Cytisine for Smoking Cessation

Summary

A Cochrane review [Abstract] 1 included 4 studies with a total of 4 623 subjects comparing cytisine with placebo or nicotine replacement therapy (NRT). Cytisine helped more people to quit smoking than placebo (RR 1.30, 95% CI 1.15 to 1.47; 4 studies, n=4623; I²=83%) without difference in the severe adverse effects (RR 1.04, 95% CI 0.78 to 1.37; 3 studies, n=3781). Cytisine appeared to be as effective as varenicline (RR 1.00, 95% CI 0.79 to 1.26, 2 trials, n=2131).

Another Cochrane review [Abstract] 2 included a component network meta-analysis with 319 RCTs and 157 179 participants. Varenicline (OR 2.33, 95% CrI 2.02 to 2.68; 67 RCTs, n=16 430) and cytisine (OR 2.21, 95% CrI 1.66 to 2.97; 7 RCTs, n=3 848) were associated with higher quit rates than control. Combination NRT (patch and a fast-acting form of NRT (OR 1.93, 95% CrI 1.61 to 2.34), nicotine patch alone (OR 1.37, 95% CrI 1.20 to 1.56; 105 RCTs, 37 319), fast-acting NRT alone (OR 1.41, 95% CrI 1.29 to 1.55; 120 RCTs, 31 756) and bupropion (OR 1.43, 95% CrI 1.26 to 1.62; 71 RCTs, n=14 759) were more effective than control.