{"doi":"10.1111/add.16592","title":"Systematic review and meta‐analyses of cytisine to support tobacco cessation","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Background and Aims</jats:title><jats:p>Cytisine (also known as cytisinicline) is a low‐cost partial agonist of nicotinic acetylcholine receptors used to assist tobacco cessation. We aimed to review the effectiveness of cytisine for tobacco cessation and the effects of dose and co‐use of behavioural or other pharmacological interventions on cessation outcomes.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We searched seven databases, Google Scholar, and reference lists of included publications for randomised controlled trials investigating use of cytisine as a tobacco cessation aid. Studies were eligible if participants were ≥15 years old and used tobacco upon study enrolment. We conducted four random effects meta‐analyses and sensitivity analyses with fixed effects models. We used the Cochrane risk‐of‐bias tool for randomised trials version 2 to assess risk of bias in included studies, with adjustments recommended by the Cochrane Tobacco Addiction Group.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Participants using cytisine were significantly more likely to quit tobacco than participants who received placebo/no intervention/usual care (risk ratio [RR] = 2.65, 95% confidence interval [CI] = 1.50–4.67, 6 trials, 5194 participants) or nicotine replacement therapy (RR = 1.36, 95% CI = 1.06–1.73, p = 0.0152, 2 trials, 1511 participants). The difference in cessation rates among participants receiving cytisine versus varenicline was not statistically significant (RR = 0.96, 95% CI 0.63–1.45, <jats:italic>P</jats:italic> = 0.8464, 3 trials, 2508 participants). Two trials examined longer versus shorter treatment duration, finding higher abstinence rates with longer treatment (RR = 1.29, 95% CI = 1.02–1.63, 2 trials, 1009 participants). The differences in the number of adverse events reported by participants who received cytisine versus placebo (RR = 1.19, 95% CI = 0.99–1.41, <jats:italic>P</jats:italic> = 0.0624; 6 trials; 4578 participants) or cytisine versus varenicline (RR = 1.37, 95% CI = 0.57–3.33, <jats:italic>P</jats:italic> = 0.4835; 2 trials; 1345 participants) were not statistically significant. Most adverse events were mild (e.g. abnormal dreams, nausea, headaches).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Cytisine is an effective aid for tobacco cessation and appears to be more effective for tobacco cessation than placebo, no intervention, usual care and nicotine replacement therapy.</jats:p></jats:sec>","journal":"Addiction","year":2024,"id":609589,"datarank":0.49983067652628066,"base_score":3.332204510175204,"endowment":3.332204510175204,"self_citation_contribution":0.49983067652628066,"citation_network_contribution":0.0,"self_endowment_contribution":0.49983067652628066,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":27,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":397576,"name":"Daniel Stjepanović","orcid":"0000-0003-4307-423X","position":1,"is_corresponding":false},{"id":1566903,"name":"Isabel Meciar","orcid":null,"position":2,"is_corresponding":false},{"id":1566904,"name":"Heewon Kang","orcid":null,"position":3,"is_corresponding":false},{"id":51247,"name":"Gary Chan","orcid":"0000-0002-7569-1948","position":4,"is_corresponding":false},{"id":1138991,"name":"Kylie Morphett","orcid":"0000-0003-4322-8825","position":5,"is_corresponding":false},{"id":1566905,"name":"Hollie Bendotti","orcid":null,"position":6,"is_corresponding":false},{"id":1566906,"name":"Garry Kunwar","orcid":null,"position":7,"is_corresponding":false},{"id":512049,"name":"Coral Gartner","orcid":"0000-0002-6651-8035","position":8,"is_corresponding":false},{"id":770109,"name":"Cheneal Puljević","orcid":"0000-0002-3658-9772","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Systematic review and meta‐analyses of cytisine to support tobacco cessation","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Background and Aims</jats:title><jats:p>Cytisine (also known as cytisinicline) is a low‐cost partial agonist of nicotinic acetylcholine receptors used to assist tobacco cessation. We aimed to review the effectiveness of cytisine for tobacco cessation and the effects of dose and co‐use of behavioural or other pharmacological interventions on cessation outcomes.