This report uses the sensational shooting death of a popular, charismatic figure, Carter Albrecht, to explore the question of whether the smoking cessation drug Chantix has dangerous, little-known side effects, particularly when combined with alcohol.
Albrecht’s death could have been used to open a fair-minded exploration of the risk-vs.-benefit question, and of the potential danger of alcohol use with the drug. Instead, the report relies on additional anecdotes, some anonymous, most of them biased.
The factual reporting about the drug’s record is too cursory to answer the questions the story raises. The viewer is left with a strong suspicion that Chantix is unsafe and possibly deadly, but without enough knowledge to make an informed judgment.
The viewer would have benefited if the host had pointed to web resources on the topic, including an overview of the risks and benefits of various smoking cessation techniques. Effective therapies for smoking cessation have profound societal as well as personal benefits. These benefits might also have been sketched out in order to put the proposed risks of Chantix into perspective.
Many drugs have serious, under-reported side effects; Chantix may turn out to be one. News organizations have a key role to play in bringing these risks to the public’s attention, often against significant commercial pressures. But once they open the safety question, journalists are obliged to try to answer it in a thorough, fair-minded way.
Clearly there was time to address what we feel was missing: this story ran for an extraordinary 5-minutes-plus, not the 75-90 seconds for many TV news stories.
While the report does not state the drug’s price, it is not necessarily germane to a story exploring potential serious side effects.
There is no quantification of either benefits or risks of Chantix.
The report is about allegations of rare but very serious side effects. The viewer should at least be given information about the rates of known side effects and their severity.
The story does report on the drug’s benefits, but it may exaggerate those too. The "wonder drug" set-up overstates the place Chantix holds in smoking cessation practice. Some doctors like it and recommend it, but even the most favorable evidence shows it is slightly more effective than, not far superior to, other approaches. Most cessation techniques, including Chantix, fail at least 70 percent of the time even when several are used together with professional support.
The evidence cited in the report to explore the link between Chantix and irrational, dangerous behavior includes:
Case reports are among the weakest forms of evidence in medical science. Thus the evidence presented is not sufficient to justify implication of serious danger.
The article uses the powerful anecdote of Carter Albrecht’s death to imply the drug has dangerous, unrecognized side effects. This generates fear that apparently is not justified by the drug’s scientific and clinical record.
The fact that Albrecht died sensationally, while making the story more emotionally compelling, amplifies the fear inappropriately. He died of a gunshot wound, not a drug reaction. In addition, he’d been drinking alcohol before the incident.
This story was broadcast before criminal and forensic investigations were completed. Facts that emerge may weaken or strenghten the case for the dangers of Chantix, alone or when used with alcohol.
The report relies almost entirely on anecdotal observations by interested sources.
The most credible source in the report is the clinician who prescribes the drug and finds it valuable. The Pfizer researcher’s response, while implictly biased, is useful.
The report raises the question of whether Chantix is safe, but does not indicate what other choices are available to people who want to quit smoking.
The article states that Chantix is a widely used drug, prescribed to 3 million people.
The report does not imply treatment with Chantix is novel.
The report highlights the possible danger of drug interactions (alcohol and Chantix), and there is little prior publicity of this potential risk. In this sense the novelty (of the adverse effect) is implied, appropriately.
There is no evidence that a press release triggered or shaped the report. This story is similar to other newspaper and television reports on Albrecht’s death.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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