Pfizer wants you to make a New Year’s resolution

“80% of you will fail to quit smoking with Chantix. “ That’s what the ad should say, but it doesn’t. Instead, it shows a smiling woman who “quit smoking with Chantix and support in June ’07” and it promises “with Chantix you can smoke during the first week of treatment.” Nowhere does it say how likely you are to quit smoking.

This is from a very large, full-page ad that’s been running for weeks, almost every day, in the Washington Post and other newspapers. The top 1/3 of the page is the “sell,” and the rest of the page contains the required safety information, which tells you some of the problems, including hostility, depression, suicidal thoughts or actions, and nausea. Naturally, the top of the page is in a larger font with a colorful picture.

Why is Pfizer (Chantix’s manufacturer) running these ads now? Well, quitting smoking is a very popular New Year’s resolution. It’s on many top-10 lists, even one from the U.S. government. Pfizer is trying to grab smokers’ attention now, so they’ll ask their doctors for a prescription, which I have no doubt they’ll get. These direct-to-consumer ads work, big time, and the drug makers know it. The U.S. should never have allowed drug makers to advertise directly to consumers – and Congress should re-institute laws prohibiting these ads.


I guess Pfizer is hoping that people have forgotten about all the problems with Chantix. After all, it’s been over a year since the Wall St. Journal reported on heart irregularities, seizures and over 100 vehicle accidents linked to Chantix. And few people are likely aware of this study from 2008: “Varenicline may trigger severe hypoglycaemia in Type 1 diabetes.”

Ironically, the last time I wrote about Chantix, it was after a “corrective” ad that Pfizer placed to warn people about the dangers of Chantix – although the ad didn’t exactly say that, but instead reassured people that Chantix was safe. When I looked into it, I discovered that Pfizer had not only paid for all the studies supporting Chantix, but it seemed that it had paid doctors at reputable medical institutions to add their names on the studies, which were written by Pfizer itself or by companies working for Pfizer.

But does it work? My conclusion, after looking at the evidence, was that virtually every study has been biased towards an optimistic, pro-Chantix outcome (see my previous post). Several scientists evaluating one of the studies in JAMA agreed, and wrote in 2006 that

“the relapse prevention results reported are probably more optimistic than what would occur in a real-world situation.”

They were also concerned about the “enthusiasm” for Chantix that would result from Pfizer’s advertising. They concluded that although Chantix appears to help,

“Patients currently cannot and probably never will simply be able to "take a pill" that will make them stop smoking.”

You won't see that in a Pfizer ad, of course. If you believe the studies, they report only occasional success: 22% of patients quit smoking for 9-52 weeks, versus 16% who used Wellbutrin, an older drug, and 8% on placebo. (There was no report of how many lasted longer than a year.) So even in their own study, almost 80% of people taking Chantix failed to quit smoking. I suspect that the benefit is even smaller than Pfizer’s studies have reported.

In fairness, a very recent study reported in the British Medical Journal looked at the question of whether Chantix increased the risk of suicide. These authors, who were not funded by Pfizer, reported that “no clear evidence of an increased risk of self harm or depression associated with varenicline [Chantix].” (Note that this study didn’t look at whether Chantix worked or not.)

Here’s how I’d re-write the Pfizer ad. After “With Chantix, you can smoke during the first week of treatment”, I’d add “and you’re very likely to smoke after treatment too!”

I should mention that my last blog about Chantix has been my #1 source of blog spam over the past year: various hucksters who sell Chantix have repeatedly posted comments on this blog with links to their Chantix-promoting sites. You won’t see those comments now, because I’ve deleted all but one, which I left in place (it's the 4th comment here) to show people what the spammers were doing. Note to spammers: I will delete you.