Tobacco smoking is one of the leading causes of death among people. Cytisine, a plant alkaloid considered to be the oldest medication for smoking cessation, has been used in Poland since the 1970s. The drug is a partial nicotinic receptor agonist, with pharmacological actions close to those of nicotine and varenicline (a synthetic cytisine derivative and most expensive smoking cessation medication currently available). Cytisine has several advantages compared to existing smoking cessation drugs, including: 1) it is more effective than placebo and nicotine replacement therapy, and at least as effective as varenicline, 2) its use is associated with a low frequency of adverse events, 3) it is available as over the counter medicine and is much cheaper than other smoking cessation drugs that are cost-prohibitive, 4) it derives from a natural plant and may be preferred by smokers who do not want to use other treatments, 5) it has shorter duration of treatment (i.e. 25 days) compared to other medicines for smoking cessation. This review describes the use of cytisine for nicotine addiction treatment, mechanism of anti-smoking action, pharmacokinetics, efficacy, tolerability and safety.
Over-the-counter nicotine patch therapy for smoking cessation: results from randomized, double-blind, placebo-controlled, and open label trials.
