Am J Psychiatry, June 17, 2014
Many patients try nicotine replacement products in an attempt to quit smoking, but are rarely successful. E-cigarettes have not only been proven to be ineffective, but they are probably also not safe. Currently, the FDA bans the sale of these products to minors. Behavior therapy, hypnosis and acupuncture may help some people but the results are variable. The reason most people cannot quit smoking is that they are psychologically addicted as opposed to being physically addicted. The best success I have seen over the years involves the antidepressant buproprion (Wellbutrin, Zyban). Several years ago, the FDA approved CHANTIX for patients who could not quit smoking using other methods. Once again, the benefits vary from patient to patient. Now, the results of several intuitional studies have shown that by combining Chantix and Bupropion MALE SMOKERS had success rates much higher than when these medications were used alone. Nicotine patches were not even close. What is interesting is that these findings were not seen in women.
Bupropion is well tolerated but many patients have a fear of using CHANTIX due to behavior changes and suicidal thoughts. Just because a medication may have serious side effects, it doesn’t mean that it occurs in everyone. All medications should be taken under strict physician supervision and side effects reported immediately.
As always, we have to weigh risks vs benefits and I’m still trying to find any benefits in smoking!