Stop Smoking

What Back Pain Patients Should Know about Stop-Smoking Drugs Chantix and Zyban

cmaynard — Tue, 07 Jul 2009 11:43:47 -0700

July 8, 2009
by: Sylvia Marten

The U.S. Food and Drug Administration (FDA) just announced that a black box warning will be carried on two popular, “stop-smoking” drugs – varenicline (Chantix) and buproprion (Zyban, Wellbutrin) – following a report detailing some very significant side effects with their use.

According to the FDA’s adverse event reporting system, use of these two drugs has been linked with serious changes in behavior, including:

depression
agitation
hostility
thoughts of suicide.

More specifically, the report linked:

98 suicides and 188 attempted suicides to use of varenicline
14 suicides and 17 attempted suicides to buproprion use.

While noting the importance of getting people to quit smoking, the FDA added that it simply wants closer monitoring of these two drugs.

Consequently, the FDA is going to ask the manufacturers of Chantix and Zyban – Pfizer and GlaxoSmithKline, respectively – to conduct clinical trials examining behavioral changes with usage of these drugs.

Smoking has long been linked to causing back pain and is often a reason why surgeons may not want to perform spinal surgery on certain patients.

Since smoking can slow down the recovery time after back surgery, many patients may have to quit smoking prior to surgery.

If you have recently quit smoking in wake of a scheduled back surgery, or have stopped smoking following back surgery, it’s important that you know the risks of stop-smoking drugs, as the above information about Chantix and Zyban demonstrates.

And if you have used any of these stop-smoking drugs and noticed changes in your behavior similar to the symptoms listed above, get in touch with your doctor as soon as possible.

More on This Topic

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[url:738,type=|node|,content=|Does Smoking Cause Low Back Pain?|]

[url:6679,type=|node|,content=|Quitting Smoking: A Must for People with Back Pain|]

[url:6742,type=|node|,content=|Ways to Quit Smoking|]

[url:6741,type=|node|,content=|Why It Is So Hard to Quit Smoking?|]

[url:6724,type=|node|,content=|Quitting Smoking before a Spinal Fusion|]

Chantix Helps Quit Smoking

Thu, 17 Apr 2008 13:44:59 -0700

April 17, 2008
by: Sylvia Marten

Everyone is aware that smoking is not good for your health, but many do not realize that smoking is also closely linked to [url:137,type=|term|,content=|chronic pain|].

In my experience as a spine physician, if a patient has had pain for a long time and continues to smoke, he or she is highly unlikely to find pain relief from any type of treatment. The reason for this is not entirely understood, but it is probably due to multiple factors, such as blood vessel spasms and not allowing oxygen to get to tissues.

For people who are in a lot of pain, this information alone should be good motivation to help them kick the smoking habit, but many patients will need some assistance to [url:327,type=|term|,content=|stop smoking|] due to the strong physical and emotional addictive qualities of smoking.

[url:6745,type=|node|,content=|Medications to quit smoking|]

Previously, a drug in the antidepressant line of pharmaceuticals was approved for use in quitting smoking, called Zyban. This drug worked by keeping a neurotransmitter (serotonin) around longer in the brain, which seemed to helped decrease the craving for nicotine.

Lately, a newer drug, Chantix, has been released that has a different mechanism of action. Chantix is designed to bind right to the nicotine receptors in the brain. Many patients even report that after starting Chantix, smoking is repulsive to them and they can’t stand the smell.

Like all drugs it does have some side effects (such as difficulty sleeping, loss of appetite, nausea, etc…), but the one that has gotten the most media attention is a possible link to suicidal ideation. While this is a concern, it should be noted that many people who are trying to quit smoking are already depressed, so it is difficult to know if this is a causal link or not.

In my clinical experience, Chantix has worked remarkably well, especially for people who are motivated to quit smoking.

By: Peter Ullrich, Jr., MD

Smoking and Low Back Pain

spine-health — Tue, 04 Mar 2008 14:14:23 -0800

March 4, 2008
by: Sylvia Marten

The fact that smoking is not good for your health is not exactly news, but most people do not associate smoking with pain.

Lifestyle issues such as smoking, as well as lack of exercise and obesity, hamper the patient’s ability to find sufficient pain relief over the long term. In fact, research has shown that [url:738,content=|smoking causes back pain|].

In my own personal experience with treating back pain patients, I have seen that chronic smokers rarely ever recover from [url:137,type=|term|,content=|chronic pain|] conditions even with a variety of treatments.

While quitting smoking is a necessary component of any patients’ personal rehabilitation from low back pain, it is rarely a sufficient means, and other [url:154,type=|term|,content=|pain treatments|] such as injections, surgery, medication, and exercising are essential.

As far as [url:173,type=|term|,content=|spinal fusion surgery|] for patients with low back pain, quitting smoking prior to surgery is critical. There is a lot of research showing that smoking is detrimental to obtaining a solid fusion, but now there is also research showing that even if a smoker gets a solid fusion, their ultimate result is not nearly as good as a non-smoker. A recent study by Dr. Steven Glassman found that smokers who did not quit at least a month prior to their surgery were far more likely to return to smoking within a year. Given the expense, pain and lengthy recovery of any lumbar fusion surgery it is only reasonable to have the best biological situation for a successful outcome.

Get the Flash Player to see this player.

For many patients, there is a distinct choice between continuing to live in pain or going through the challenge and discomfort of quitting smoking. When the pain gets bad enough, the choice can be easy enough, especially if the patient realizes that smoking is very closely related to the pain.

