation, is the biggest financial supporter of the anti-smoker crusade. In fact, funding for the Clinical Practices Guideline, which recommended Chantix and other smoking cessation drugs, apparently came from the Robert Wood Johnson Foundation.

So, the drug companies fund the activities of the antismoker crusaders. The anti-smoker fanatics lobby governments to impose draconian smoking bans and extortion levels of taxation on smokers to force them to quit. Then, they pitch the benefits of smoking cessation drugs which profit the drug companies which funded them in the first place.

And, the ones paying the price are the tobacco farmers who lose their farms; workers in the tobacco and hospitality industry who lose their jobs; and, of course, smokers.

And, quite possibly, those forced to use drugs like Chantix. There ought to be a law.

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1 comment:

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