Do whatever it takes to quit tobacco

I spend a lot of time thinking about smoking. That’s because nearly 500,000 people die each year from issues related to tobacco use — lung cancer, COPD, heart attacks. Tobacco attacks nearly every organ of your body.

On average, people who smoke die 10 years sooner than nonsmokers. Too many people think about their Uncle Jack who smoked two packs a day and drank half a bottle of whiskey every night. Well, that’s the extreme, but there are so many more smokers out there who suffer the consequences.

I’m surprised how many people in Wisconsin still smoke, 14.3%, which is above the national average of 14%. And I’m frankly alarmed about this statistic from the Centers for Disease Control and Prevention: In 2023, 10% of middle and high school students reported using tobacco products.That’s one in 10 kids still using tobacco, despite all we know about the dangers. The CDC notes that tobacco use remains the leading cause of preventable disease and death in this country.

So, here’s the latest data on how to quit. If you know someone who smokes, share it with them.

First, varenicline (the drug in brand name Chantix) is your best bet. With a GoodRx coupon, you can get a month’s supply of the generic version for about $36. You’ll need a doctor’s prescription for this — the pharmacist will give you good instructions on how to take it.

Like any drug, not everyone tolerates Chantix; it can cause nausea for some and insomnia for others. But 95% of those who get the prescription do tolerate it.

Kicking butt — the cigarette kind — is not for the faint at heart. It takes some work and tolerance. And, by the way, recent research shows that doubling the normal dose of Chantix for those who failed with the first round of the drug worked for a lot of smokers. So keep that in mind.

The other drug that’s highly effective is the antidepressant bupropion, which costs about $10 a month. It has a high success rate of up to 30% in some studies. You need to take it for about three to six months, but it’s my second-best recommendation when it comes to stopping cigarettes. One in five smokers who take it are quitters at one year, and that’s a fine number.

What about the patches and gum? And where does vaping fit in — is it worse than smoking? I get these questions all the time.

Tobacco is worse than vaping. We have enough information to say that unequivocally. Vaping is a nicotine delivery system, just like Nicorette gum, nicotine lozenges and the patch. As for which of these might be a superior choice to help smokers quit, well, it’s a bit hazy there.

Studies have shown that nicotine replacement therapy by gum, lozenge or patch is not as good as Chantix but works for many. Adding these to Chantix use did increase the chances of quitting by a modest amount.

As for vaping, it was superior to the patch and gum in randomized controlled studies. The one-year quit rate was twice as good and the patch or gum.

The downside to vaping was that those who did it were much more likely to remain vaping one year later, with nearly 80% continuing to vape down the line. With nicotine replacement by patch or gum, only 10% were still using it a year later.

My spin: If you smoke, try to quit. It’s as simple as that.

When I was in college, I thought smoking was cool. I smoked a pack every day or two for about four years — too long, for sure, but that’s when nearly half of all college students smoked. I was in good company, or maybe bad company.

It took me four tries to quit. And when I first quit cigarettes, I went to a pipe on and off for a year or two, thinking it was a “healthy” alternative. Not.

One issue here is the question of vaping. It might help you kick butt, but how healthy is it for a lifetime? We don’t have the data on that yet since vaping is too new. But we do have the data on smoking, so if I had to choose between the two, I would choose vaping.

If I look at this overall, using Chantix, perhaps more than once — and considering the higher dose if it doesn’t work at first — is still the best way to go. Any way you can find to give up tobacco products will improve your health. Stay well.