Champix

Champix is a medicine containing the active ingredient varenicline to help adults stop smoking. Champix tablets work by helping to relieve the symptoms of craving and withdrawal when you stop smoking. This is done by blocking nicotine, which reduces the positive influence that cigarettes have on your mood, and releasing reduced levels of dopamine (compared to nicotine), which helps lessen craving and withdrawal symptoms. Champix has been created for people who want to give up smoking and are ready to do so, but who require assistance. You usually smoke for the first two weeks while taking Champix tablets, but if you continue after that, Champix can also reduce the enjoyment of smoking to help you stop.Smoking is one of the biggest causes of death in the UK. Around 78,000 people a year die from smoking-related illness and many more have to live with the effects of debilitating illnesses caused by smoking. If you smoke, you are putting yourself at risk of more than 50 serious health problems, some of which are fatal. You are also putting the people around you at risk, as they are exposed to passive smoking – inhaling secondary smoke.Smoking can cause various types of cancer including lung, throat, bowel, kidney and liver cancer. Passive smoking can increase the risk of lung cancer by around a quarter, and smoking is responsible for 7 out of 10 cases of lung cancer in the UK. It also causes other types of lung damage such as chronic obstructive pulmonary disease (COPD), emphysema and bronchitis. It can also cause heart problems, strokes, heart attack and heart disease.If you are reading this, then it is likely that you are thinking about trying to stop smoking. This is no easy task due to the addictive nature of nicotine and the habits you will have developed around smoking over the years. You will probably need help and there are a variety of organisations, methods, books and medicines out there you can turn to.

Champix is a medicine containing the active ingredient varenicline to help adults stop smoking. Champix tablets work by helping to relieve the symptoms of craving and withdrawal when you stop smoking. This is done by blocking nicotine, which reduces the positive influence that cigarettes have on your mood, and releasing reduced levels of dopamine (compared to nicotine), which helps lessen craving and withdrawal symptoms.

Champix has been created for people who want to give up smoking and are ready to do so, but who require assistance. You usually smoke for the first two weeks while taking Champix tablets, but if you continue after that, Champix can also reduce the enjoyment of smoking to help you stop.

• Adopt a positive mental attitude

If you have tried before and failed, try to work out what let you down and how can you avoid those pitfalls this time. Get a plan and set yourself up for success. Believe you can do it and focus on why you want to give up. The health benefits are obvious, but perhaps you also have children or grandchildren and want to prevent them from inhaling your passive smoke or simply improve your chances of seeing them grow up.

• Plan ahead

Work out when and why you get cravings and have a plan to deal with them. If you know you are going to be in a situation where you are likely to be tempted (for example social occasions), have a get-out clause and plan an escape route. It can help to have an end-goal in mind, for example aiming to go one month without smoking to start with. Mantras can help in tough situations.

• Change what you eat and drink

A US study has showed that certain foods such as meat make cigarettes more appealing whereas cheese and fruit make them taste terrible. The same study also looked at drinks, with alcohol, coffee and fizzy drinks making cigarettes taste better. Try to drink more water and fruit juice therefore, as this can help lessen the craving for a cigarette.

• Get support

Professional support from your doctor or a stop-smoking group, friends and family or others is invaluable when trying to quit. Ask your non-smoking friends for help and tell people what you need from them. It sounds obvious, but many hands really do make light work and it is easier to achieve your goals with good help and support.

• Medication

There are many options to help you stop smoking, the main three being:

• Champix tablets (varenicline)
• Nicotine replacement therapies (patches, gum, lozenges, nasal sprays, inhalators and microtabs)
• Zyban tablets (bupropion)

See below for more information about how Champix can help you quit smoking.

Champix tablets are designed to support your decision to stop smoking. You will need to be motivated and have a plan in place. It is not a substitute for willpower and to stop smoking, you will still need to use as many other resources as you can. However, Champix tablets do make the process a little easier by lessening cravings and withdrawal symptoms.

Before you start taking Champix tablets, you should decide on a date that you will stop smoking. This should be between 10 and 14 days after you start taking Champix. Although continuing to smoke after you have decided on a quit date will not cause any problems with the medication, if you fail to stop on your decided date, then your chances of succeeding are reduced. Champix tablets will help, as after the two-week period, they will lessen your enjoyment of cigarettes. It is worth remembering that every single cigarette you smoke causes damage to your health, so every cigarette you do not smoke is a step in the right direction. Champix tablets should be taken daily with a glass of water, with or without food. For dosages see below.

Initially, you should take Champix tablets every day for a 12-week period. If you have stopped smoking after 12 weeks, your doctor may recommend a further 12 weeks of treatment to help prevent a relapse. If you cannot stop smoking straight away, you should reduce your cigarette intake for an initial 12-week period and then completely stop with a second course of treatment.

