title: Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis.
abstract: BACKGROUND
  A recent rigorous study has shown that cytisine, a low-cost drug, is effective for smoking cessation. A number of earlier studies exist, mostly from former communist countries where cytisine has been used since the 1960s. The key question now is whether there is sufficient evidence to warrant licensing cytisine or whether more work is needed. A systematic review was undertaken to assess the efficacy of cytisine in smoking cessation.
  
  
  METHODS
  The Cochrane Library, CINAHL, Embase, Medline and PsycINFO databases were searched for relevant data. Data from controlled trials were entered into two separate meta-analyses. The first considered the strictest definition of outcome and longest follow-up from all available studies and the second pooled outcomes from studies with biochemically validated abstinence and follow-up of 6 months or longer.
  
  
  RESULTS
  Eight controlled trials were identified. Seven trials provided extractable data and, when pooled (first meta-analysis), produced a risk ratio (RR) of 1.57 (95% CI 1.42 to 1.74). Data from two high-quality studies (second meta-analysis) produced a pooled RR of 3.29 (95% CI 1.84 to 5.90). Patients on cytisine reported more gastrointestinal symptoms than patients on placebo (RR=1.76, 95% CI 1.28 to 2.42). There was no difference in overall reports of adverse events and no specific safety concerns emerged.
  
  
  CONCLUSIONS
  Cytisine is an effective treatment for smoking cessation with efficacy comparable to that of other currently licensed treatments. Given its low cost and potential for public health benefit, expedited licensing of cytisine for smoking cessation is warranted.
authors: UK Centre for Tobacco Control Studies, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, , London, UK.
authors: Peter
authors: P
authors: Hajek
authors: Hayden
authors: H
authors: McRobbie
authors: Katie
authors: K
authors: Myers
mesh_terms: D000470:Alkaloids / Q000494:pharmacology*; D001392:Azocines / Q000494:pharmacology; D006801:Humans; D009538:Nicotine / Q000037:antagonists & inhibitors; D011634:Public Health; D011807:Quinolizines / Q000494:pharmacology; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D016896:Treatment Outcome; D000093843:Quinolizidine Alkaloids
chemical_list: D000470:Alkaloids; D001392:Azocines; D009538:Nicotine; D011807:Quinolizines; C004712:cytisine; D000093843:Quinolizidine Alkaloids
keywords: Not Applicable