Chantix advertisements and smoking cessation

From a medical perspective, Chantix (varenicline) is the gold standard in smoking cessation. It has been found to be more effective at helping smokers quit than bupropion (Wellbutrin) or nicotine replacement therapies (patches, gum). The drug is heavily advertised, so I thought I would examine how Pfizer markets Chantix.

https://www.ispot.tv/ad/ws46/chantix-mark

This ad starts by introducing Mark, a real life person who smoked for 26 years but was able to quit with the help of Chantix and "support". He details how he tried quitting cold turkey and with patches, but these methods were ineffective. Pfizer is implying that Chantix is unique and more self-empowering than other smoking cessation products. The other implication also seems to be that the pharmaceutical industry is so clever that they have created a product that allows patients to restore their self control. Taking Chantix seems to be a no brainer!

Chantix, methadone, and other pharmaceutical addiction treatments assume that addiction is primarily a chemical process. Therefore, it makes sense that there could be a chemical that would interrupt this process and cure the patient. This premise is generally well received by addicts because taking a pill is much easier than addressing deep-seated patterns of behavior and negative thought patterns. The medical community also likes this because pharmacology seems to be a much more concrete science (with receptor sites and binding affinities) than psychology (with feelings and perceptions).

The end of the ad is where the legal disclaimers come in and the list for Chantix is disturbing. Nausea, sleep-walking, seizures, and allergic reactions are all mentioned as possibilities. The viewer is also advised to exercise caution when driving and to tell their doctor if they have unusual changes in thinking or thoughts of suicide. Quitting smoking with Chantix doesn't seem so easy by this point of the commercial.

While the list of horrible side effects is rolling off, Mark can be seen enjoying a glass of water at a pizzeria with his wife. The commercial closes with Mark saying, "I'm finally free of smoking." Chantix has restored Mark's ability to make free choice and now he enjoys simple things like pizza and cold glasses of water. The message is simple here: you are powerless over your smoking and you should turn to modern science to correct what is wrong with your brain. There are vague allusions to the addition of "support" to help smokers quit, but this messaging takes a back seat to a pharmaceutical solution.

An aside on Chantix and suicidal thoughts:
For several years, the FDA required a black box warning on Chantix packaging that warned that the drug should be stopped if the patient has thoughts of suicide or self-harm. The FDA required this label after reports that some smokers trying to quit with Chantix experienced these symptoms. However, after post-marketing studies showed that those taking Chantix did not have disproportionate risk for suicidal thoughts and tendencies relative to other smokers trying to quit, the label was removed. While this is good for Pfizer, it raises a disturbing point: some people become so disturbed while trying to quit smoking that they begin having suicidal ideations. Clearly addiction has a psychological component that transcends simple pharmacology. The Wikipedia entry for Chantix does a nice job on summarizing the FDA's decisions (with citations).