Chantix works on two levels. First, it partially activates sites in the brain, known as nicotinic acetylcholine receptors, that are affected by nicotine. This gives new ex-smokers mild nicotine-like effects and eases symptoms of nicotine withdrawal. Second, Chantix has the unique ability to stop nicotine from attaching to those nicotine receptors if you do smoke while using it.
How Nicotine Affects Brain Chemistry
Nicotine gives you an almost immediate kick of euphoria (a feeling or state of intense excitement and happiness) that’s the result of rapidly changing brain chemistry. It starts within seven seconds of the first puff on a cigarette. The nicotine molecule is very similar in shape to a neurotransmitter (a chemical messenger that transports and maintains signals between nerve cells and other body cells) called acetylcholine, which affects many bodily functions, including breathing, heart rate, learning, and memory. Acetylcholine also affects other neurotransmitters that have an influence over appetite, mood, and memory. In the brain, nicotine binds to nerve cell receptor sites in places where acetylcholine would, creating the same effects. Once it’s attached, a release of dopamine is triggered. Dopamine is the neurotransmitter thought to be responsible for reinforcing the pleasure/reward associations people have with smoking. It is this chemical process that is thought to be responsible for addiction. Other addictive drugs such as cocaine, amphetamines, and opioids also trigger the release of dopamine.
How Chantix Affects Nicotinic Receptors
When Chantix is introduced into the brain, it targets alpha4beta2 nicotinic receptors, which are a specific type of nicotinic receptor. It docks with these receptors, triggering a release of dopamine in the same way nicotine would, though not quite as much. For ex-smokers, the effect is equal to a low to medium dose of nicotine that lasts until the drug wears off, which is several hours. In this way, Chantix helps to relieve symptoms of nicotine withdrawal that people experience when they quit smoking. The added bonus is that while Chantix is docked at these receptor sites, nicotine cannot be. If you smoke a cigarette while you have Chantix in your system, the cigarette will not offer its usual dopamine boost. Smoking will be a flat and dull experience, which may make quitting easier to achieve.
Research on Chantix’s Effectiveness
Six clinical trials involving 3,659 chronic cigarette smokers tested the effectiveness of Chantix as a therapy for smoking cessation. The trials showed that Chantix was more effective than a placebo to help people quit smoking. In two trials, people using Chantix therapy were more successful at quitting smoking (22% succeeded) than those using Zyban (bupropion hydrochloride) as a quit smoking aid (16% succeeded). For those taking a placebo, success at the one-year mark was approximately 8%. In another study, researchers looked at 1,086 people who quit smoking using Chantix, the nicotine patch, or the patch and nicotine lozenges used in combination. The results indicated that the three methods were similar in success rates at both six months and one year. At six months, 23% of participants who used the patch were still smoke-free, compared to 24% of those using Chantix, and 27% of people who used a combination of the patch and lozenges. At one year, the success rate was 21% for the patch, 19% for Chantix, and 20% for the combination method. Other research has also suggested that a combination of Chantix and the nicotine patch is more effective than using Chantix alone. However, more studies are needed.
Even Small Success Is a Victory
While the success rate may not seem like great odds, keep in mind the sheer number of people who are addicted to nicotine and dying because of it today. Globally, smoking-related diseases cause more than 8 million deaths every year. Put another way, tobacco claims a human life every five seconds somewhere in the world. A drug that has the potential to help about 25% of people using it to quit smoking is worth considering. It’s also important to have quit aid choices available, because what works for one might not work for the next person. Greater choice ultimately equals a greater chance for success.
A Word From Verywell
In the years since Chantix became available, a number of serious health concerns associated with its use have been identified, including changes in behavior, hostility, agitation, depressed mood, and suicidal thoughts or actions. For some people, these symptoms begin when taking the drug. Others develop them after several weeks or even after stopping Chantix. As with any drug, it’s important to tell you doctor about any history of depression or other mental health problem before taking Chantix. Together, you can decide whether it might be a good quit smoking aid for you. For more mental health resources, see our National Helpline Database.
