Quit-smoking drugs safe for your heart
December 10th, 2013
11:03 AM ET

Quit-smoking drugs safe for your heart

Smoking is the leading cause of preventable death world-wide. About half of all long-term smokers will die because of their addiction. But the good news is that nearly 70% of current smokers want to quit, says the CDC.

And using an effective treatment to help kick the habit can almost double or triple one's chance of success. Replacement therapies like the nicotine patch or gum, or medications like the antidepressant buproprion (sold as Wellbutrin or Zyban) and varenicline (commonly known as Chantix), can help reduce one's cravings to smoke and deal with withdrawal symptoms.

Headlines in recent years have questioned the cardiovascular risks of these drugs. But new research says that these drugs carry little risk of heart attack or stroke.

The new meta-analysis published this week in the journal Circulation is the largest analysis of its kind, with study authors surveying 63 different clinical trials encompassing more than 30,500 smokers. Unlike previous studies, which only looked at the effectiveness and safety of each individual drug, this analysis compared all three methods of smoking cessation.

The study found that none of these three therapies  – gum, patch and  antidepressants – increased the risk of major cardiovascular events. Those taking Zyban, Wellbutrin and Chantix had lowest risk of any serious heart event, while those taking nicotine replacement therapy, such as gum or a patch, had a slightly increased risk for minor side effects like a rapid or irregular heartbeat.

The study results even suggest that Wellbutrin may even  protect against serious cardiovascular events. But the study authors cannot explain why.

"Undoubtedly, the benefits of quitting smoking outweigh any potential risks from smoking cessation therapies," said Dr. Edward Mills, co-author of the study and an associate professor of medicine at the Stanford University School of Medicine.

Mills, along with other study authors, has consulted to Merck, Pfizer, Takeda, Novartis, or GlaxoSmithKline, which all manufacture smoking cessation drugs.  However, none of the companies were involved with this particular analysis.

Dr. Jonathan Samet, director of the University of Southern California's Institute for Global Health, argued that  a large meta-analysis is difficult and imprecise. "I think they've done technically a good job - but there's just not as much as we like in terms of the evidence," he said.

He also added, "there isn't a huge risk that we're likely to be missing" when it comes to these therapies.

When looking specifically at the heart, "the main problem are side effects, not heart attack and death," said  Dr. Russell Luepker, spokesman for the American Heart Association. "The risks are low, and if you look at the benefits of quitting smoking, they are greater than the benefit."

The findings seem to counter the last meta-anlysis of Chantix back in 2011, which found the drug increased the risk of heart attacks.  Mills said that this new study is more precise because of its comparative method, allowing for "greater power and precision" of results.

Wellbutrin, Zyban and Chantix also come with increased mental health risk. In 2009, the US Food and Drug Administration required black box labeling for all three drugs because they cause side effects  like behavior changes, depression, hostility, and suicidal thoughts.

However, the FDA also admitted that it was unclear whether some of these effects weren't actually symptoms of nicotine withdrawal .

Mills acknowledged that the risk for suicide and mental health issues remains, "even though all assessments have not demonstrated an effect of these therapies on suicidality. The current thinking is that the stress of quitting may be a causative factor."

What all the doctors do agree on is that quitting smoking doesn't have a blanket prescription, but rather needs to be individualized for the patient. According to Luepker, that most commonly means a combination of both drugs and behavioral therapy, like counseling. "If you can use the two of them, a program plus drug, you're more likely to be successful."

soundoff (76 Responses)
  1. Sebastian

    Honestly, going cold turkey is the easiest way, at least for me it was. Don't know if you knew, but most of these tobacco companies are selling these nicotine patches and gums claiming that it helps with your cravings. In reality it strengthens your craving for nicotine because I'm a scientist and I have a microscope.

    December 10, 2013 at 16:07 | Report abuse | Reply
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    December 10, 2013 at 16:21 | Report abuse | Reply
  3. ChristianzMP

    In the article "Quit-Smoking Drugs Good For Your Heart" by Nadia Kounang she informs readers that smokers are at more risk of a heart attack and side effects than people who are clean. Not only does smoking increase the risk of a heart attack it also causes side effects such as behavior changes, hostility, and even suicidal thoughts. Smoking is the leading cause of preventable death worldwide. She states that 70 percent of smokers to current day want to quit and when they decide to effective treatment to kick the habit can double and almost triple the chance of success.

