Review: Cytisine Effective for Smoking Cessation Versus Placebo

Based on moderate-quality evidence, direct association seen for greater intensity of behavioral therapy with efficacy findings

By Elana Gotkine HealthDay Reporter

TUESDAY, Jan. 2, 2024 (HealthDay News) — Cytisine increases the chances of successful smoking cessation compared with placebo, according to a review published online Dec. 31 in Addiction.

Omar De Santi, from the Hospital Nacional Profesor Alejandro Posadas in Buenos Aires, Argentina, and colleagues reviewed the efficacy and safety of cytisine for smoking cessation. Twelve randomized controlled trials (RCTs) conducted in health centers of any level and involving smokers of any age or gender were included.

The researchers found that eight RCTs (with 5,922 patients) compared cytisine to placebo at the standard dose; the risk ratio was 2.25 for the 2,996 who took cytisine. There was a direct association for greater intensity of behavioral therapy with the efficacy findings (moderate-quality evidence). In trials conducted in low- and middle-income countries, the confirmed efficacy of cytisine was not evidenced. The number needed to treat was estimated at 11. The efficacy of cytisine was compared to nicotine replacement therapy in two trials; modest results in favor of cytisine were yielded by the combination of both studies. No clear benefit was seen for cytisine in three trials comparing cytisine with varenicline. The risk ratio was 1.24 on meta-analyses of all nonserious adverse events in the cytisine group versus placebo groups.

“More investigations regarding cytisine should fully consider assessing the cost-effectiveness and economic evaluations of community-based tobacco dependence interventions,” the authors write.