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Citisine in smokin cassation

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  • Citisine in smokin cassation

    Good morning,
    I have been consulting some breastfeeding mothers who smoke but are determined to quit. Some of them believe that the only way to do so is to use citisine tablets. I would not recommend that due to lack of research and evidence on safety during breastfeeding, but perhaps you could provide other opinion. As always I would be grateful for your reply.
    Best regards,
    Karolina Morze

  • #2

    The only thing I can find is Cystisine. Wikipedia has a description of this drug. It is similar in structure to nicotine, molecular weight of 190, and activates the acetylcholine receptor site. It is not legally available in the US. I anticipate its levels in milk will be moderate and breastfeeding mothers should use this product cautiously, perhaps waiting 4 hours or more after taking this medicine before breastfeeding. Observe infant for nausea, vomiting, and convulsions. The case report below covers its use.

    Tom Hale Ph.D.

    Thorax. ([url][/url]) 2013 Nov;68(11):1037-42. doi: 10.1136/thoraxjnl-2012-203035. Epub 2013 Feb 12. Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis.

    Hajek P ([url] id=23404838[/url])1, McRobbie H ([url] r_uid=23404838[/url]), Myers K ([url] id=23404838[/url]). Author information ([url][/url])



    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. KEYWORDS:

    Not Applicable Comment in

    • Cytisine is effective for smoking cessation: should clinicians use it? ([url][/url]) [Evid Based Med. 2014]
    • Cytisine and the failure to market and regulate for human health. ([url][/url]) [Thorax. 2013]
    • ACP Journal Club. Review: cytisine increases smoking abstinence. ([url][/url]) [Ann Intern Med. 2013]
    PMID: 23404838