Cytisine is a universal smoking cessation aid that has been shown to double the success rate of smoking cessation compared to placebo. Although it is safe and effective, it remains largely unavailable outside of Eastern Europe, which limits its impact on global health.
A new study published in the journal Addiction found that cytosine, a low-cost universal smoking cessation aid that has been used in Eastern Europe since the 1960s, more than triples the chances of successfully quitting and may be more effective than nicotine replacement**.
It has a benign security profile and there is no evidence of serious security issues. Sounds like a perfect fit for your New Year's resolutions, doesn't it? But there's a catch: Cytisine is not licensed or marketed in most countries outside of Central and Eastern Europe, making it unavailable in much of the world, including many low- and middle-income countries, and it could have a significant impact on global health.
Cytisine is a plant-based compound that relieves smoking cessation symptoms. It was first synthesized in Bulgaria in 1964 as tabex and later spread to other countries in Eastern Europe and Asia, where it is still sold today.
In 2017, Polish pharmaceutical company AFLOfarm began marketing it as a prescription drug, Desmoxan, and Canada approved it as an over-the-counter natural health product, CR**V.
Because caspanine is a low-cost drug, it can be part of a program to increase smokers' access to the drug**, which is often limited in low- and middle-income countries.
Lead author Dr. Omar de Santi explained: "Our study adds to the evidence that cytosine is an effective and inexpensive smoking cessation aid. It may be very useful in reducing smoking in LAMI countries where cost-effective smoking cessation medications are urgently needed. Worldwide, smoking is considered the leading cause of preventable death. Cytisine has the potential to be one of the important answers to this question.
The study pooled the results of eight randomized controlled trials comparing cypine to placebo, involving nearly 6,000 patients. The combined results showed that cytosine more than tripled the chances of successfully quitting smoking compared to placebo.
The study also looked at two randomised controlled trials comparing cetizine with nicotine substitution** with modest results in favour of cystine, and three trials comparing cytosine with varenicline with no clear benefit for cytosine.
Reference: "Assessing the effectiveness of cyprine** for smoking cessation: a systematic review and meta-analysis", by Omar de Santi, Marcelo Orellana, Cecilia Andrea Di Niro, and Vanina Greco, December 31, 2023, Addiction.
doi： 10.1111/add.16399
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