A New Medication for Smoking Cessation?

Cytisinicline (historically called cytisine) is a plant-based alkaloid that, like varenicline, acts as a partial agonist at nicotinic acetylcholine receptors. It's been used as an aid for smoking cessation for decades in parts of Europe and Asia. In a recent phase 3 trial of cytisinicline versus placebo, the drug was well tolerated and effective for smoking cessation (JAMA 2023; 330:152); now, the same researchers seek to replicate these results.

In this multisite trial, 800 adults who smoked 10 or more cigarettes daily (mean duration of smoking, ≈35 years) were randomized to 6 or 12 weeks of cytisinicline or to placebo. In the 6-week group,15% of cytisinicline recipients and 6% of placebo recipients were abstinent (defined by self-report an…