Smoking cessation assisted by the administration of cytisine
Summary
Cytisine is a partial agonist that binds with high affinity to the alpha 4 beta 2 subtype the a nicotinic acetylcholine receptor. This receptor subtype has been implicated in the development and maintenance of nicotine dependence. It is the target of the drug, varenicline.
Cytisine could be a far less expensive treatment than varenicline, and therefore the authors conducted a study to assess the safety and efficacy of cytisine in regards to smoking cessation.
This was a single-center, randomized, double-blind, placebo-controlled trial. Participants were assigned cytisine or placebo for 25 days. The primary outcome was sustained, biochemically verified smoking abstinence for 12 months after the end of treatment. 740 patients were enrolled, and 370 were assigned to each study group.
The rate of sustained 12-month abstinence was 8.4% (31 participants) in the cytisine group, and 2.4% (9 participants) in the placebo group. Gastrointestinal symptoms were reported more frequently in the cytisine group.
The authors concluded that cytisine was more effective than placebo for smoking cessation, and commented that the lower price of cytisine as compared with other pharmacotherapies may make it an affordable treatment option.
Reference
West R, et al. Placebo-controlled trial of cytisine for smoking cessation. New England Journal of Medicine 2011; 365:1193-1200.