- Chantix is a prescription medication that helps people quit
smoking by making cigarettes unsatisfying. - Chantix also works by preventing tobacco cravings, much like nicotine replacement therapy.
- Experts in nicotine
addiction say Chantix is the single-most effective treatment to help smokers quit. - This article was reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.
Chantix, the brand name version of a drug called varenicline, is a nicotine-free prescription pill used to help people quit smoking gradually. Unlike nicotine replacement therapies, varenicline blocks the brain from getting pleasure due to nicotine.
Chantix makes smoking less gratifying
Smoking is the leading cause of preventable death worldwide. This is likely because it's so difficult to quit, thanks to how nicotine affects the brain.
When you smoke, nicotine attaches to receptors located in the brain's reward center. This causes those receptors to release dopamine, a hormone that elicits feelings of pleasure. Once that dopamine rush wears off, you begin to crave nicotine, says Panagis Galiatsatos, MD, the director of the Tobacco Treatment Clinic at Johns Hopkins Medicine.
Chantix helps break this nicotine addiction in two ways:
- Chantix attaches to nicotine receptors, blocking nicotine from reaching them. This means smoking no longer provides the same sense of pleasure, breaking the reward cycle.
- Chantix causes receptors to release dopamine, but in smaller doses compared to nicotine. Much like nicotine replacement therapy, this helps ease cravings.
When smoking becomes an addiction, your brain associates certain smells, locations, or emotions with the action. This makes you want to smoke when you're in certain situations, even if your brain isn't in need of a dopamine rush, says Galiatsatos.
If you smoke on Chantix, not only will it be unsatisfying, but it will also break the association between specific circumstances and the need to smoke.
"If you try to smoke [while on Chantix], it won't be successful," says Galiatsatos. "Varenicline also keeps [higher] dopamine [levels] in the brain, satisfying pleasure sensors without nicotine, and cuts cravings."
How to use Chantix
Chantix is available by prescription only and is usually prescribed for 12 weeks. It's important to speak with your healthcare provider to determine the right dosage and plan for you.
There are three proven ways you can use Chantix to quit smoking:
- Fixed quit: Stop smoking one week after taking Chantix, and continue taking it for 11 weeks.
- Flexible quit: Stop smoking one month after taking Chantix, and then finish your prescribed 12-week course
- Gradual quit: Aim to cut your smoking in half each month you're on Chantix, with the goal being to completely quit at the end of 12 weeks.
How long quitting takes will depend largely, but not solely, on your smoking habit. "Some patients can quit immediately but others need to be on it for longer than 12 weeks. Guidelines are fine but they are not rules, you have to adapt treatment to the patient," Galiatsatos says.
How effective is Chantix?
In the United Kingdom, one in four people who quit smoking were using Chantix.
A 2020 report found that experts specializing in tobacco addiction recommended that those who wish to quit smoking take varenicline over all other treatment options. The experts also recommended pairing Chantix with a nicotine patch.
A 2016 review also found that varenicline is "the most effective single-use agent for treating tobacco addiction." Two large trial studies compared smokers who took either varenicline, bupropion, or a placebo for 12 weeks. It found that 44% of those in the varenicline group had successfully quit smoking four weeks after they completed their 12-week dose, compared to 30% in the bupropion group and 18% in the placebo.
The study also found that the efficacy of varenicline is improved when paired with bupropion — an antidepressant — and nicotine replacement therapies such as gum, patches, or lozenges.
A note on side effects
While there are side effects to be aware of when taking Chantix, Galiatsatos says that the drug poses no more of a risk than commonly used antidepressants. However, some people, especially those with a history of mental illness, may experience serious adverse side effects, such as:
- Changes in mood — including depression and mania
- Hallucinations and delusions
- Paranoia
- Thoughts of homicide and/or suicide
- Aggression and hostility
- Anxiety and panic
- Skin redness, swelling, and peeling
If you experience any of these symptoms, stop taking Chantix immediately and see your doctor.
The bottom line
Chantix works by delivering a one-two punch to smoking: It blocks nicotine from reaching receptors in the brain, which breaks the pleasure cycle of habitual smoking, and prevents cravings by releasing small amounts of dopamine.
Studies show that Chantix is particularly effective when paired with nicotine replacement therapies such as a nicotine patch. However, those on Chantix should pay close attention to any adverse side effects, especially mood changes, and check-in with your doctor if you experience them.
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