Practicing family physicians from the UNC Department of Family Medicine have teamed up with The Carrboro Citizen to bring you a weekly feature responding to your questions about health and medicine. Send your questions or comments to yourhealth@unc.edu
This week we respond to questions about Chantix and back pain.
Dear HOUSE Calls, I’m trying to quit smoking and my doctor prescribed Chantix, but I’ve heard it can cause heart attacks. Is it safe?
There was a study suggesting an increase in the short-term risk of heart events with Chantix, but mostly in people with heart conditions. The tricky thing here is that quitting smoking is far and away one of the best things you can do for your health. But the near-term risk of heart events is scary for some people. Continuing smoking over time increases your heart-attack risk far more than six months of Chantix. We think that for some people Chantix can be a great aid in the struggle to quit smoking. There are other medicine and non-medicine techniques. These include nicotine-replacement therapy (patch, pill, gum, lozenge and inhaler), buproprion (Wellbutrin and Zyban), behavioral therapy, hypnotherapy and group support. Talk to your doctor about the pros and cons of each, but the most important thing you can do is keep on that road toward quitting.
Dear HOUSE Calls, I have a desk job and my lower back hurts. Is there anything that I can do to help?
Sitting places a lot of stress on your back and makes your core weak, but there are many things you can do to reduce your pain. First, make sure your ergonomic position is reasonable. Your feet should be flat on the floor with your knees slightly above your hips. Hopefully you can adjust your chair to make this happen with your desk still in reach (but watch keyboard position as your chair drops or you might get carpal tunnel syndrome). Some offices and companies can help with this by having an ergonomic specialist evaluate your office environment, especially if your back pain becomes a big problem. Second, get up frequently. This is good for you in so many ways, and will actually increase your productivity. Third, get into the habit of stretching your back daily for just five minutes. There are hundreds (maybe thousands) of suggestions online. Pick four to six stretches and make them a habit. Better still, consider an exercise that will strengthen your core and stretch your back at least twice per week. We like yoga, pilates and swimming.
House Calls is a weekly column by Dr. Adam Goldstein, Dr. Cristy Page and Dr. Adam Zolotor on behalf of Your Health and the UNC Department of Family Medicine.
Thanks for the comments on Chantix. It seems very scary, with the suicides and such. I might stick with something on the rest of the list. Do you know of any herbal remedies for quitting smoking? Does Quit Tea work? http://www.quittea.com
A variety of traditional and alternative therapies exist to help address problems associated with nicotine addiction, and evidence supports both behavioral support and medication.
As of now, unfortunately, none of what most providers would recognize as alternative therapies increases tobacco cessation over the long term. We consulted an expert in our department in herbal medicines and accupuncture, Dr. Gary Asher for further expertise.
While the Society for Integrative Oncology recommends that a trial of acupuncture for tobacco cessation in lung cancer patients may be useful in patients that are having difficulty quitting, this therapy should not take the place necessarily of established medications with proven outcomes, such as wellbutrin, varenicline or combination nicotine replacement therapy.
For now, trials of herbals, such as St. John’s Wort, to help quit smoking have not revealed any positive outcomes for nicotine addiction. Quit Tea is made from a variety of herbal products, including St. John’s Wort, Valerian Root, Licorice, Cinnamon, Ginger and a half dozen other spices. Quit Tea has not undergone trials to receive approval as a drug for tobacco cessation, and there is no evidence it will successfully treat nicotine addiction.
Thank you for the question and good luck.