Cytisine is more effective in helping to quit, more affordable than other methods

Cytisine is a plant-derived alkaloid that naturally occurs in families of Laburnum anagyroides and other members of the leguminous plant. Like varenicline, cytosine is structurally similar to nicotine and acts as a partial agonist of the nicotinic acetylcholine receptor (nAChR) (Coe et al. 2005, Webb 1980, Godley 2006), for α-4β-2 The nAChR subtype has high affinity. (The main receptor that mediates nicotine central potentiation through dopamine release in the brain). Like varenicline, cytokines are thought to help quit smoking by reducing the severity of withdrawal symptoms (through their agonist effects on nAChR) and reducing smoking-related rewards and satisfaction (through their antagonistic properties) (Tutka&Zatonski 2006) ). Studies in rats have shown that after administration of nisimidine, the amount of dopamine released is about 40% of that when nicotine is administered (Coe et al., 2005).

Tabex, a low cost treatment which contains Cytisine, a nicotine substitute derived from laburnum seeds, triples a new person's chances of efficiently quitting smoking, compared to be able to a placebo, researchers reported in NEJM (New Britain Journal of Medicine).

Tabex has been accessible in elements of Eastern Europe over four decades. However, there was not enough evidence displaying the medication's efficacy in smoking cessation.

A demo carried out by experts from University College London, the Cancer Center in addition to Institute of Oncology, Biskupiec, poland, and the University regarding Birmingham, England, found that will Tabex is not only much cheaper than additional smoking cessation products, that also appears to be effective.

Robert West, Ph.D., and team carried out a single-center, randomized, double-blind, placebo-controlled trial involving 740 participants. They were randomly selected into two groups:

The cytisine group
The placebo group
The participants were administered either a placebo or Cytisine for 25 days. Both groups received a minimal amount of counseling.

The researchers wanted to find out how many participants managed to quit smoking for 12 months after the treatment period was over.

They found that:
8.4% of those in the cytisine group were abstinent from smoking for 12 months
2.4% of those in the placebo group stayed off tobacco products for 12 months
In the cytisine group - the 7-day point prevalence for abstinence from smoking at the 12-month follow up was 13.2%
In the placebo group - the 7-day point prevalence for abstinence from smoking at the 12-month follow up was 7.3%
The researchers concluded that in this single centre trial, cytisine was clearly more effective than a placebo in helping people give up smoking.

The authors added:

"The lower price of cytisine as compared with that of other pharmacotherapies for smoking cessation may make it an affordable treatment to advance smoking cessation globally."

Doireann Maddock, the Senior Cardiac Nurse at the British Heart Foundation, said:

"If you want to live a longer and healthier life, stopping smoking is the single most important thing you can do. However, even though it is a major risk factor for heart disease, it can be a challenging habit to break.

Getting professional help to stop smoking increases your chance of success enormously and the results from this latest trial are encouraging. We need some bigger trials first but this pill may yet offer a low cost treatment to help people break this harmful habit.

In the meantime, those looking to quit smoking should speak to their GP about the huge range of proven services that are out there to help.

Cytisine is a more effective smoking cessation treatment than placebo

To date, six placebo-controlled trials of cytisine have been published (Paun & Franze 1968, Benndorf et al. 1968 & 1969, Scharfenberg et al. 1971, Schmidt 1974, Dobreva & Danchev 2005, Vinnikov et al. 2008, West et al. 2011). Three of these trials were published in non-English language journals and were conducted over 40 years ago in East and West Germany prior to the advent of good clinical practice guidelines, therefore raising concerns about the overall quality of the trials. One trial clearly stated that randomisation occurred (Schmidt 1974), two used double-blinding (Benndorf et al. 1968, Schmidt 1974), the trials had different treatment durations (17 to 21 days) and different follow-up periods (from 8 to 24 weeks), the outcome measures were poorly defined, information on loss to follow-up was not consistently presented and biochemical validation of self-reported quitting was not undertaken. Behavioural support was provided in one of the three trials (Paun & Franze 1968). A review article combined the data from the three trials in a meta-analysis and reported a pooled odds ratio (OR) for cessation at 3-8 weeks of 1.93 (95% Confidence Intervals [CI] 1.21 – 3.06) (Etter 2006). The pooled OR for cessation at 3-6 months was 1.83 (95% CI 1.21 – 2.99), based on data from two of the three trials, using a random effects model due to significant heterogeneity. One of the trials had long-term follow-up, with an OR of 1.77 (95% CI = 1.29 – 2.43) for cessation at two years (Scharfenberg et al. 1971).