Tedium - The Cold Cocktail 🥃

Today in Tedium: The weather is changing, and so is its impact on sinuses. While COVID-19 is still far from being under control, odds are that, if you’re a bit sniffly with the changing season, you might just have a damn cold or the flu (though the difference is a little hard to deduce sometimes). But while you’re pondering your own sniffles (and, hopefully, isolating yourself in your household), I’d like to discuss a groundbreaking over-the-counter drug that you probably know well if you’ve ever had a cold. Depending on when you’re reading this, you may be feeling the effects already. Today’s Tedium talks about NyQuil, a great way to make a bad night a little bit better. If you have the sniffles, maybe it helped you out last night. — Ernie @ Tedium

(Anita Hart/Flickr)

Why NyQuil, despite being built from off-the-shelf parts, was a revolutionary option for people battling the common cold

In a medicine cabinet full of not-great options for managing a cold, NyQuil stands out—and has stood out for more than 50 years. It puts you to sleep, it seems to hit multiple symptoms at once, and while not exactly pleasant to consume, you can certainly drink a cup of the thick syrup and feel like it’s having an effect.

In many ways, NyQuil, first released in 1966, was a culmination of 70 years of innovation on the part of Vicks, a company that had been developing over-the-counter medicines of varying types for fighting colds, pneumonia, and other common sinus-led ailments for generations. Vicks’ other iconic product, Vaporub, became a breakout hit during the Spanish Flu of 1918, tripling the company’s sales of the salve in a single year.

But it took until the 1950s for Vicks to become serious about cough syrups. Before NyQuil, cough medications struck an unusual balance between dangerous and useful. To give you an idea: One of the first popular cough syrups, originally pitched as a safe, non-addictive alternative to morphine, was called Heroin. Yes, that heroin. So no, that approach did not really work out quite so well.

Other common types of cough syrups don’t have particularly great track records, either. Codeine syrup, often used as a cough suppressant, has a reputation for abuse in the modern day. And Sudafed, with its active ingredient of pseudoephedrine, gained such a negative reputation from its use in amphetamine production (making it a controlled substance in many parts of the country) that the drug came out in a new version, Sudafed PE, which uses a different active ingredient, phenylephrine.

Vicks also had trouble figuring out the right formula. Vicks Medi-Trating Cough Syrup, the company’s first attempt at the market, was not exactly a fun walk in the park. A brown substance that relied on the Vicks-branded “cetamium” (chemical name cetylpyridinium chloride, an ingredient commonly used in toothpastes) as its active ingredient in its original formula, it was not exactly a lot of fun to consume.

A pre-NyQuil ad for Vicks cough syrups. The company’s major selling point was that it did not use narcotics.

After the Food and Drug Administration allowed for the use of dextromethorphan in over-the-counter drugs in the mid-1950s, Vicks took another stab at cough syrup, with Formula 44 coming out in 1958. The company again came up with a marketing-driven name for the active ingredient—this time, “silentium”—and sold it specifically as a codeine-free cough syrup alternative that was nonetheless powerful. (It’s still sold today.)

In many ways, NyQuil was the culmination of this work—Vicks was good at marketing over-the-counter medicine to consumers, selling common ingredients in new ways, such as Sinex, one of the first over-the-counter nasal sprays.

NyQuil reflected this legacy of marketing innovation. The thing that made it stand out was that it was designed to tackle multiple things that people hated about being sick: They were coughing. They were sneezing. They had a runny nose. They couldn’t sleep. They had a headache. They were feeling aches and pains.

Vicks’ solution to this problem wasn’t so much one single drug; it was a variety of them. For congestion, the syrup included ephedrine; for sneezing, it included doxylamine; for headaches, it had acetaminophen; and for coughing, it included dextromethorphan … or should I say silentium. And to help encourage sleepy time, the syrup had a not-insubstantial amount of alcohol—though the doxylamine also helped on that front, too. Despite Leary’s claims, the formula has changed somewhat over the years—no more ephedrine, for one thing—but the approach is basically the same as it was when it was first sold 55 years ago.

And while the licorice flavor tasted not-particularly-great—“green death,” as it was so eloquently described by Leary, was the only flavor available for its first couple of decades on the market—it certainly was a upgrade from where Vicks Medi-Trating Cough Syrup started nearly two decades prior.

Even the packaging was innovative—the additional cup that comes with the bottle, which may be taken for granted today, was a legitimate feature of NyQuil that made it stand out upon its release in the fall of 1966.

It was a cocktail of things that could help people get through a tough night with an illness, and it was an immediate hit. A January 1969 article in the Wichita Beacon gives the impression that NyQuil is something of a miracle drug that gained quick popularity with the not-feeling-so-hot. Pharmacist Patrick Alkire, quoted in the piece, noted that Vicks’ marketing prowess likely played a quick role in the early success of the drug.

