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New hope for smokers

A promising drug may help those who want to quit.

With the new year upon us, it's time to make resolutions. One of the healthiest is to quit smoking. In fact, according to a 2004 report from the Centers for Disease Control and Prevention, men who smoke die an average of 13.2 years earlier than men who don't smoke, and women who smoke die an average of 14.5 years earlier than women who do not. In spite of data showing the deadly effects of smoking, it was estimated that more than 46 million adults in the United States still smoked cigarettes in 2002. The good news is that rates of smoking continue to decline, and recent information from the American Heart Association indicates a new tool soon may be available for those who want to quit.

For decades, researchers have sought effective tools to help those who want to kick the habit. These include nicotine delivery systems such as gums and patches designed to decrease the urge to light up. And there are non-nicotine methods, including behavior modification and the prescription drug bupropion hydrochloride (Zyban). Unfortunately, the effectiveness of these methods is limited. That doesn't mean that people don't want to quit, just that it's difficult. In fact, an estimated 70% of U.S. adult smokers want to quit, and about 40% of daily smokers stop for at least one day of the year in an effort to quit completely. Because quitting is so difficult, success often comes only after multiple attempts. Anything that would aid smokers in their quest would be welcomed.

New studies presented at the American Heart Association's national meeting last month may offer fresh hope. A drug called varenicline was researched to see how effective it was compared with bupropion hydrochloride in helping smokers quit. The studies revealed that when given varenicline, 44% of smokers were able to quit after three months of treatment, compared with 30% of those given bupropion hydrochloride and just 18% of those given a placebo (sugar pill). More important, at the end of a year, 23% of the subjects who had taken varenicline were still off cigarettes, compared with 15% who took bupropion hydrochloride. Varenicline may be available as soon as late 2006.

What does varenicline have that gets the job done? The drug may work by activating receptors in the brain that are stimulated by cigarette smoke. As a result, people don't feel the need for nicotine, minimizing withdrawal symptoms.

Despite these findings, we must not overstate the potential benefit of varenicline. Each time a new method for smoking cessation hits the market, we all get excited, only to be disappointed later because we underestimated the challenge. However, these results are encouraging: A significant percentage of smokers on varenicline were still smoke-free after a year, and it's long-term success that's meaningful.

Tedd Mitchell, M.D., is medical director of the Wellness Program at Dallas' Cooper Clinic.