Posted by: Peter Ullrich, Jr., MD

More reading:

[url:6673,type=|node|,content=|Stop Smoking to Reduce Back Pain|]
Stop Smoking Message Boards

Stop Smoking to Reduce Back Pain: Why the Anti-Smoking Crowd Hurts Less

Fri, 14 Dec 2007 15:25:49 -0800

December 14, 2009
by: Sylvia Marten

That cigarette with your cup of morning coffee is relaxing, isn't it? You can just feel the tension release from your body as you light one up and deeply inhale. Smoking is a powerful habit, the anxiety release fully understood only by people who either currently smoke or have smoked in the past.

However, according to Dr. Edit Balan, your brain and your serotonin levels aren't fooling your back and you can reduce your back pain if you stop smoking. Dr. Balan, director of the pain clinic of the GHS in Haifa, Israel, presented a study at a conference on back pain which shows that smokers have twice the risk of experiencing back pain than non-smokers.

The Oxford Journal on Rheumatology hypothesizes the reason for a higher of incidence of back pain amongst smokers is that smoking leads to malnutrition of discs, which in turn become more brittle and vulnerable to stress. Nicotine constricts blood vessels (known as nicotine-induced vasoconstriction), can potentially cause changes to interior arterial walls and changes in blood flow. Perhaps the reason for less back pain in the anti-smoking crowd can be attributed to more efficient blood flow.

A study of 3,222 smokers and non-smokers conducted by the Division of Clinical Epidemiology in Montreal, Canada concluded that smokers have more frequent episodes of back pain than non-smokers, further evidence that quitting smoking is an important consideration for back pain sufferers.

If you're considering a "stop smoking" New Year's resolution, we know it's not easy (but it's healthy!) - so here are some tips, tricks and resources to help you get through the adjustment period. These tips come from the American Cancer Society's suggestions about how to kick the smoking habit for good.

Make a definitive decision to quit. Don't try to cut back, or "think about" quitting smoking -- decide to do it and stick with your plan. Choose a date that you will stop smoking and pick a smoking cessation plan that will work for you.
Stay away from places where smokers convene or where you are used to smoking.
Do something different. Go for a walk instead of a smoking, take a drive to somewhere new, drink water or juice instead of alcohol, or purchase an herbal tea in the morning instead of coffee.
When you get that craving to smoke, keep your hands busy. You can try woodwork, knitting, pottery or even taking up an instrument. Snack on healthy, crunchy foods like carrot sticks or seeds. You can chew sugar-free gum. If you are having an exceptionally hard time kicking the smoking habit, many people "take the edge off" by starting with nicotine gum and gradually transition to non-nicotine gums.
Do your deep breathing. Inhaling deeply can help simulate that feeling you had while smoking, but you'll feel better breathing clean air rather than smoke.
If do break down and feel like you absolutely need a cigarette, force yourself to wait 10 minutes. Often, by the time the 10 minutes are up, the craving has passed and you will be able to skip the cigarette. Distract yourself during that 10 minute span - call a friend, walk into a store, pay a bill, watch TV, etc.
Save up the money you would have spent each week on cigarettes. Use some of the money to treat yourself to dinner or a movie, book, CD or other reward for quitting smoking!

There are also anti-smoking medications available such as Chantix and Zyban (please see their respective websites for information on effectiveness, research and contraindications).

You can also keep a Stop Smoking Craving Journal to keep track of when your cravings are the worst and make informed decisions about what to do during those times to improve your anti-smoking efforts.

Additional Stop Smoking Resources

SmokeFree.gov - Information and resources for quitting smoking from the U.S. government
The Stop Smoking Guide - Anti-smoking product reviews, forums and blog
QuitSmokingSupport.com - Support and information to help you stop smoking

New Hope for Smokers with Back Pain

Wed, 08 Aug 2007 15:15:12 -0700

August 8, 2007
by: Sylvia Marten

There’s a unique drug now on the market for smokers trying to quit - Chantix (manufactured and distributed by Pfizer). It was actually approved by the FDA in May 2006 and given priority FDA review because of its significant potential benefit to public health.

Chantix, a prescription drug indicated for smoking cessation, is different because it acts on the brain in two ways: by providing some nicotine effects to ease withdrawal symptoms and by blocking the effects of nicotine from cigarettes if patients resume smoking.

According to the Centers for Disease Control and Prevention (CDC), an estimated 44.5 million adults in the United States smoke cigarettes and more than 8.6 million of them have at least one serious illness caused by smoking. In particular, smokers are nearly 3 times as likely to develop chronic low back pain as non-smokers.

According to a user survey conducted on Spine-health.com, about 30% of the chronic back pain population self reports having a smoking addiction. Couple this with the fact that about 80% of those same people are candidates for [url:165,type=|term|,content=|back surgery|] – and we have trouble. Smokers are at higher risk for healing problems after fusion surgery, which means that potentially the chronic back pain problem and the smoking addiction will remain after surgery if smokers with back pain don’t quit.

It is common for back surgeons to ask their patients to quit smoking prior to surgery and commit to not smoking for at least three months after surgery (and hopefully longer, from an overall health standpoint). In recent months, we have heard anecdotally from some of our physician members that they have seen great results using Chantix with their back pain patients. Other smoking cessation aids include: [url:6745,type=|node|,content=|Zyban|] (pill), Nicotrol (nasal spray), Nicorette (gum), Nicoderm CQ (patches), Habitrol (patches), Commit (lozenges), and counseling and support groups.If you are a smoker with back pain, you should consider talking to your doctor about smoking cessation aids – to help you quit smoking and to ease your back pain.

Posted by: Sylvia

More reading:

Chantix patient information sheet at FDA
[url:1826,type=|node|,content=|Healing after spine fusion surgery|]
Varenicline (Chantix) shows greater continuous smoking abstinence