New Look at Old Treatment to Stop Smoking


In the ongoing search to find help for smokers wishing to quit, scientists have taken another look at an older solution and found merit. A study in the New England Journal of Medicine reports on a comparison between cytisine and placebo. Cytisine faired well in the tests, showing a large improvement in those who were able to stay off cigarettes.

The study used a 12-month endpoint and didn’t rely on patient testimony. They checked for metabolites of nicotine to prevent those in the study from lying about tobacco use. The percentages between placebo (2.4% quit at a year) and cytisine (8.4% quit) were very encouraging. However, note that the majority of participants went back to smoking – the substance is an aid, but not a cure.

The results are encouraging however, because, unlike other medications and smoking aids, cytisine is safe and cheap. This is a concern when a large part of the developing world smokes and lower economic opportunity prevents them from being able to afford other treatments. The World Health Organization estimates that most yearly smoking-related deaths are among people from developing countries. At $5 a month, treatment with existing forms of the drug are within reach.

Cytisine (not to be confused with cytosine or cysteine) is a naturally occurring nicotine receptor agonist – this means it competes with nicotine at active sites in the body. For those who are not tobacco users, taking the drug actually gives some of the symptoms of nicotine intoxication: nausea, dizziness and visual disturbances. The drug is “older” in the sense that it has been used to treat nicotine addiction in Russia and Bulgaria (and other parts of the Soviet bloc) since the 1960s. Until now however, it was not examined closely by the US medical community.


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