    I believe this article is one of the few that i recommend that many people should consider reading. Having family members that smoke i hate to read about the danger that they are putting their lives in. In the article one of the researchers denies that smoking increases risk of heart attack but that isn't a reason to take it more lightly. Not only the heart attacks themselves are very dangerous but the side effects that are listed by the same researcher are just as serious.

    December 10, 2013 at 18:35 | Report abuse | Reply
  4. Gregg D

    I give up, I'm trying to post something and it has not shown up after 3 tries – LATER

    December 10, 2013 at 21:55 | Report abuse | Reply
  5. Gregg D

    Back in the late 90's I was a 1.5 pack a day smoker. I developed severe depression due to interferon treatment.
    I was put on WellButrin, 2 months later I was doing my normal inventory check of cigarettes. (I was buying 4-5 cartons per month to cover the 1.5 per day habit) I am looking in my cabinet and counting the packs of cigarettes and was confused on why I had so many packs left over. Wow ! it was this anti depressant I was taking. It is like it turns off the light bulb that tells your brain (I need another smoke)

    December 10, 2013 at 22:02 | Report abuse | Reply
  6. Gregg D

    Eventually I decided I did not want to quit all together so I planned on 6-7 cigarettes per day which was no problem with Wellbutrin. I eventually needed to quit all after moving to 8500 ft. I simply could not breath. I still needed to buy nicotine gum but I did it with 1/2 a box. I don't miss it , I used to wash my hands after every smoke I had outside after putting on a coat and gloves in the winter etc. I certainly feel free of that process.

    December 10, 2013 at 22:03 | Report abuse | Reply
  7. Gregg D

    OK well I got 2 paragraphs in – wont take the 3rd for some typo I cannot find but there you go.
    This is driving me to drink – LOL

    December 10, 2013 at 22:07 | Report abuse | Reply
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    My current event from monday

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  9. Armond D

    Here are some of the most effective techniques to quit smoking: http://www.squidoo.com/healthy-lungs

    December 11, 2013 at 01:15 | Report abuse | Reply
  10. Boo

    I have friends that took Chantix. They experienced migraines, muscle pains and nightmares. I'll pass.

    December 11, 2013 at 12:35 | Report abuse | Reply
  11. Timmy Suckle

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    But us big wigs at insurance companies, hospitals, and pharmacy companies don’t ever need to worry about health care no matter what it costs. We get our health care paid for one way or another by you little people. And we get the little people that work at our companies to contribute to our PACs. And us big wigs say it’s to protect the little peoples’ jobs. But in reality it would be in the little peoples’ best interest to NOT contribute to the PAC. Again, little people are so easily fooled. I won’t ever have to worry about losing my job with so many little people being brain washed by the Medical Cartels’ PAC money. Not only that, the Medical Cartels’ PAC money is used to elect so many republicans that will never allow a single payer system. Republicans have always fought against any meaningful health care reform. But that’s what our Medical Cartels’ PACs pay them for. Politicians can be bought so easily.
    Pretty soon the only people that will be able to afford health care is us big wigs. And that’s the way it should be. We don’t want you little people using up the resources when we need them. And once again, I thank you little people for capping my SS tax at the $113,700 level. Now I only pay 1.2% SS tax and you little people pay 6.2%. Also, thank you for extending my tax breaks. I’m using the extra money on my vacation houses.

    December 11, 2013 at 16:57 | Report abuse | Reply
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    depression, hostility, and suicidal thoughts are nicotine withdrawal symptoms

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  14. Meatmon

    It's great that they have drugs to help individuals quit smoking and maybe outweighing the long term effects of smoking against the actual risk of the medicine may be greater, however in the end a person needs to find their will power. Because that will dictate the outcome of whether a person really does need drugs to quit.

    December 13, 2013 at 16:15 | Report abuse | Reply
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    December 24, 2013 at 09:02 | Report abuse | Reply
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    Smoking is a deadly disease but I did it anyway, and when I got pregnant I was scared because I couldn’t stop. I knew smoking is a terrible health risk issue for my baby but anything I tried ended in vain until I went to http://hypnosis2change.com/hypnosis/. I was able to quit in time before my child developed any problems, and I was able to feel better about myself as I felt healthier. Now my son is running happily around the house, and I am able to smile every time I look at him.

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