Another option to quit


Flowers from the Laburnum anagyroides, the common laburnum, golden chain or golden rain tree.
A study has found cytisine is more effective than nicotine replacement therapy (NRT) at helping smokers to quit. But to date it has not been compared head-to-head with varenicline.

Could this common plant provide a low-cost, effective treatment option for smokers trying to quit?

NSW smokers who want to quit are being recruited to take part in a world-first trial comparing two smoking cessation medications – a natural plant extract, cytisine, and the prescription medicine, varenicline.

Cytisine is a natural, plant-based compound that occurs in the golden rain tree (Laburnum anagyroides), and although not currently available as a stop smoking medicine in Australia, it has been used in Central and Eastern Europe for more than 50 years.

“This is a great opportunity for smokers in NSW to receive free quit medication, support and advice, to help them quit smoking for good,” said trial leader Dr Ryan Courtney.

Varenicline and cytisine both work by reducing craving and other withdrawal symptoms caused by quitting smoking.

Varenicline is available in Australia as a prescription medicine and as an alternative to nicotine replacement therapies like lozenges, patches and gum.

Results from a study published in the New England Journal of Medicine of 1,310 New Zealand smokers found that cytisine is more effective than nicotine replacement therapy (NRT) at helping smokers to quit. But to date it has not been compared head-to-head with varenicline.

The CESSATE study led by researchers from the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney will for the first time compare the effectiveness of the two treatments in a randomised controlled trial.

Dr Courtney said that cytisine acts similarly to varenicline, the most effective smoking cessation treatment currently available in Australia, and is considerably cheaper.

“Both cytisine and varenicline act in a similar way and increase the chances of quitting smoking,” said Dr Courtney.

“However, cytisine requires a shorter treatment period of a month, compared to three months required for varenicline, and cytisine is substantially cheaper.”

Currently a full course (12 weeks) of varenicline costs approximately $300 (with up to $120 paid by the smoker themselves and the rest paid by the government) while cytisine is available in Europe at a significantly cheaper cost of approximately $25.

Dr Courtney said, “If cytisine is shown to be as effective as varenicline but at a significantly lower cost it could produce substantial savings for health care systems and consumers.”

Key points

  • Eligible participants must be over 18, want to quit smoking and be available for three telephone interviews and two check-in calls over a seven-month period.
  • A medical professional will review the screening file and provide final approval for the study enrolment.
  • Eligible participants will be randomly assigned to either cytisine (Desmoxan) or varenicline (Champix). The

The cystisine (Desmoxan) group will receive 25 days’ supply of the medication. They must stop smoking on the fifth day. The Champix group will receive four weeks’ supply initially and then eight weeks supply following a check in call. They must stop smoking completely on the eighth day. Both medications will be delivered to the participant at no cost.

Please visit the NDARC website for more information about the CESSATE study and to view the participant information sheet.

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