Cytisine for smoking cessation

January 01, 0001

Cytisine for smoking cessation

Cytisine, a partial agonist that binds with high affinity to the alpha4beta2 nicotinic acetylcholine receptor, is a low-cost treatment that may be effective in aiding smoking cessation. This study by authors from the UK and Poland assessed the efficacy and safety of cytisine as compared with placebo in a randomized, double-blind trial. Participants were randomly assigned to receive cytisine or matching placebo for 25 days; participants in both groups received a minimal amount of counseling during the study. The primary outcome measure was sustained, biochemically verified smoking abstinence for 12 months after the end of treatment. Of 1542 adult smokers screened, 740 were enrolled and 370 were randomly assigned to each study group.

They found: "The rate of sustained 12-month abstinence was 8.4% (31 participants) in the cytisine group as compared with 2.4% (9 participants) in the placebo group (difference, 6.0 percentage points). The 7-day point prevalence for abstinence at the 12-month follow-up was 13.2% in the cytisine group versus 7.3% in the placebo group. Gastrointestinal adverse events were reported more frequently in the cytisine group (difference, 5.7 percentage points)."

The authors concluded: "In this single-center study, cytisine was more effective than placebo for smoking cessation. The lower price of cytisine as compared with that of other pharmacotherapies for smoking cessation may make it an affordable treatment to advance smoking cessation globally."

A low-cost alternative for smoking cessation would be a great addition.

For the full abstract, click here.

N Engl J Med 365:1193-1200, 29 September 2011 © 2011 to the Massachusetts Medical Society
Placebo-Controlled Trial of Cytisine for Smoking Cessation. Robert West, Witold Zatonski, Magdalena Cedzynska, et al. Correspondence to Dr. West: robert.west@ucl.ac.uk

Category: Z. Social Problems. Keywords: smoking cessation, pharmacological treatment, cytisine, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 18 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.