Daniella A. Zipkin, MD
Does cytisine increase smoking cessation more than placebo in adults who receive minimal behavioral counseling?
Randomized placebo-controlled trial. Current Controlled Trials ISRCTN37568749.
Blinded (patients and clinicians).*
12 months after the end of treatment.
Smoking cessation clinic at the Maria Sklodowska-Curie Memorial Cancer Center in Warsaw, Poland.
740 adults (mean age 48 y, 54% women, mean number of cigarettes/d 23, mean duration of smoking 28 y) who smoked ≥ 10 cigarettes/d, wanted to permanently stop smoking, could be contacted by telephone, and were willing to attend all study sessions. Exclusion criteria were pregnancy or intention to become pregnant, breast-feeding, or current psychiatric disorder or other contraindicated medical condition.
Cytisine, 1.5 mg, 6 times/d (1 tablet every 2 h) for 3 days, 5 times/d for 9 days, 4 times/d for 4 days, 3 times/d for 4 days, and twice daily for 5 days (n = 370); or placebo (n = 370).
Abstinence from smoking for 6 months and 12 months after treatment. Abstinence was defined as a self-report of < 5 cigarettes smoked in each of the past 6-month periods at 6- and 12-month follow-up visits, no cigarettes smoked in week before the follow-up visit, and an exhaled carbon monoxide level < 10 ppm.
77% completed follow-up, and 16% were lost to follow-up but had known lack of efficacy (intention-to-treat analysis).
Patients in the cytisine group were more likely than those in the placebo group to have stopped smoking after 25 days of treatment and to be abstinent over both 6 months and 12 months (Table). Cytisine increased risk for gastrointestinal events more than placebo (14% vs 8.1%, relative risk increase 70%, 95% CI 10% to 160%, 77% follow-up); groups did not differ for other reported adverse events.
In adult smokers, cytisine increased 6-month and 12-month smoking cessation more than placebo.
†Abbreviations defined in Glossary. RBI, NNT, and CI calculated from data in article.
Zipkin DA. Cytisine increased smoking cessation in adults. Ann Intern Med. ;156:JC1–6. doi: 10.7326/0003-4819-156-2-201201170-02006
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Published: Ann Intern Med. 2012;156(2):JC1-6.
Cardiology, Coronary Risk Factors, Smoking, Tobacco, Alcohol, and Other Substance Abuse.
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