Are Docs Using Chantix on Your Floor?

Hi all - I have a few questions about Chantix, I'm wondering if anybody has insight into this.

This all arises out of my recent quit with Chantix (still going strong!), and I can't help but think how useful this would be for pts who smoke. I have yet to see it used on our floor, however.

My first thought is that the literature states Chantix takes about a week to establish therapeutic blood levels. This is purely anecdotal, but for me it took about 3 days before I was unable to smoke. That tells me there is some variance, likely depending on the degree of addiction, how much the person smokes, how willing they are to quit, etc. My guess is the length of time it takes to establish therapeutic blood levels is the reason perhaps we are not seeing it used a lot on the floor - because most people stay less than that. Chantix is another drug which is gradually increased - typical dosing is as follows:

0.5mg qdaily x3days
0.5mg BID x4days
1mg BID x 3-6months

The main side effect from Chantix is nausea, which one experiences for the first week if you are going to have that side effect (I did, but not until day 4). I would hazard a guess that the reason Chantix is gradually increased is d/t this side effect? My thought is that if it were started at the higher dose in the in-patient setting, so that it would take effect sooner, we would also have anti-emetics to use to combat the nausea.

Not the best option, to have one drug causing SEs and then give another drug to combat it, but still better than people leaving the floor (I work tele and they do this AMA all the time) with their gosh darn nicotine patches on. Mind you, I've done extensive education with pts at that point. If this is happening it is totally AMA and despite a great effort on my part to assist the pt in doing otherwise.

Anyway, my recent experience with Chantix makes me think it could be very useful in this capacity. I'm wondering if perhaps MDs aren't very familiar with it yet and are as such not varying dosages like they would with another drug.

Thoughts? Experience? I plan to bring this up with one of our (awesome) hospitalists at some point, I just haven't had the opportunity.