Old product might help smokers quit

Drug used in Eastern Europe for decades beats nicotine patch in short-term test

A compound called cytisine, used in Eastern Europe since the 1960s as a smoking-cessation drug, works better than nicotine replacement therapy in a quit test, researchers report in the Dec. 18 New England Journal of Medicine.

Scientists in New Zealand randomly assigned 1,310 smokers to get cytisine tablets or nicotine patches, gum and lozenges. After one month, 40 percent of the people on cytisine and 31 percent of those on nicotine had quit. At two months, it was 31 percent and 22 percent, and at six months cytisine still held an edge with 22 percent of the volunteers having quit compared with 15 percent of those using the nicotine products. Among those who failed the test, the median time to relapse was 53 days in the cytisine users and 11 days in the nicotine group.

Cytisine is a natural plant compound that works like the quit-smoking drug varenicline, marketed as Chantix, by attaching to a protein receptor molecule on cells. This blocks nicotine from binding to the receptor and triggering its trademark effects. Like Chantix, cytisine causes side effects in some users. In this trial, 31 percent of people taking cytisine reporting side effects compared with 20 percent of those on nicotine.  The most frequent problems were nausea, vomiting and sleep disruptions.

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