Want to quit smoking? Researchers have identified a plant-based compound that may aid in smoking cessation and is more effective than nicotine replacement therapy.Cytisine is a plant-based compound that eases smoking withdrawal symptoms. The low-cost, generic stop-smoking aid has been used in eastern Europe since the 1960s.
The new study, published in Addiction, found that cytisine increases the chances of successful smoking cessation by more than two-fold compared with placebo and may be more effective than nicotine replacement therapy.
It also has a benign safety profile, with no evidence of serious safety concerns.“Our study adds to the evidence that cytisine is an effective and inexpensive stop-smoking aid," said lead author Omar De Santi from Centro Nacional de Intoxicaciones (CNI) in Buenos Aires, Argentina.
However, cytisine is not licensed or marketed in most countries outside of central and eastern Europe, making it unavailable in most of the world, including many low- and middle-income countries where it could make a big difference to global health.
It was first synthesised in Bulgaria in 1964 as Tabex and later spread to other countries in eastern Europe and Asia, where it is still marketed.In 2017, the Polish pharmaceutical company Aflofarm began selling it as Desmoxan, a prescription-only medicine, and Canada approved it as an over-the-counter natural health product, Cravv.
Because cytisine is a low-cost drug, it could form part of a plan to increase accessibility to drug therapy for smokers, which tends to be limited in low- and middle-income (LAMI) countries.This study pooled the results of eight randomised controlled trials comparing cytisine with placebo, with nearly 6,000 patients.
The combined results showed that cytisine increases the chances of successful smoking cessation by more than twofold compared with placebo. The study also looked at two randomised controlled trials comparing cytisine with nicotine replacement therapy, with modest results in favour of cytisine, and three trials comparing cytisine with varenicline, without a clear benefit for cytisine.
"It could be very useful in reducing smoking in LAMI countries where cost-effective smoking cessation drugs are urgently needed," De Santi said. "World-wide, smoking is considered the main cause of preventable death. Cytisine has the potential to be one of the big answers to that problem.”