As reported by the Boston Globe, May 18, 2006.

Co-creator of Anti-smoking Drug Gratified to Make a Difference

By Judy Benson

GROTON, Conn. --For chemist Jotham Coe, the real reward for his discovery of the molecule that is the basis of the smoking-cessation drug Chantix is yet to come.

The 47-year-old Pfizer research fellow and Niantic resident, who with trial and error, luck and persistence created the compound in the pharmaceutical giant's Groton laboratories in 1995, has watched his discovery through the long process from concept to experimental drug to approved treatment.

But it won't be until some future day, when an ex-smoker he meets tells him he was able to quit by using Chantix, that Coe expects he will experience the best kind of satisfaction -- knowing his work made a difference in someone's life.

"That's when I'll get the real sense of accomplishment, that sense that you've done a good thing," Coe said.

Coe is quick to emphasize that he is part of a team of about 35 scientists at Pfizer's Groton research lab who all had a part in creating the new drug, considered a novel approach to smoking cessation because of the way it works in the body. Instead of trying to replace the nicotine delivered by a cigarette with a nicotine patch or gum, or employing an antidepressant to counteract the effect of losing the addictive nicotine dose, Chantix stimulates the same part of the brain as nicotine, but more gradually. If someone smokes a cigarette while taking the drug, the nicotine has no added effect.

"This is a breakthrough," Coe said.

Dr. Cheryl Oncken, a physician at the University of Connecticut Health Center in Farmington, oversaw one of the most recent clinical trials on Chantix. Since 70 percent of smokers say they'd like to quit, and many who do quit succeed only after multiple tries, the drug is a welcome addition to what's now available to help people stop smoking, she said.

"I think this is going to be a significant new treatment for smoking cessation," she said. "People in the trial did have an easier time quitting. They didn't seem to be having a lot of the cravings and withdrawal symptoms."

Patients in the trial took the pills for 12 weeks, with about one-third of them experiencing some moderate nausea, she said.

"But most were able to work through it," she said.

As with all smoking-cessation drugs available, Oncken did see high rates of relapse with Chantix -- about one-third to half the patients began smoking again, some because of a stressful event in their lives or other trigger. In some of those cases, the patients were able to resume taking Chantix and quit again. She added that taking the medication in combination with some type of counseling or support system would probably increase its effectiveness.

"The more intensive the counseling, the better the chances of success," she said. "Typically it does take three to five serious quit attempts" before someone stops permanently.

Coe has firsthand knowledge of just how powerful an addiction cigarettes are. A former smoker himself, he is the son of parents who were smokers. His father died of emphysema at age 69.

For anyone who wants to try Chantix and wants to give themselves the best chance of success at breaking the cigarette habit, he said, understanding a bit about the psychology and physiology of smoking is key. Pfizer plans to provide patients who take Chantix with self-help information, perhaps via a Web site, to explain what triggers a desire to smoke, how to disassociate a trigger from the impulse to smoke, and the physical sensations accompany smoking.

"Nicotine turns on a natural release of body chemicals that's like a church bell effect of going on strong and then slowing down with persistent ringing," he said. "It causes you to reset the level of dopamine (the brain's pleasure and motivation hormone) you expect to get."

What Chantix does, he explained, is help bring the body back to normal dopamine levels, and close off nicotine receptors in the brain "so that if you did smoke, you wouldn't get rewarded."