There are two types of Champix tablets: white (containing 0.5 mg of varenicline) and blue (1 mg of varenicline). Start with the white Champix tablets and then move on to the blue ones as time goes on. While you should always follow your doctor’s instructions when it comes to taking medicines, the general dosage guide for Champix tablets is:

• Week 1, day 1-3: one white tablet (0.5 mg) once a day;
• Week 1, day 4-7: one white tablet, twice a day, morning and evening at around the same time each day;
• Week two onwards: one blue tablet (1 mg), twice a day, morning and evening at around the same time each day.

If you experience strong side effects, your doctor may decide to reduce your dosage to just the 0.5 mg white Champix tablet, and they also may decide to taper off your treatment by reducing the dose towards the end of the course to help prevent withdrawal symptoms. If you accidentally take more than the advised dose, seek medical advice straight away. Do not take a double dose: if you forget to take a Champix tablet, take it as soon as you remember unless there are less than four hours until you are due to take another one. In this case, you should just skip the forgotten dose. It is important to take your Champix tablets at the same time every day.

Whether you are taking medication to help you or not, stopping smoking can cause mood swings, depression, irritability, difficulty sleeping or concentrating, increased appetite, weight gain and decreased heart rate. If you are trying to quit smoking and are worried about changes in your mood or depression, you should talk to a doctor or pharmacist, regardless of whether or not you are taking medication to help you.

Like all medications, Champix can cause side effects, and of course not everyone will suffer from them. If you are worried about any of the side effects, you should talk to your doctor or pharmacist.

Very common side effects of Champix are:

• Nausea;
• Inflammation of the nose and throat;
• Abnormal dreams or difficulty sleeping;
• Headaches.

Common side effects, affecting up to 1 in 10 people are:

• Chest infection;
• Changes to your appetite;
• Dizziness;
• Heartburn;
• Skin rashes;
• Aching joints;
• Tiredness.

Rare side effects that may affect up to 1 in 100 people:

• Fungal infection;
• Blood in your stools;
• Night sweats or increased sweating;
• Mood swings, depression, anxiety;
• Seizures or tremors;
• Muscle spasms, chest wall pain;
• Increased menstrual flow;
• Heart attacks;
• Suicidal thoughts;
• Frequent urination;
• High blood sugar;
• Flu-like symptoms.

Very rare side effects that may affect up to 1 in 1,000 people include:

• Excessive thirst;
• Diabetes;
• Sleepwalking;
• Severe skin reactions;
• Serious allergic reactions;
• Stroke;
• Feeling unwell or unhappy.

Champix tablets should not be taken by people with certain mental health problems as it can cause changes to your mood. Please seek professional medical advice on this issue. Champix tablets should not be used by people under the age of 18, women who are pregnant or breastfeeding, people with severe kidney failure or if you are allergic to any of the ingredients. Avoid driving or operating heavy machinery until you know whether Champix makes you tired or dizzy. Do not take Champix tablets if you are not committed to quitting smoking – it is not a substitute for willpower.

If you plan to use Champix tablets in conjunction with other anti-smoking therapies, you should discuss this with your doctor first to make sure they are compatible. If you are stopping smoking with or without taking Champix tablets, you may need to alter the doses of certain other medicines you take, including warfarin, insulin and theophylline.

You should avoid taking cimetidine if you have kidney problems as this reacts with Champix tablets and may cause increased levels of varenicline in your blood. You should always tell your doctor or pharmacist about any medication you are taking or have recently taken, including herbal supplements. They will be able to tell you whether it is advisable to take both medications together.

You can buy Champix tablets from any pharmacy (online, local, supermarket etc.) provided you have a prescription.

No, Champix is a prescription-only medicine. You will need to speak to a doctor so they can see whether Champix tablets are suitable for you and give you any necessary advice.

NHS: Ten self-help tips to stop smoking (October 2018) retrieved from https://www.nhs.uk/live-well/quit-smoking/10-self-help-tips-to-stop-smoking/

NHS: What are the health risks of smoking? (October 2018) retrieved from https://www.nhs.uk/common-health-questions/lifestyle/what-are-the-health-risks-of-smoking/

Pfizer Europe: CHAMPIX Information for smokers prescribed Champix (April 2018) retrieved from https://www.champix.co.uk/champix-smoker

Pfizer Europe: Package leaflet Champix (August 2018) retrieved from https://www.medicines.org.uk/emc/files/pil.266.pdf

Royal Free NHS: Champix (August 2016) retrieved from https://www.royalfree.nhs.uk/patients-visitors/stop-smoking/treatment-to-help-you-stop-smoking/champix/