A recent study in the New England Journal of Medicine reports that cytisine, which has been marketed as a smoking cessation product in former socialist countries for decades, may be an affordable alternative to traditional smoking cessation therapies. In some countries, notably China and India,
A recent study in the New England Journal of Medicine reports that cytisine, which has been marketed as a smoking cessation product in former socialist countries for decades, may be an affordable alternative to traditional smoking cessation therapies. In some countries, notably China and India, traditional North American therapies (nicotine-replacement therapy, bupropion, varenicline) amount to hundreds of dollars for a single course of treatment, while a pack cigarettes costs just a few cents. In contrast, a course of cytisine (Tabex, Sopharma AD) is around $15.
Cytisine is a partial agonist that binds with high affinity to the α4β2 subtype of the nicotinic acetylcholine receptor. The authors of this study conducted a single-center, randomized, double-blind, placebo-controlled trial and found that patients were 3.4 times more likely to remain abstinent from smoking 12 months after cytisine therapy than placebo. This is higher than rates for varenicline (2.3) and nicotine-replacement therapy (NRT, 1.6). However, the absolute difference in the rate of abstinence between participants receiving cytisine and those receiving placebo in this trial was lower than varenicline and was similar to that of NRT. It should be noted that the course of treatment for cytisine in this particular study was 4 weeks, which is lower than the typical length recommended for varenicline (12 weeks) and NRT (8 weeks).
Link to article: http://www.nejm.org/doi/full/10.1056/NEJMoa1102035
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