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Drug helps smokers extinguish habit

Providence program sees impressive results with new medication
by: JIM CLARK, Longtime smoker Beverly Terry is among the first in Oregon to try Chantix, which blocks nicotine’s effects in the brain. She hasn’t had a cigarette in seven weeks.

Beverly Terry has been smoking for 36 years.

Make that had been smoking for 36 years. Terry hasn't touched a cigarette in seven weeks.

And this time, she thinks the quit is going to stick.

Terry, a 56-year-old Beaverton manufacturing buyer, has been taking a new medication intended to help smokers quit. The drug, called Chantix, approved by the Food and Drug Administration in May, is the first new drug in 10 years intended to help smokers quit, and it takes a new approach to smoking cessation by acting specifically to block nicotine's effect in the brain.

Terry is among the first in Oregon to get started on Chantix. In August, the Tobacco Cessation and Prevention Program at Portland's Providence St. Vincent Medical Center decided to offer Chantix (also known as varenicline) to participants in its ongoing eight-week smoking cessation classes.

St. Vincent is the first in the Portland area to offer the drug in smoking cessation classes, and Terry was one of the first participants.

According to Charles Bentz, medical director of the St. Vincent's program, the initial results have been impressive. The first class had 14 participants attending 11 sessions. Nine chose to take Chantix, supplied by Pfizer. Of those nine, five - Terry among them - remained smoke-free at the end of the 11 sessions.

Those statistics match the data from a clinical trial held at Oregon Health and Science University prior to the drug's release. Researchers at OHSU's smoking cessation center, which performs research but not treatment, found that, after one year, 22 percent of the heavy smokers who took Chantix still were not smoking.

A second group in the OHSU study took Wellbutrin/Zyban, the only other prescription drug approved to help smokers quit. Sixteen percent of those participants were smoke-free after a year.

A third group in the study received a placebo, and those participants had quit at an 8.4 percent rate after a year.

'It looks like it's very effective,' Bentz said. 'The medicines can double the effectiveness of quit rates.'

Drugs don't work alone

But Bentz cautions that people who simply get a physician's prescription for Chantix and take the drug on their own might not duplicate the results in the St. Vincent's classes.

'The medications double the quit rates, but what are they doubling?' Bentz said. 'If you don't do anything to change behavior, you're not going to get good quit rates.'

The classes at St. Vincent's, and in the clinical studies, have included a great deal of behavioral work, from regular counseling sessions to support groups. And it is the combination of the drug and the counseling that yields results, Bentz said.

Bentz said smokers need to learn when they smoke and why. 'If you're most likely to smoke in the car,' he said, 'then you need to change something about the car.'

That is exactly what Beverly Terry had to face. The Beaverton resident tried to quit a number of times over the years, even making it to two months on one occasion. She'd tried the nicotine patch and the gum. But old habits die hard. And that, she said, is something she learned in the St. Vincent class.

'Every day when I get in the car and I hit the I-5 traffic I want a cigarette,' Terry said. 'It's just because I'm used to it.' Same thing, Terry said, with her morning cup of coffee, which for years, out of habit, has been accompanied by a cigarette.

The classes made her aware of the habits, Terry said, but the Chantix has done something else.

'It (Chantix) took away the taste of tobacco,' Terry said. 'It kind of made it real bland.'

Chantix is supposed to work two ways - by reducing cravings and withdrawal symptoms, and diminishing the satisfaction associated with smoking in case of a relapse.

Terry said Chantix worked differently than the patch or gum. 'It takes the tension out, the aggressive agitation you feel,' she said.

Her first few days in the St. Vincent program she took Chantix but still smoked. But she said the satisfaction had disappeared. 'You don't really get a response from smoking the cigarette because you don't really get a feeling from it,' she said.

Cigarette costs add up, too

Bentz said he expects Chantix to become more widely used in the next few months, when Pfizer begins its marketing campaign.

Bentz said the drug costs between $100 and $120 a month and most participants are taking it for three months, some as long as six months. It's no extra charge while participants are in the class, which costs $225 for 11 weeks, but after that people will have to pay for Chantix on their own. Some insurance plans provide coverage and others don't, Bentz said.

Terry said her insurance won't pick up the tab for Chantix, but now that she's completed the St. Vincent program she's not ready to quit the medicine.

'It works so good I'm a little fearful of not taking it,' Terry said. As for the cost, she said, 'I spend that easily on cigarettes.'

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