Supplement Detective

By Curtis Alexander, Pharm.D.
America’s Natural Pharmacist

Summary: There is more than one quit smoking shot on the market.  Quit smoking shots – as a whole – are as effective and, in some cases, more effective than some of the popular oral smoking cessation medications.  Each shot must be given behind the ear by a doctor and has prescription drugs in it that can cause side effects.

Dear Curtis: I know that smoking is bad and I have, like so many other people, tried to quit smoking on a number of different occassions.  But, in the end, I have never been able to kick the habit.  I have heard that they have now developed a shot to quite smoking.  Is this true?  And, if so, how much does it cost and is it worth the money?

A: Believe it or not, there are actually a number of shots on the market to help you quit smoking.  Each has different ingredients in them and each has different levels of effectiveness, price and side effects.

The first of the quit smoking shots was called Welpex and used two prescription medications called scopolamine and atropine.  Scopolamine is often used in patch form (placed behind your ear) to prevent or treat motion sickness.  It is also used a lot in hospice patients.  Atropine is an old medication which isnt used that much anymore.  Why?  It has a whole host of side effects because its effects are spread out in your body.  But the most serious one is making your heart beat faster.  Also, Welpex required three individual shots to be administered by a doctor so its convenience was not very good.

The second shot on the market was called The SMART™ Shot.  The SMART acronym stands for Scopolamine Mediated Anticholinergic Receptor Treatment.  The idea behind this treatment is to improve upon Welpex and get rid of the atropine in the shot and replace it with hydroxyzine which goes by the brand name Atarax.  This is an anti-histamine drug that acts in a very similar fashion to Benadryl® (diphenhydramine).  While The SMART™ Shot does get rid of the atropine side effects, antihistamines like hydroxyzine are notorious for causing drowsiness and, frankly, are not tolerated by a lot of patients especially if they drive or operate machinery or require good attention spans.  In trials, The SMART™ Shot reports to have better smoking cessation rates than the popular stop smoking drug Zyban® (just over 80%).

The last shot that I know of on the market is called QUIT 1-2-3.  Like Welpex it is a 3 shot treatment.  And, like Welpex and the SMART shot – they are injected behind your ear and are eventually followed up with pills to be taken by mouth.  The biggest difference is that QUIT 1-2-3 follows everything up with smoking cessation counseling to help you quit.  Reported quit rates at 60 days with QUIT 1-2-3 are 86%.  Quit rates at six months are 71%.

Effectiveness and Price

Obviously, using a shot to quit smoking is an option.  And, in many cases, it can be one of the more effective options.  But, like anything, there are downsides to this type of treatment.  Suprisingly, the cost for these shots is usually around $400.  While that sounds pretty high all you need to do is price out some of the other smoking cessation products and you will find this is not all that bad.

I would say the biggest downside to the shots is the incovenience of getting the shot itself not to mention that from all the reports I have read it is tough to find a doctor and a clinic who are comfortable administering the shots.

The biggest take home point for you is that the shots do appear to be fairly effective.  At least as effective, and even more so in some cases, then some of the more popular oral medications.  But, in my experience, the most important ingredient to help you quit smoking is the actual desire to quit smoking and having a really profound reason for doing so.  Nicotine is one of the most addictive substances around.  It has been compared in that regard to drugs like cocaine.  So, if you are going to quit you better have something driving you or it does not matter whether it is a shot, a pill or going cold turkey.

The smokers who I have know have always had this driving force: they just found out they are pregnant, a friend or family member gets lung cancer, emphysema, a woman sees an older woman with the tell-tale rings around her mouth and wrinkles in her face from 40 years of smoking.  Whatever it is, just make sure its strong enough to keep you going long term.

Hope this answers your question.