Ask Your Pharmacist

October 2, 2019
Q:

I started vaping nicotine last summer because I thought it would be safer than smoking cigarettes, but with everything in the news lately I’m worried vaping might be worse. I would like to stop completely. What do you think?

A:

Reports of death related to vaping are beginning to add up in the United States. This does not mean that vaping caused these deaths; however, it does mean there is a link between the two. In saying that, I do think we need to be aware that we do not know the long-term safety in regards to vaping. Let’s not forget that cigarettes were marketed as healthy until the 1960’s. “More doctors smoke Camels than any other cigarette” says one ad from 1946. We now know that smoking is the number one cause of preventable death and is directly associated with cancer, heart attacks, strokes, and breathing disorders (COPD or emphysema). Whether quitting smoking or cutting down on nicotine through a vape, the process of quitting is difficult, but we do have options to help you if you are willing.

There are generally two pharmaceutical paths recommended to help you quit. The first is by replacing nicotine from cigarettes or vaping with Nicotine Replacement Therapy (NRT) and the other is through prescription medications designed to help you quit. NRT uses products like patches or gum to supplement nicotine (the addictive substance in cigarettes) until the habit of reaching for a cigarette is broken then gradually decreasing the amount of nicotine supplied.  Both options help manage cravings and lessen withdrawal symptoms including irritability, depressed mood, restlessness, trouble concentrating, and feeling unwell. This helps people stick with their decision to quit. The nicotine patch is convenient; you just have to put it on once per day. Combining nicotine patches with nicotine gum, lozenges or sprays for sudden cravings has also shown to more effective than the patch by itself.

Champix (Varenicline) has shown slightly higher rates of smoking cessation than NRT or other medication, but it may not be for everyone. Champix is a pill taken twice a day; it works by blocking that rewarding feeling your body has from smoking a cigarette. Most people experience no side effects with Champix, but commonly the issue I hear is nausea. Taking the pills with food and a glass of water can help reduce nausea in many cases. The other side effect I hear is vivid dreams or nightmares, but those rarely cause people to stop taking the drug. Champix does have a warning to use with caution for those with mental health conditions. As the drug has been used over the years, this has become less of a concern as rates of depression and suicidal thoughts are likely more related to quitting smoking than the drug itself.  

Helping people quit smoking has become a large part of my day-to-day work in the pharmacy. Pharmacists can prescribe for smoking cessation in New Brunswick when appropriate, and this allows us to help our patients quit smoking in an individualized manner. People looking to quit have different levels of commitment to quitting and different outcome goals which makes individualized smoking cessation plans extremely valuable. Pharmacists are also highly accessible, so we can alter plans as needed and provide coaching and other resources that improve your chances of quitting.

I highly recommend anyone who is thinking about quitting smoking to talk to their own pharmacist for advice.

Jared Mactavish (BSc., Pharm) is a pharmacist at Guardian Pharmacy in Hampton and St. Stephen. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.