Varenicline: What is the new anti-smoking pill available on the NHS?

An improved anti-smoking drug called Varenicline is being rolled out by England’s National Health Service (NHS).

The pill is more effective than nicotine-replacement gum or patches, and as effective as vapes, in helping people to stop smoking, according to NHS England. 

Taken daily, it reportedly reduces cravings for nicotine and blocks its pleasurable effects on the brain. It can also help with reducing withdrawal symptoms, including irritability and insomnia.

When used in conjunction with psychotherapeutic assistance like counselling, the treatment has been shown to help around one in four people to stop smoking for at least six months, NHS England said. 

It is available by prescription only, offered through general practitioners or the NHS’ stop smoking services.

Varenicline could help over 85,000 people stop smoking each year while its use over the next five years could prevent up to 9,500 smoking-related deaths, according to research from University College London (UCL).

“Prevention is better than cure. The rollout of this pill can save the NHS millions of pounds, save appointments to help other patients be seen faster, and save lives,” the UK’s health and social care secretary, Wes Streeting, said. 

The smoking cessation pill was previously available on the NHS under the brand name Champix but was withdrawn in 2021 as a precaution due to an impurity. This relaunched version has since been approved as safe by the Medicines Health and Regulatory Authority (MHRA). 

Moving towards a smoke-free UK

The drug arrives at a time when the UK is pushing to implement some of the toughest anti-smoking measures in the world, introducing an anti-tobacco bill that could potentially ban anyone born after January 1, 2009, from legally smoking. 

Around one in eight adults in the UK smoke, according to the NHS, with more than 400,000 hospital admissions in England linked to smoking from 2022 to 2023.

“This simple daily pill could be a game-changer for people who want to quit smoking and is another vital step in shifting our NHS further towards prevention,” NHS Chief Executive Amanda Pritchard said during a speech at the NHS Providers annual conference. 

“Smoking remains one of the biggest public health issues facing the NHS and has devastating impacts on the body – from the lungs, to the heart, blood and brain, while also increasing risk of cancer, diabetes and stroke,” she continued. 

“Alongside supporting the Government’s ambition to create the first smoke-free generation, we are giving current smokers the tools they need to quit – with proven treatment options like this, alongside specialist care, helping to save thousands of lives and the NHS millions of pounds in treatment costs”. 

The NHS spends around £2.5 billion (€3 billion) on treating health issues caused by smoking each year, making it the leading cause of preventable illness and deaths, NHS England stated. 

Other smoking cessation treatments offered by the NHS include nicotine replacement therapies such as nicotine patches or gum and a drug called Bupropion (marketed under the brand name Zyban), an antidepressant that was found to help reduce peoples’ cravings. 

While vapes are also commonly used to help people quit cigarettes, they are not available on prescription from the NHS, with NICE guidelines recommending that people use “a licensed stop smoking medicine instead”.

In response to the rollout of Varenicline, Nick Hopkinson, a professor of respiratory medicine at Imperial College London, said it is “the most effective smoking cessation medication” and that “people are most likely to quit successfully if they have a combination of counselling support and medication to relieve cravings and help break their tobacco dependence”. 

Dr Sarah Jackson, a principal research fellow at the UCL Tobacco and Alcohol Research Group, said “the availability of varenicline can help more people to quit and avoid years of ill health and early death”.