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Smokers more likely to quit with natural cytisine: Argentinian review

A pill that dampens nicotine cravings could play a major role in helping people kick the smoking habit, say scientists, who found that potential quitters are more than twice as likely to succeed when taking the tablet called cytisine.

While many people have resorted to products like vapes, patches and gums in efforts to end their dependence on nicotine, doctors looked at the evidence for cytisine to help smokers break their addiction.

Cytisine is a natural ingredient in laburnum seeds, however, the seeds themselves are poisonous, reports The Guardian.

Cytisine pills have been safely used in central and eastern Europe for decades, but the ingredient is unavailable in most countries.

Regulatory approval was passed only recently in Britain, where the pills will be made available later this month.

Researchers in Argentina analysed 12 randomised controlled trials that compared the success rates of smokers who tried to quit while taking cytisine, a placebo, another smoking cessation drug called varenicline (Champix), or nicotine replacement therapies like patches and gum.

They found that the cytisine pills were more than twice as effective as the placebo at helping people quit smoking, while a number of the trials in the review suggested the drug was similar to varenicline and possibly more effective than nicotine replacement therapy.

Their findings were published in the journal Addiction.

“Our study adds to the evidence that cytisine is an effective and inexpensive stop-smoking aid,” said Omar de Santi, a toxicologist at the Posadas National Hospital in Argentina, who led the review. “Worldwide, smoking is considered the main cause of preventable death. Cytisine has the potential to be one of the big answers to that problem.”

Cytisine pills are due to be available in the UK as a prescription-only medicine by the end of January.

Study details

Evaluation of the effectiveness of cytisine for the treatment of smoking cessation: A systematic review and meta-analysis

Omar De Santi, Marcelo Orellana, Cecilia Andrea Di Niro, Vanina Greco

Published in Addiction on 31 December 2023

Abstract

Background and aims
Smoking is considered the main cause of preventable death world-wide. This study aimed to review the efficacy and safety of cytisine for smoking cessation.

Methods
This review included an exhaustive search of databases to identify randomised controlled trials (RCTs) in health centres of any level with smokers of any age or gender investigating the effects of cytisine at standard dosage versus placebo, varenicline or nicotine replacement therapy (NRT).

Results
We identified 12 RCTs. Eight RCTs compared cytisine with placebo at the standard dose covering 5922 patients, 2996 of whom took cytisine, delivering a risk ratio (RR) of 2.25 [95% confidence interval (CI) = 1.42–3.56; I2 = 88%; moderate-quality evidence]. The greater intensity of behavioural therapy was associated directly with the efficacy findings (moderate-quality evidence). The confirmed efficacy of cytisine was not evidenced in trials conducted in low- and middle-income countries. We estimate a number needed to treat (NNT) of 11. Two trials compared the efficacy of cytisine versus NRT, and the combination of both studies yields modest results in favour of cytisine. Three trials compared cytisine with varenicline, without a clear benefit for cytisine. Meta-analyses of all non-serious adverse events in the cytisine group versus placebo groups yielded a RR of 1.24 (95% CI = 1.11–1.39; participants = 5895; studies = 8; I2 = 0%; high-quality evidence).

Conclusions
Cytisine increases the chances of successful smoking cessation by more than twofold compared with placebo and has a benign safety profile, with no evidence of serious safety concerns. Limited evidence suggests that cytisine may be more effective than nicotine replacement therapy, with modest cessation rates.

 

Addiction article – Evaluation of the effectiveness of cytisine for the treatment of smoking cessation: A systematic review and meta-analysis (Open access)

 

The Guardian article – Smokers twice as likely to quit by using cytisine, study finds (Open access)

 

See more from MedicalBrief archives:

 

Smoking cessation drugs may have role in also reducing alcohol use – clinical trial

 

Strong EU public response in favour of tobacco harm reduction policies

 

Childhood smoking, adult cessation and heart risk — Large Oxford study

 

 

 

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