Cytisine can help smokers quit

Cytisine is superior to nicotine replacement therapy in helping smokers quit, a trial in 1310 smokers showed. Recruited from the New Zealand national quit line, participants were aged at least 18 years, daily smokers, and motivated to quit. They were divided into 2 treatment groups: 1 received a 25-day course of cytisine tablets, and the other nicotine replacement patches along with gum or lozenges for 8 weeks. Both treatment groups received behavioral support via the telephone.

At 1 month, 40% of participants who received cytisine reported continuous abstinence from smoking compared with 31% of participants who received nicotine replacement therapy. Cytisine remained more effective than nicotine replacement therapy for continuous abstinence at 2 and 6 months, with 348 participants in the cytisine group relapsing within 6 months compared with 389 participants in the nicotine replacement group.

In addition, compared with the nicotine replacement group, those in the cytisine group reported fewer symptoms of tobacco withdrawal, found smoking less rewarding, and reduced the number of daily cigarettes they smoked. However, the cytisine group experienced almost twice as many adverse events over 6 months as did the nicotine replacement therapy group.

In both groups, these events, primarily nausea, vomiting, and sleep disorders, ranged from mild to moderately severe (Walker N, et al. N Engl J Med. 2014;371[25]:2353-2362).

Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.