Cytisine--a tobacco treatment hiding in plain sight.

Nancy A Rigotti

Index: N. Engl. J. Med. 371(25) , 2429-30, (2014)

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Abstract

A randomized, controlled trial published in this issue of the Journal brings renewed attention to cytisine, a potentially useful pharmacotherapy for smoking cessation that has been hiding in plain sight.1 A naturally occurring plant alkaloid, cytisine has been sold in Eastern Europe as an inexpensive smoking-cessation aid for 50 years but is unavailable elsewhere.2 Two events brought it to broader attention in 2006. First, Etter's review2 of overlooked, older studies suggested a potential efficacy of cytisine for smoking cessation, although a firm conclusion could not be drawn because previous trials did not meet contemporary standards. Second, varenicline, a drug with . . .