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The α4β2 nicotinic acetylcholine receptor is involved in nicotine dependence. Cytisine, a plant-derived partial agonist of this receptor, is sold inexpensively to facilitate smoking cessation in some European countries. Of note, varenicline (Chantix) is a derivative of cytisine.
In this randomized trial from Poland, 740 heavy smokers received a 25-day tapering course of cytisine or placebo, with instructions to quit smoking on day 5. At 1 year after the end of treatment, sustained abstinence from smoking, verified by exhaled breath carbon monoxide testing, occurred in significantly more cytisine recipients than placebo recipients (8.4% vs 2.4%). Gastrointestinal side effects were more common with cytisine than with placebo (14% vs. 8%); othe…