“When Vicks is ready to market a new product, they send samples to people’s homes,” he said. “They use it there first and if they like it, then they come in and buy it.”

One of the first ads for NyQuil, as it appeared in LIFE Magazine in 1968.

NyQuil’s sudden marketing coup raised a lot of questions

In many ways, NyQuil emerged onto the market and came to dominate cough medicine so quickly and suddenly that it led to an array of critics, who understandably felt that the combination of drugs could be harmful.

Quick success led to quick skepticism. By the end of 1969, concerns about NyQuil being misused led Canada’s The Ottawa Citizen to reach out to local pharmacies to figure out if the drug was being abused by customers, leading to this very timely lede:

A survey of 10 pharmacies and two drug-distributing companies today revealed little evidence that teenagers and hippie types were buying large quantities of NyQuil, the sleep-inducing cold remedy, in Ottawa.

NyQuil’s novel combination of a number of types of different over-the-counter drugs even led to criticism from a former employee of Vicks, Dr. Donald C. LaBrecque, who spoke out against the drug in Senate subcommittee hearings, basically taking the stance that the combination of over-the-counter drugs was so unusual that it probably should have been a prescription drug.

“Someone in a rather high position agreed with me that this should possibly not be an over-the-counter but an ethical drug, if at all,” LaBrecque said during one such hearing.

In one sense, NyQuil’s success was significant and sudden; in another, it came at a time that ensured almost immediate scrutiny, as the Food and Drug Administration decided to take a close look at the entire over-the-counter drug market during this period. One of the questions that arose was whether drugs like NyQuil should have so many active ingredients, as well as whether they needed to back up their marketing claims. As I pointed out above, NyQuil had four active ingredients in its original formulation—and the FDA eventually recommended that it, and other drugs like it, be limited to three. (The standard version of NyQuil cuts it down to three ingredients by cutting out the decongestant, but the severe version, which adds back in the phenylephrine, has four.)

Additionally, Vicks, along with other makers of over-the-counter cold medicine, gave data to the Federal Trade Commission backing up their claims that the drugs actually did something—with the company saying that 87 percent of those tested showed positive results (particularly, the ability to go to sleep) from taking NyQuil.

This scrutiny was likely deserved for a drug that was sold over the counter, but essentially tried to use a lot of existing drugs to create a new kind of drug.

An early NyQuil ad, dating to the early 1970s, before the company’s well-known slogan was put into use.

The case that NyQuil may be the best-marketed substance in the medicine cabinet

Perhaps this is a funny way to think about all this, but the truth of the matter is, a drug like NyQuil is as much a testament to the power of marketing as it is the ability to combine a whole bunch of active ingredients into a single bottle or batch of pills. It’s an over-the-counter drug marketer’s dream, because it does so much.

It’s reflected in its famed marketing. As slogans go, “The nighttime sniffling, sneezing, coughing, aching, stuffy head, fever, so you can rest medicine” doesn’t exactly roll off the tongue. But that slogan, decided upon in the late 1970s, actually works quite well for the brand. In a world of short, snappy sentences, its strength is basically highlighting that NyQuil does a lot for a single medicine, even if there are probably stronger options out there.

But Vicks and its various corporate parents have been able to mine marketing gold out of that slogan for decades.

One of its best-known ads features Nathan Lane, in a pre-Birdcage, pre-Lion King role, but at a time when he was a frequent lead actor on Broadway. (So not exactly a household name, but getting there.) Lane’s gimmick: He doesn’t have any NyQuil, and nothing else he has in his medicine cabinet does quite as much as NyQuil does, so he ends up going door-to-door in his apartment building, begging his neighbors for a cup of NyQuil. If it were any other kind of drug, it would be sad, rather than funny.

(Years later, Conan O’Brien used the ad as fodder against Lane in a late-night segment, pointing out that he’s really good at pretending to be sick.)

While traditionally NyQuil has been played for laughs in advertising along the lines of the Lane ad (generally with unknown actors, though Sherman Hemsley made an appearance in the early ’70s during his All in the Family run), in more recent years it’s received a prominent celebrity endorsement, with an ad featuring someone who likely does a lot of traveling and as a result might be at risk of getting a cold—recently retired NFL quarterback Drew Brees.

While NyQuil is not a perfect drug—like any medication, you should read up on its side effects—it does represent a marketer’s dream. It doesn’t cure a cold or the flu—like Vaporub, it’s a temporary salve more than a cure—but it makes it slightly easier to bear. Which means they can always sell you more.