A new drug called varenicline has shown significant but moderate success in helping smokers quit compared to placebo and another smoking cessation drug, bupropion, according to three studies published in the Journal of the American Medical Association. Varenicline is a non-nicotine drug that may help smokers quit by stimulating the release of the chemical dopamine in the brain to reduce craving and withdrawal, while also blocking the effects of nicotine from cigarettes.
Varenicline shows promise as a tool to help smokers quit. However, it is far from a panacea. In fact, the increase in quit rates was fairly small, even among those smokers who were able to stay off cigarettes for the first twelve weeks of the analyses. Varenicline has been approved by the FDA as a twelve-week course of treatment, with an additional twelve weeks if the smoker was able to quit initially. It is important to note that the majority of participants in these three studies did not quit smoking, even with varenicline. The best results in the American studies were only 23% abstinence at one year. Many participants experienced adverse effects from the medication, stopped taking it before they were supposed to, and dropped out of the study.
About 70% of smokers want to quit and nearly 41% say they have attempted to quit within the past year. Only 4-5% of smokers who try to quit each year succeed in doing so. However, after repeated attempts, 40-50% of smokers eventually quit smoking. Varenicline may be helpful for some smokers who wish to quit, but others will need to use another method.
One method that could help some smokers quit is the use of smokeless tobacco. Using smokeless tobacco causes significantly fewer adverse health effects than smoking cigarettes. While using smokeless tobacco is not risk-free, it can be a helpful form of harm reduction for smokers for whom complete tobacco abstinence is unrealistic. Others may want to quit tobacco completely, and while it takes most smokers more than one attempt to quit, switching to smokeless tobacco in the meantime can reduce the harmful effects of smoking.
Smokeless tobacco is a topic often avoided in discussions on smoking cessation. This is a disservice to the millions of American smokers attempting to quit. For some of them, smokeless tobacco could be the method that works and potentially saves their lives.
Molly Lee is the Earhart Foundation Research Intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
See also: ACSH's guide to smoking cessation methods, Kicking Butts in the Twenty-First Century.
