Quitting cigarettes

A recent small study suggests that Hypericum spp. (St. John’s wort) may help people quit smoking. The study was based on research showing that some prescription antidepressants can help people quit smoking, and hypothesized that St. John’s wort might have a similar effect but with fewer side effects. The participants took 450 mg of standardized (0.3% hypericin and a minimum of 4% hyperforin) twice daily. Almost 38% were not smoking 12 weeks later. This study did not have a control group but other studies suggest that maybe 17% of those determined to quit are able to do so cold turkey. The study is well reasoned and admits that it is preliminary, cautioning us not to “over interpret the results.”

They also note that Zyban (buprion, an antidepressant studied in smoking cessation) yielded about the same results but was only available by prescription, cost $120/month plus the cost of a doctor visit, and up to 48% of those taking it experienced side effects such as dry mouth, seizures, insomnia, and headaches. They even calculated that patients with good insurance coverage actually might only spend $20 on the drug. In contrast, St. John’s wort is readily available at a cost of about $11/month and at most 7.5% suffered side effects of GI disturbances and photosensitivity.

Anyone who has smoked knows that quitting smoking involves much more than overcoming nicotine addiction. Smoking, like drug use and overeating, is a form of self-medication. I have found that adaptogens are useful in helping people maintain their resolve to quit smoking. I will now be advising people to take St. John’s wort as well to provide some more focused emotional relief.

In the study, the participants began taking St. John’s wort for a week before their “quit date.” The study also suggested that it might be better to take it for a while longer before that date as studies suggest that the effect of the herb builds slowly in most people. The same is true of adaptogens, so it probably makes sense to have people take both for 3-4 weeks before trying to quit.

Lawvere S, Mahoney MC, Michael Cummings K, et al. A phase II study of St. John’s wort for smoking cessation. Comp Ther Med 2006; 14:175-184.

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