Chantix Recall: What Recall? Military Now Has Questions

Washington, DCThe TV commercials still feature the darling little duo of the tortoise and the hare and the announcer still oozes comforting charm as he rattles off all the side effects. However, the message has changed now—and in spite of the viewers rooting for the determined little tortoise while the hare lollygags in the background, losing the race—it's hard not to notice the reference to Chantix and suicide, suicidal thoughts and Chantix suicide ideation. There has been no Chantix recall.

Meanwhile, various organizations aren't taking any chances. Months ago airline pilots and air traffic controllers were banned from using Chantix. And now at least one military pharmacy in the Pacific has pulled the medication amidst strong warnings linking Chantix to the potential for severe psychiatric problems.

It should be noted that Chantix remains an option for soldiers and military personnel wishing to quit smoking, and there are still health care providers who feel that Chantix has generally proven effective and has a positive risk/benefit profile considering that for some the chance for a smoke-free life outweighs the risks associated with using Chantix.

However, that wasn't good enough for medical officials at Yokota Air Base in Japan. The decision to pull Chantix was made after digesting a May 21st report from the Institute for Safe Medication Practices, a not-for-profit organization dedicated to preventing medication errors, and advocating safe medication use.

According to the report varenicline—which is what Chantix is—was linked to 988 serious injuries in the fourth quarter of 2007 alone. Among the concerns were seizures, sudden loss of consciousness, muscle spasms, vision disturbances, hallucinations, paranoia and psychosis among other side effects.

The Office of the Chief Medical Officer for the Defense Department recommended that personnel operating aircraft, aircrew, air traffic controllers and missile crewmembers should under no circumstances use varenicline.

At Yokota, military patients who are currently taking Chantix will be allowed to see the program through. However, the formulary will not refill prescriptions until a patient consults his or her doctor. As for the remainder of the military, that appears to be the plan. Chantix will be governed by the doctor-patient relationship. Aside from those who have been expressly forbidden to use Chantix, patients on the medication must attend counseling as part of their program.

It should be noted that during the clinical trial for Chantix, all participants had the benefit of counseling as part of their Chantix regimen. Given the recent health concerns with regard to Chantix, including hundreds of suicide attempts and actual suicides, such counseling is vital not only to the potential success of the program, but also to the safety of the patient.

There is little doubt that America had embraced Chantix before the health concerns came along. Current estimates have 5 million adults in the US prescribed Chantix—and that kind of support is reflected in the military.

For example, in 2006—the year that Chantix first appeared—there were 262 prescriptions originating from the military. A year later, that number had grown to 67,580.

The Catch 22 for military personnel is that there are too many other serious risks inherent with serving one's country to be concerned with the potential risk of adverse side effects associated with Chantix. The fear, of course, is that some brave soldier somewhere survives everything the enemy can throw at him or her, only to be felled by psychological problems triggered by an effort to quit smoking aided by Chantix.

Mercifully, such an event hasn't happened.

Yet.