A Safe, Low-Cost, and Effective Smoking Cessation Treatment



In lung cancer screening volunteers, cytisine may be a secure and efficient smoking cessation treatment, according to a recent study published in the Journal of Thoracic Oncology.

Cytisine, a plant-based alkaloid produced from Cytisus laburnum, has been authorized for use as a smoking cessation aid in Europe since the 1960s. It selectively stimulates nicotinic acetylcholine receptors in a small amount. The two smoking cessation medications that are now FDA-approved in the United States are varenicline and bupropion. In 2018, the Food and Drug Administration granted permission for a research in the US to assess cytisine's efficacy.

Researchers from the Fondazione IRCCS Istituto Nazionale dei Tumori in Milan, Italy, under the direction of Dr. Ugo Pastorino, established the single-center, randomized controlled trial known as the Screening and Multiple Intervention on Lung Epidemics (SMILE) study to examine the efficacy and safety of cytisine as a smoking cessation therapy during low-dose computed tomography (LDCT) screening.

869 current smokers were randomly assigned; 470 (54%) were placed in the intervention arm, which also contained cytisine, and 399 (46%) were placed in the control arm. The main result was a 12-month period of continuous smoking cessation, which was biochemically confirmed using carbon monoxide testing.

The quit rate was 32.1% (151 participants) in the intervention arm and 7.3% (29 participants) in the control arm at the 12-month follow-up. Continual abstinence had an adjusted odds ratio (OR) of 7.2 (95% confidence interval, 4.6 to 11.2). In the intervention arm (399 occurrences among 196 participants), self-reported adverse events occurred more frequently than in the control arm.

According to Dr. Pastorino, "The efficacy and safety found in the SMILE RCT indicate that cytisine, a very inexpensive drug, is a suitable treatment choice for smoking cessation and a workable method to improve LDCT screening outcomes with a potential benefit for all-cause mortality."

By INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER  

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