DR. WEIL: Drug no guarantee you'll kick smoking habit

By Dr. Weil

Published July 21, 2008 at 6 p.m.

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What do you think of this new drug, Chantix, to stop smoking?

Chantix (varenicline) is a new prescription drug designed to help smokers quit by stimulating the release of small amounts of dopamine, the brain chemical that mediates pleasure. A lack of dopamine is responsible for the irritability and other withdrawal symptoms that people addicted to tobacco feel when they try to quit and that drive so many of them to light up again.

Nicotine replacement products (patch, gum, lozenges and the drug Zyban) all work by prompting release of low levels of dopamine. The purported advantage of Chantix is that it also makes smoking less pleasurable by blocking nicotine receptors in the brain.

You may have read claims that Chantix works better than Zyban or a placebo. Clinical trials showed that of those who took Chantix for 12 weeks, 44 percent quit smoking compared to 30 percent of those who took Zyban and 17 percent of those who received a placebo. That means, of course, that even during a 12-week trial, 56 percent of those who took Chantix were not able to quit smoking.

Less well-publicized is the fact that over the course of a year, only 14 percent to 23 percent of those who used Chantix in the study remained smoke-free. Side effects of the drug included nausea (affecting about 30 percent of all study participants), headache, vomiting, gas, insomnia, abnormal dreams and changes in taste perception. Chantix also can affect kidney function and probably should be avoided by anyone with kidney problems, especially those on dialysis.

Chantix (or any other drug) wouldn't be my first choice of a strategy to stop smoking. I don't underrate the difficulty of quitting. Tobacco in the form of cigarettes is the most addictive drug in the world, and nicotine is one of the strongest stimulants known. Most smokers who manage to quit do it on their own after one or more unsuccessful attempts, and most find that stopping cold turkey is better than trying to cut down gradually.

If you're determined to quit, you have many options - acupuncture, hypnosis, nicotine gum and support groups. All can help, but no single method works for everyone. Whatever method you choose, if you don't immediately succeed, recognize that very few people do, and keep trying.

I am always cold. No matter what the temperature, summer or winter, my body inside is always on ice. What could be causing this?

People can feel cold all the time for several different reasons. Low thyroid function (hypothyroidism) could be responsible. If you haven't had your thyroid function tested recently, it would be worth your while to ask your physician to test you - all that's required is drawing some blood.

In addition, be sure to get your complete blood count done. You could be anemic, another possible explanation for feeling cold. Here are other possibilities to consider:

* Weight: If you're thin, you have less body fat to insulate you than does a heavier person and may feel the cold more acutely.

* Body composition: Muscles produce up to 25 percent of your body heat. So the more muscle mass you have, the warmer you should be. Focus on building muscle mass (as opposed to gaining fat) to help your body better regulate temperature.

You may just be cold-sensitive. You can also learn to keep yourself warm - wear layers of clothing, drink hot liquids - ginger tea or foods spiced with ginger and red pepper.

• July 22, 2008

  10:43 a.m.

  Suggest removal

  VJSleight writes:

  When SSRI's, first came out, they were hailed as a "safe" medication also and it took years before it become well known about the side effects from these "safe" drugs. for 20 years I have been helping smokers quit and often smokers are looking for that magic wand that will just take their nicotine addiction away but real change comes from the inside out. That magic wand is "You do something to me so I don't have to change." I agree that everything quitting method will work for some, NO method works for everyone. The tirck is finding out what will work for YOU. For free quitting advice, visit: www.StopSmokingStayQuit.blogspot.com
  VJ Sleight, Queen of Quitting, a former smoker, and Cancer Thrivor

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