Varenicline (Champix)
Champix is one of the best known brands of stopping smoking medication. The active ingredient in Champix is varenicline and you will not be able to take this medication if you are allergic to varenicline or any of the other ingredients of Champix. Varenicline is not recommended for people under the age of 18, who are pregnant or breastfeeding or who have severe kidney problems.
Champix works by relieving the craving and withdrawal symptoms that are associated with quitting smoking; it does this by stimulating the nicotine receptors to mimic receiving nicotine. It also reduces the enjoyment of smoking by blocking reward signals from the brain that are released when you inhale nicotine. This means that it could be effective for those who take particular enjoyment from the habit, such as people who only smoke socially.
What are the pros and cons of varenicline?
Varenicline is only available on prescription, meaning that you will need an appointment with your doctor to receive it. A course of varenicline lasts around 12 weeks, which is longer than a course of bupropion, after which time you will need to be reviewed. It may be possible for you to continue with treatment beyond the 12 weeks if necessary.
The biggest advantage of varenicline is that the risk of side effects isn’t as high as it is with bupropion. The longer treatment course also means that your quit attempt could be more successful than after a single course of bupropion.
What are the alternatives to Champix?
As Champix has been recalled by Pfizer for safety reasons, many people are seeking an alternative to Champix. In terms of medications on the market, it can be argued that bupropion (Zyban) is the most similar option. Research suggests that it’s not quite as effective as Champix, but there’s not a great deal in it. A course of Champix lasts for around 12 weeks, whereas a course of Zyban typically only lasts for 7-9 weeks, so you won’t have to take it for as long.
They both work in a similar way in the brain, which is to make smoking less appealing and pleasurable to you.
If you want to go down a different route, though, there’s always nicotine replacement therapy. This is much less of a ‘like-for-like’ replacement for Champix, but it could be a good option for you if bupropion isn’t suitable for you, or if you’ve tried it before and it hasn’t worked.
What does switching from Champix to an alternative involve?
If you’ve been taking Champix and can’t get it any more, or you’ve taken it in the past and want to use a similar treatment, then switching is quite simple. You’ll need to start the new course from scratch to allow your body to get used to the new treatment, which means starting at the low dose before increasing it.
So, for example, if you’re switching from Champix to Zyban, you’ll need to cut down from your current dosing schedule to your new one. This might mean going from four tablets a day to one, which will be necessary for you to become accustomed to the new active ingredient.
Bupropion (Zyban)
Zyban is a popular brand of anti-smoking medication. The active ingredient is bupropion. Although originally an antidepressant, bupropion has been shown to be effective at helping people to quit smoking. Exactly how it does this isn’t fully understood, but it’s thought to prevent the absorption of dopamine and noradrenaline – two chemicals that act as stimulants and pleasure-enhancers. This helps to reduce the feeling of pleasure experienced when smoking, thereby helping to curb the desire to do so.
Zyban is not recommended for people under the age of 18, those who are pregnant or breastfeeding, or people with epilepsy, bipolar disorder or eating disorders.
What are the pros and cons of bupropion?
Bupropion is only available on prescription from your doctor. Treatment courses are usually only around 7-9 weeks long, meaning that you may need more than one to quit smoking.
There is a higher risk of side effects, and patients will need to have their blood pressure monitored during the course of their treatment. However, it is less expensive than varenicline and some consider the side effects of bupropion less severe than those associated with varenicline.
Nicotine replacement therapy (NRT)
Nicotine replacement therapy (NRT) is considered the best way to stop smoking by many ex-smokers. The treatment consists of a range of different products that are designed to provide a small amount of nicotine – enough to curb cravings and lessen the effects of withdrawal – but without the carbon monoxide, tar and other chemicals found in tobacco smoke. NRT products include:
Nicotine patch
Nicotine patches are attached to your skin in the same way as a plaster, and deliver a small, constant supply of nicotine through your skin and into your bloodstream. This slow release reduces withdrawal symptoms and cravings, making you less likely to smoke. They are very discreet and can be worn under clothing.
Nicotine gum
Nicotine gum works by releasing small amounts of nicotine into your mouth as you chew. You then hold the chewing gum between your cheek and gums and the nicotine passes into your bloodstream, providing the hit that you need to keep cravings at bay. Patients are usually advised to chew a piece of gum every 1 to 2 hours for up to six weeks.
Nicotine lozenge
Nicotine lozenges work in a similar way to gum. Patients let the lozenge dissolve slowly in the mouth where nicotine will be released into the bloodstream. It’s essential that you use the lozenges exactly as directed as having too few will prove ineffective, and too many can cause side effects.
Nicotine nasal spray
Nicotine spray is directed into the nose. Once administered, the nicotine passes through the soft lining inside your nose and into your bloodstream. This curbs your cravings and helps to break the habit of smoking.
Nicotine inhaler
Nicotine inhalators provide an instant hit of nicotine that makes them particularly effective for counteracting sudden cravings. Inhalators look a little like plastic cigarettes and contain 15mg of nicotine which is absorbed through the lining of your mouth.
What are the pros and cons of NRT?
One of the biggest advantages of nicotine replacement therapy is that it can be used by the majority of patients, including those under 18 but over the age of 12 (with the exception of lozenges which could only be given after obtaining medical advice). Pregnant and breastfeeding women are also advised to avoid NRT. It is also readily available from a range of drug stores, meaning that you can get most products without too much cost or inconvenience. The side effects of NRT are largely less serious than prescription medications too.
The only real disadvantages of NRT are that it doesn’t actually lessen the enjoyment of smoking and it still involves the absorption of nicotine, albeit at much smaller doses.