The UK’s National Health Service (NHS) is making available a free anti-smoking pill called varenicline to British smokers. Studies have shown varenicline to be more effective than traditional nicotine replacement treatments such as gum or patches.

Around 85,000 smokers will be eligible to receive anti-smoking medication, which will be provided alongside “behavioral support” programs aimed at helping people quit smoking, the NHS announced earlier this week.

Research carried out by University College London suggests that around 9,500 smoking-related deaths could be prevented over the next five years.

“This simple daily pill could be a game-changer for those looking to quit smoking and a vital step to move our NHS even further towards prevention,” NHS chief executive Amanda Pritchard said.

So how does the new drug work and could it help prevent serious smoking-related diseases?

How many people smoke in the UK?

According to the 2023 Annual Household Population Survey in the United Kingdom, approximately 11.9 percent of adults aged 18 and over (about 6 million people) are current smokers.

The number of adult smokers in the UK by country is as follows:

• England 11.6 percent
• Wales 12.6 percent
• Scotland 13.5 percent
• Northern Ireland 13.3 percent

What drug is the NHS planning to use?

This is a new version of an older drug called Champix. The new app is part of a wider UK initiative to reduce the number of smokers in the area and deliver overall cost savings to the NHS.

Champix, manufactured by Pfizer in 2006, was the brand name of this anti-smoking drug in the UK market, but it was withdrawn in October 2021 due to concerns about its nitrosamine content, a known carcinogen.

A recall has been issued for community pharmacies and wholesalers following the discovery of nitrosamine impurities in the medicine that exceed acceptable limits set by the European Medicines Agency (EMA) and the Medicines and Healthcare products Regulatory Agency (MHRA).

In August 2024, the anti-smoking pill was reintroduced to the UK market as a generic anti-smoking drug called varenicline and was officially approved by the MHRA this month.

How does it work?

Varenicline works as a “nicotine receptor agonist,” a substance that activates a specific type of receptor in the brain. This agonist works in the same area of ​​the brain as nicotine.

While the drug reduces the effect of nicotine on the brain, it also reduces cravings and withdrawal symptoms. This provides patients with a controlled way to stimulate these receptors without actually using nicotine.

Professional clinicians recommend taking varenicline as part of a broader smoking cessation program that also includes education and counseling to help the patient quit smoking completely.

Clinicians recommend taking the anti-smoking pill for 12 to 24 weeks to successfully eliminate nicotine cravings.

According to information on the NHS website, one to two tablets should be taken a day and smokers should start taking the tablets a week or two before trying to quit smoking.

The NHS also notes the following side effects:

• Feeling and/or being sick
• Difficulty sleeping (insomnia)
• Sometimes vivid dreams
• dry mouth
• Constipation or diarrhea
• headaches
• feeling sleepy
• feeling of dizziness

How is this drug expected to save the NHS money?

Smoking remains the leading cause of preventable disease and death in the UK, and treating people with smoking-related health problems costs the NHS around £2.5 billion ($3.17 billion) a year.

There have been more than 400,000 hospitalizations directly linked to smoking-related problems in England between 2022 and 2023, according to figures from the NHS.

A 2018 study by the National Institute for Health and Care Excellence (NICE) showed £1.65 in cost savings for every pound spent on the branded drug Champix, the previous anti-smoking pill prescribed to smokers along with behavioral support. Treatment of smoking-related diseases.

Where else is this drug used?

Varenicline has been approved for use in 116 counties, according to a report published in June 2023 in the weekly peer-reviewed general medical journal Lancet.

Although Champix (varenicline) is approved in many countries, it has been largely unavailable since being removed from shelves worldwide in October 2021, including in the UK, EU, Japan, South America and most of North America.

Champix wasn’t reintroduced to the market until this year as a generic anti-smoking pill called varenicline.

What results did it achieve?

According to the Lancet, varenicline has been prescribed to more than 24 million smokers worldwide. Although clinical studies vary, between 14 percent and 50 percent of people successfully quit smoking, depending on the specific study and the duration of the clinical trial.

But most researchers agree on one point: Varenicline and other anti-smoking drugs are the most effective way to help people quit smoking.

Although many nicotine replacement therapy (NRT) options are available, including nicotine patches, nicotine gum, and even nicotine sprays, to help people manage nicotine cravings and withdrawal symptoms when quitting smoking, options such as varenicline have proven to be more effective. Studies conducted on people who use nicotine replacement products to quit smoking have produced a wide range of results. However, it is thought that only 10 percent of smokers successfully quit using this method alone.

What other anti-smoking medications are available?

Varenicline isn’t the only anti-smoking pill available.

Cytisine, another smoking cessation drug similar to varenicline, is reportedly available in only 18 countries worldwide. It has not yet received approval from the US Food and Drug Administration (FDA) or EMA.

According to a December 2023 study by researchers in Argentina led by Omar De Santi, a toxicologist at Posadas National Hospital in Buenos Aires, clinical trials found that siticine pills were less likely to help participants successfully quit smoking than those taking these medications. showed that it was twice as high. a placebo.

“It could be very useful in reducing smoking in LAMI (low- and middle-income) countries where affordable smoking cessation drugs are urgently needed. Smoking is recognized as the leading cause of preventable death worldwide. Cytisine has the potential to be one of the biggest answers to this problem,” he said. Santi told the media in January, following last year’s study.

How else is the UK government tackling smoking?

Last week the UK government introduced the Tobacco and Electronic Cigarette Bill, which will see the legal age for purchasing tobacco products gradually increase over the next few years.

Under the bill, the minimum age for purchasing cigarettes would increase by one year each year, effectively barring anyone born after January 1, 2009 (those currently aged 15 and under) from legally purchasing tobacco.

This “smoke-free generation” initiative, alongside the launch of new anti-smoking drug, could save taxpayers more than £500 million ($633 million) a year, according to NHS Chief Executive Amanda Pritchard.

The government has abandoned plans to ban smoking in pub gardens but is considering making it illegal in children’s play areas and outside schools and hospitals. However, the main focus of the updated Tobacco and Electronic Cigarette Bill will continue to be on creating a smoke-free UK generation by making it currently illegal for anyone aged 15 and under to buy cigarettes.

“Prevention is better than cure. The launch of this pill could save the NHS millions of pounds, save appointments to help other patients be seen faster and save lives,” Wes Streeting, Health and Social Care Secretary, told reporters this week.

How serious a health problem is smoking worldwide?

The World Health Organization (WHO) estimates that the annual global cost of tobacco-related diseases has been approximately $500 billion each year since 2010.

1.3 billion people worldwide use tobacco, causing 8 million deaths each year from smoking-related diseases. It’s not just smokers who are affected. Approximately 13 million of these deaths annually occur in nonsmokers exposed to secondhand smoke.

It is estimated that another 68 million people use e-cigarettes.

In 2021, WHO published the Global Investment Case for Tobacco Cessation study; This study found that, on average, if countries spent $0.21 per person per year, an estimated 88 million people could quit smoking by 2030.

It is also stated that the lives of a total of 9.3 million people could be saved among those who quit smoking before the age of 65.