Why anti-vaxxers are twisting the facts behind the Chantix recall

When the smoking cessation medication, Chantix, was trending on Twitter Monday, it quickly became apparent that it wasn’t just because the manufacturer had recalled it.

Yes, the recall of the drug (generic name: varenicline) was making headlines, but many were using those headlines to make a different point: arguing that the recall reinforces the idea that you can’t trust the safety of medications. Specifically, some argued, the recall meant you can’t trust the Covid-19 vaccine.

It didn’t help that Chantix’s manufacturer, Pfizer, has for many become synonymous with the Covid-19 vaccine. The majority of vaccinated adults in the United States have gotten Pfizer’s two-dose mRNA vaccine.

Chantix was recalled for higher than FDA-approved levels of the chemical N-nitrosamine. The FDA warns that long-term use of nitrosamines may be associated with an increased risk of developing some cancers.

Arguments about why the recall of Chantix was evidence against vaccine mandates were as bold as they were inaccurate. Some argued that the drug had already caused cancer in people who took it, and implied it had been doing so since it came on the market 15 years ago. How could anyone trust even approved medications in such a reality?

Fortunately for Chantix users (full disclosure: I used the drug over a decade ago to quit smoking), there’s a lot of misinformation floating around. Unfortunately, that misinformation is being used as evidence of other misinformation about Covid-19 vaccines.

Here’s what’s actually happening with the Chantix recall, and what those who are using it as evidence against Covid-19 vaccination are getting wrong.

Why is Chantix being recalled?

Pfizer is recalling Chantix due to higher than acceptable levels of nitrosamines. The FDA announced the recall on September 16.

The first Chantix recall was actually issued for select lots of the drug in July. Lots are essentially batches of something, all manufactured around the same time. When a company recalls a lot, it means they think whatever contamination occurred may have affected that batch.

Pfizer added more lots to the recall list later in July and August, suggesting the company believed more batches were contaminated than previously thought. In September, it went ahead and recalled all of it “out of an abundance of caution” pending further testing. Basically, Pfizer isn’t sure how many lots were affected so the company is recalling and testing all of them.

Contrary to what you might hear on social media, there are currently no reports of the drug causing cancer in anyone. It’s early and that may change, but it also might not.

Anyone wanting to follow the latest regarding recalls should check the FDA’s MedWatch page.

What are nitrosamines and what do they do to the body?

Nitrosamines are natural chemical by-products found in food, water, medication, and even our own digestive system (we sometimes make them when digesting food). Of course, just because something is natural, doesn’t mean high doses of it are safe — hence the FDA’s warning about acceptable levels of nitrosamines.

A few key facts about nitrosamines:

• The kind of nitrosamine found in Chantix is called N-nitroso-varenicline. There are no reports of this particular nitrosamine causing harm to animals or humans, but it’s wise for the FDA to treat it like other nitrosamines and limit how much can be in medication.
• High levels of nitrosamines have been found to cause cancer in lab animals, no studies have been done to test the effect on humans.
• There is nothing to suggest that high levels of N-nitroso-varenicline have always been present in Chantix. In fact, the recently approved generic version of Chantix/varenicline also has some N-nitroso-varenicline, though not above FDA limits. These recalls appear to be the result of contaminated products, not products as designed.
• The FDA doesn’t specify what’s considered “long term” but it’s important to note that people don’t take Chantix on an ongoing basis. The recommended course of the drug is between 3 to 6 months.

Is Chantix otherwise a safe drug?

Research suggests Chantix can be a doozy of a drug, albeit fairly effective. There are psychiatric side effects, and while Chantix is currently unavailable, anyone considering the drug in the future should talk to their doctor, especially if they have a history of mental health disorders. (Personally, it gave me the weirdest dreams of my life.)

Again, we don’t know if down the road someone will be able to connect their Chantix use from these contaminated lots to developing cancer. But it is most definitely too soon to say these lots cause cancer, or to associate any Chantix use with developing cancer.

How are anti-vaxxers using Chantix to promote vaccine skepticism?

Basically, they’re saying that because an approved drug was recalled, no drug should be trusted and certainly shouldn’t be mandated. Being a Pfizer product adds to the illusion that there’s an association between the two.

It’s completely healthy to have some skepticism about what you put in your body, or think the FDA should have more stringent guidelines for drugs. Drug recalls happen every year, sometimes mandated by the FDA. Other times, like in the case of Chantix, the recall is initiated by the manufacturer.

By this point, the possible side effects of the Covid-19 vaccine, of which 43.5 percent of the world has now had at least one dose, are pretty well established. Anti-vaxxers want to make it seem like there was this deadly chemical in Chantix all along, but that’s a bit like saying no yogurt from the supermarket can be trusted because once you got one that had mold on the top. Gross, yes. A possible indication that others are contaminated, yes, but “all the yogurts in the history of this brand have mold?” Not so much.

What’s at play here is a logical fallacy: The Chantix news has nothing to do with the Covid-19 vaccine. Furthermore, getting vaccinated isn’t just about what you’re putting in your body: It’s about keeping yourself and those around you safe.