Drug doubles the odds of quitting vapes

3 minute read

The plant-based drug helps patients quit the e-cigarettes they might have started using to quit tobacco.

A drug used for decades as a herbal tobacco smoking cessation tool may also help patients quit e-cigarettes, research suggests.) 

The US study participants who took cytisinicline were twice as likely to abstain from using e-cigarettes for four weeks, the researchers found. 

The new research comes as the Advisory Committee on Medicines Scheduling considers an application to allow cytisinicline to be available in Australia.  

The 160 participants were randomised to take either cytisinicline or a placebo three times a day for 12 weeks and were then followed up for another four weeks.  

All the participants had vaping-cessation support sessions from trained counsellors.  

Participants were excluded if they also smoked tobacco or if they had taken other smoking cessation medication in the month before the study began. 

Of the participants who took cytisinicline, 32% abstained from using e-cigarettes during the last four weeks of treatment compared with 15% of those who took a placebo. 

“For individuals seeking to quit vaping, cytisinicline might fill the existing gap in pharmacologic treatments and enhance the emerging evidence of efficacy of behavioral treatments for vaping cessation,” the researchers said in JAMA Internal Medicine. 

Cytisinicline, or cytisine, is derived from the golden rain tree (Cytisus laburnum) and reduces nicotine dependence by binding to α4β2 nicotinic acetylcholine receptors in the brain.  

The drug has already been shown to be effective at reducing cigarette smoking and has been used in several other countries in herbal form as a smoking cessation tool for decades.  

It was approved for use in the UK by prescription in January this year and is subsidised by the NHS. 

This month the Advisory Committee on Medicines Scheduling (ACMS) is considering a private application to make cytisinicline available in Australia. 

The application has strong backing from the RACGP, which supports “increasing the available options of approved first-line medicines indicated for nicotine dependence”.  

“Despite calls for wider availability of cytisine, accessibility to date has been limited by market forces, with little incentive of return on investment by pharmaceutical companies,” the RACGP said in a submission to the ACMS. 

“Hence the current application for scheduling presents an important opportunity for Australian smokers and health professionals to benefit greatly from an additional first-line medicine for smoking and vaping cessation,” the submission said. 

“There is moderately certain evidence supporting the efficacy of cytisine for smoking cessation and while it can cause some mild gastrointestinal symptoms, it has a very low risk of serious adverse effects.” 

RACGP President Dr Nicole Higgins Dr Higgins said last month that cytisine had been safely used in eastern Europe for smoking cessation since the 1960s and approving the drug would play a key role in helping patients quit nicotine. 

“This medicine has a proven track record in smoking cessation, it has minimal side effects, and it is sorely needed to tackle the ongoing battle of nicotine addiction, particularly among our youth,” she said. 

According to this year’s National Drug Strategy Household survey, the number of Australians who regularly using e-cigarettes and vapes almost tripled from 2.5% in 2019 to 7% in 2022-2023. 

JAMA Internal Medicine 2024, online 6 May 

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