CHAMPIX: The Magic Pill?

Arjun Kumar

July 28, 2020

If you’ve been thinking about quitting smoking, chances are you have heard of the prescription medication called Champix (Chantix in United States). Perhaps you’ve come across this smoking cessation aid following your own research, or you know a family member or friend that has been through the course of medication. If so, there may be a few questions arising as you plan your next steps on the journey to quitting…

So, how does it work?

Firstly, let’s look at the cycle of nicotine addiction. When we light up that cigarette and take that deep inhale, nicotine is sent to the brain creating a chemical reaction within roughly 7-10 seconds. The nicotine attaches to receptors in the brain and releases a neurotransmitter called dopamine – the feel-good or reward chemical and the reason we become addicted to the cigarettes. Once the cigarette is smoked, the dopamine levels drop and soon after we want to light up again – the brain wanting that pleasurable feeling and to avoid the withdrawal.  

The cycle continues (reward-based learning) and the reward or feeling of nicotine becomes wired into the brain, and associated as coming from the cigarette – the brain wants this feeling more often, tricking us to smoke more to get it. If your favourite cigarette is with a morning coffee or after a meal, these can become trigger situations when reinforced over time.  

Champix: A Magic Pill?

Most people will still smoke once starting on champix (usually for the first 10-14 days of beginning, but this can vary depending on the person), and whilst doing so, varenicline - the active chemical in the pill - attaches to the nicotine receptors in the brain, creating a block so the nicotine can’t attach to the same receptors. Effectively, without the nicotine and the chemical feeling that it triggers, smoking the cigarette becomes a useless and dull experience, pretty much like smoking paper (as well as hundreds of harmful chemicals), hopefully helping with the desire to give them up. After smoking these ‘impotent’ cigarettes over a week or so, in theory people notice a gradual decline in the cigarettes smoked and after a few weeks (on average) quit altogether as the brain does not associate the dopamine hit with the cigarette. On the flip side, the truly harsh taste and strong smell of the cigarettes, that are always there, become obvious now the nicotine is not taking away our attention.

The champix mimics the production of dopamine in the brain, as well as helping with the withdrawal symptoms, this helps break the reward cycle. The brain learns that there is no reward now when smoking, so we can begin to investigate new ways of dealing with our triggers.    

So whilst the champix may seem like it is a magic pill, it really works best in combination with actively interrupting habitual acts or routines in our day, and finding new ways of releasing the feel-good chemical dopamine – over time the brain becomes wired to these new rewards. For example, light stretching in the morning or 5 minutes of deep breathing or cooking a new recipe. This is especially helpful when coming off the champix, the new routines and activities we’ve implemented in our day to make us feel-good will make it harder to slip back into our old habits.

NHS data suggests that champix, in combination with a structured support programme, has over 60% success rate.

Things to note:

Champix is a 12-week course of pill-form medication, and as with most, come with some common side-affects. These including nausea, vivid dreams, sleepiness and dizziness. These can be minimised by preparation – making sure to take the tablets with a hearty meal, having plenty of water through the day and not taking the tablets too close to bedtime.

Nicotine withdrawal symptoms can be mistakenly attributed to the champix – headaches, mood swings, irritability, lack of appetite and difficulty in concentrating – these are common with the absence of the nicotine and the chemicals it triggers within us (dopamine, serotonin etc.) and all part of the fun when quitting smoking!  

Champix is suitable for most people, however, if you are pregnant then champix can't be used. If you are using certain medications or have specific health issues, it’s best to speak to your doctor before prescribing.

If you are considering quitting smoking and would like more information on champix or any other support, do get in touch:

28 Days provide a digital and telephone service, tailored to all types of working hours with clinics running from 8am-8pm Monday – Thursday, 8am-5pm Friday and 9am-1pm Saturday. Our NCST trained Quit Coaches can offer behaviour change support to assist with the quit journey, resources, digital tools and advice on pharmacotherapy and Nicotine Replacement Therapy (NRT).