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Might an over the counter drug that's been available since the 1960s provide a more effective way to quit smoking than nicotine replacement programs?
A study published in the New England Journal of Medicine — “Cytisine versus Nicotine for Smoking Cessation” — reported on Cytisine, which “has been available both with and without prescription for smoking cessation since the 1960s, largely in Eastern Europe.” The study notes that “cytisine remains relatively unknown outside Eastern Europe despite calls for licensing worldwide because of its proven benefits, low cost as compared with other cessation medications (cytisine, $20 to $30 for 25 days; nicotine-replacement therapy, $112 to $685 for 8 to 10 weeks; varenicline, $474 to $501 for 12 weeks), and low cost per quality-adjusted-life-year.”
The authors “designed a noninferiority trial to investigate whether cytisine was at least as effective as nicotine-replacement therapy. We hypothesized that 25 days of cytisine plus low-intensity behavioral support would be at least as effective as 8 weeks of nicotine-replacement therapy plus low-intensity behavioral support for smoking cessation.”
The result: “Cytisine was not only noninferior to nicotine-replacement therapy but had superior effectiveness: 1-month continuous abstinence rates were significantly higher in the cytisine group (40%, 264 of 655) than in the nicotine-replacement therapy group (31%, 203 of 655).”
The NEJM also provides an excellent “Quick Take,” a video that explains the study. It's a fun watch.
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