By Gilbert Ross, M.D.
Posted: Monday, July 10, 2006

LETTER
Publication Date: July 10, 2006

Given the woeful success rates in smoking cessation therapy, any addition is welcome. The new Pfizer drug, varenicline (Chantix), is one such ("Drug Shows Promise Helping Smokers Quit," July 5). But the new studies show that the hoped-for benefit is small, even in this highly-motivated study group. The added benefit, compared with bupropion (Zyban), was in the range of 10% more abstinent smokers at one year. The study subjects were screened to eliminate those with depression and several common medical conditions, and those who failed to get past the first twelve weeks of treatment without smoking were also eliminated from the final tally -- not at all "real-world" conditions. Thus, those of us trying to help inveterate smokers quit cigarettes will find only minor assistance from the new drug.

Given the high rates of smoking-related illness and the abysmal success rates of current quitting methods, we must consider other ways of helping smokers. One such method has worked in Sweden: smokeless tobacco in small pouches ("snus"). Smokeless tobacco is not risk-free, but its health effects are no more than a hundredth to a tenth that of cigarettes. Sweden has seen a major decline in cigarette use and in smoking-related diseases, in parallel with an increase in snus use, over the past few decades. Given the woeful "success" rates here for all currently approved smoking cessation methods, smokeless tobacco may be one U.S. public health authorities should evaluate.

Gilbert Ross, M.D.
Executive and Medical Director
American Council on Science and Health
New York

 

 

See also: ACSH's Kicking Butts in the Twenty-First Century: What Modern Science Has Learned About Smoking Cessation.