The Baltimore Sun reported last week that the FAA has banned pilots and air traffic controllers from using the quit-smoking drug Chantix following a study that found it had apparently contributed to auto accidents and other mishaps that posed risks to both users and others.
The “easier to quit smoking” part of the hype was as advertised: 44% of people taking Chantix could quit smoking compared to 17.7% percent of those taking placebos.
Chantix is believed to block nicotine from stimulating certain brain receptors so nicotine would not give users the dopamine boost they receive when they smoke. Chantix also stimulates the release of low but consistent levels of dopamine to help decrease nicotine urge.
Correctly expecting the drug would be a real moneymaker ($883 million in 2007 alone), Pfizer had requested and received a sped-up review by the FDA, who approved Chantix in May of 2006. But it takes a while to see if serious side effects will emerge. Pfizer knows this and anyone from its experiences with Zoloft, a drug was on the market for many years before reports of suicidal behavior (and lawyers filing lawsuits) forced Pfizer to put a warning on the drug.
Why doesn’t Pfizer just play it safe and put a suicide warning on the drug? As a lawyer who spent several years representing pharmaceutical companies, I have a theory: warnings on the product label would have discouraged general practitioners from prescribing Chantix, which would have hurts sales. But in hindsight, not including a warning will cost Pfizer more in defending lawsuits and settling Chantix cases.
This post was originally written 11 years ago. Most of the Chantix cases were settled to the tune of about $300 million. There were not a ton of cases and the compelling cases received high compensation for a mass tort (we had one settle close to $1 million).
Pfizer now wonders whether these settlements were just. A 2016 study found no neuropsychiatric risk in taking Chantix versus a placebo.
Does Pfizer have a point? I don’t know. This is just one study and I don’t think that one makes the science. If this study had been known, did plaintiffs have enough evidence to bring a case? Well, Pfizer burned down thousands of trees arguing that Eric Hollander should not be allowed to testify. So this study would just give them one more weapon in that attack. So I see little change based on this one study.
That said, plaintiffs’ lawyers cannot say that there have not been cases settled that would have turned out differently if more science had come out. The silicone breast implant cases are a great example of this. That said, do you know how many plaintiffs have lost because the science has not yet caught up to their case? More plaintiffs have been burned by the science lagging than the defendants.
Should you take Chantix in 2019 if the suicide risk worries you? The best medical advice I can give you is don’t ask a lawyer for medical advice. Ask your doctor what they think is best for you.