Largely Unnoticed Agent May Be Effective Smoking Deterrent

Quit Smoking with Cytisine

A plant-derived medication that has been used to treat tobacco dependence in Eastern Europe for 40 years may be effective for smoking cessation, but it remains largely unnoticed in English-language literature, according to a review article in the same issue.

Cytisine is an alkaloid found in a plant known as the golden rain tree, or Cytisus laburnum. It has been used for decades as a smoking cessation drug in Eastern European countries, according to background information in the article.

Jean-Francois Etter, Ph.D., M.P.H., of the University of Geneva, Switzerland, reviewed the literature on the effect of cytisine on smoking cessation. Ten studies were found, and all were conducted in Bulgaria, Germany, Poland and Russia between 1967 and 2005.

"Research conducted during the past 40 years suggests that cytisine is effective for smoking cessation," Dr. Etter reports. "Thus, an apparently effective smoking cessation drug that has been used for decades in Germany and Eastern European countries remained unnoticed in other countries."

Most of the articles reviewed by Dr. Etter were never cited in English-language literature. Recent reviews of the efficacy of smoking cessation drugs omitted cytisine, and little research on the drug has been conducted in recent years.

Dr. Etter suggests the omission may be explained because studies on the efficacy of cytisine were not published in English and because the available research is based on studies that do not conform to current standards in conducting and reporting drug trials.

"An apparently effective treatment for the first avoidable cause of death in developed countries remained largely unnoticed, despite research published during the past 40 years," he concludes. "How many other effective drugs are there for which efficacy remained unnoticed because existing trials were not published in English in Western countries?" (Arch Intern Med. 2006;166:1553-1559)