Nicotine's not a patch on this

Fighting an addiction is never easy, even less so when the addiction can actually be described as a medical illness. Cigarette smoking, often looked upon as a choice rather than an addiction has, in more recent times, been medically categorised as an illness that demands appropriate medical attention and care.

And it is with this idea that drug major Pfizer launched Champix (generic name Varenicline), a non-nicotine prescription medicine designed to aid smoking cessation, in India this week.

At 200 million smokers, India currently has the second-largest smoking population in the world, after China. Smoking is a leading cause of morbidity and mortality, with about 10 types of cancers being related to the addiction.

By 2010, an estimated one million smokers will die annually of tobacco-related problems, of which 70 per cent will be of productive age. Already 50 per cent of all cancers in men and 25 per cent in women are attributed to smoking.

Champix may be welcome news for smokers here, who till now had to struggle with themselves when it came to de-addiction attempts. Little help is available in the form of nicotine patches and counsellors. However, because Champix is a non-nicotine medicine it completely removes nicotine from the diet.

"Our researchers developed a molecule that would react on the same receptor in the brain that nicotine reacts on, thus blocking nicotine craving," says Anjan Chatterjee, medical director of the global Champix team at Pfizer.

Nicotine from the cigarette causes receptors in the brain to release a chemical called dopamine, which causes the positive feelings that smokers experience.

The lack of dopamine is also the cause of the withdrawal symptoms and depression associated with quitting smoking. Chatterjee goes on to explain that, like nicotine, Varenicline also releases dopamine in the brain but the quantity is lower by almost 40 per cent.

Despite having proven its efficacy in the US, where it was launched 18 months ago under the name Chantix, the drug has been associated with drastic side-effects.

They include nausea, sleep disturbance, vivid dreams and vomiting; and the US Food and Drug Administration issued a public health advisory alert following reports of consumption of the drug having led to changes in behaviour, agitation, depression, suicidal ideation and actual suicidal behaviour.

The FDA emphasises that patients should tell their health care provider about any history of psychiatric illness before starting Chantix, and the patient's doctor and family must monitor any change in mood or behaviour once he or she starts taking the drug.