Research news: November 2011
N Engl J Med2011;365:1193-200
Cytisine, a plant extract, has been available for decades as an aid to smoking cessation in some eastern European countries. The extract is much cheaper than alternative oral treatments, such as bupropion and varenicline, and a placebo controlled trial shows it can work. Polish adults who took a 25 day course were significantly more likely to quit for good than controls who took a placebo (abstinence at 12 months: 8.4% (31/370) v 2.4% (9/370); difference 6.0 percentage points, 95% CI 2.7 to 9.2). The authors hope cytisine will prove useful in low and middle income countries, where any smoking cessation treatment typically costs an order of magnitude more than cigarettes. In Russia, a course of cytosine is available over the counter for the equivalent of just $6 (£3.8; €4.4).
Although adults given cytosine did better than controls, overall success rates were low. Fewer than one in