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We searched seven databases, Google Scholar, and reference lists of included publications for randomised controlled trials investigating use of cytisine as a tobacco cessation aid. Studies were eligible if participants were ≥15 years old and used tobacco upon study enrolment. We conducted four random effects meta‐analyses and sensitivity analyses with fixed effects models. We used the Cochrane risk‐of‐bias tool for randomised trials version 2 to assess risk of bias in included studies, with adjustments recommended by the Cochrane Tobacco Addiction Group.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Participants using cytisine were significantly more likely to quit tobacco than participants who received placebo/no intervention/usual care (risk ratio [RR] = 2.65, 95% confidence interval [CI] = 1.50–4.67, 6 trials, 5194 participants) or nicotine replacement therapy (RR = 1.36, 95% CI = 1.06–1.73, p = 0.0152, 2 trials, 1511 participants). The difference in cessation rates among participants receiving cytisine versus varenicline was not statistically significant (RR = 0.96, 95% CI 0.63–1.45, <jats:italic>P</jats:italic> = 0.8464, 3 trials, 2508 participants). Two trials examined longer versus shorter treatment duration, finding higher abstinence rates with longer treatment (RR = 1.29, 95% CI = 1.02–1.63, 2 trials, 1009 participants). The differences in the number of adverse events reported by participants who received cytisine versus placebo (RR = 1.19, 95% CI = 0.99–1.41, <jats:italic>P</jats:italic> = 0.0624; 6 trials; 4578 participants) or cytisine versus varenicline (RR = 1.37, 95% CI = 0.57–3.33, <jats:italic>P</jats:italic> = 0.4835; 2 trials; 1345 participants) were not statistically significant. Most adverse events were mild (e.g. abnormal dreams, nausea, headaches).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Cytisine is an effective aid for tobacco cessation and appears to be more effective for tobacco cessation than placebo, no intervention, usual care and nicotine replacement therapy.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":3.258096538021482,"endowment":3.258096538021482,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38965792","pmcid":null,"openalex_id":"https://openalex.org/W4400368261","authors":[],"funders":[{"funder_name":"National Health and Medical Research Council","grant_id":"GNT1198301","title":null},{"funder_name":"Australian Research Council","grant_id":"DE230101131","title":"Discovery Early Career Researcher Award - Grant ID: DE230101131"},{"funder_name":"Australian Research Council","grant_id":"FT220100186","title":"ARC Future Fellowships - Grant ID: FT220100186"},{"funder_name":"World Health Organization","grant_id":"","title":null},{"funder_name":"World Health Organization","grant_id":"","title":null}],"total_grants":5,"fwci":3.6413,"citation_percentile":0.93704092,"influential_citations":0,"citation_trend":[{"year":2024,"count":2},{"year":2025,"count":13},{"year":2026,"count":10}],"oa_status":"hybrid","license":"cc-by-nc","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/add.16592","host_type":"journal"},{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/add.16592","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/add.16592","host_type":"publisher"},{"url":"https://doi.org/10.1111/add.16592","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38965792","host_type":"repository"},{"url":"https://api.library.uq.edu.au/view/UQ:45c922f","host_type":""},{"url":"https://espace.library.uq.edu.au/view/UQ:45c922f","host_type":""}],"fields_of_study":["Nicotinic Acetylcholine Receptors Study","Smoking Behavior and Cessation","Vagus Nerve Stimulation Research","03 medical and health sciences","0302 clinical medicine","0305 other medical science","Humans","Nicotinic Agonists","Quinolizidine Alkaloids","Randomized Controlled Trials as Topic","Smoking Cessation","Smoking Cessation Agents","Tobacco Use Cessation","Tobacco Use Cessation Devices","Treatment Outcome"],"mesh_terms":["Smoking Cessation Agents","Quinolizidine Alkaloids","Alkaloids","Azocines","Humans","Quinolizines","Randomized Controlled Trials as Topic","Smoking Cessation","Treatment Outcome","Nicotinic Agonists","Tobacco Use Cessation","Tobacco Use Cessation Devices"],"keywords":["Cytisine","Smoking cessation","Medicine","Meta-analysis","Nicotine","Psychiatry","Environmental health","Nicotinic agonist","Internal medicine","Tobacco","nicotinic receptors","Systematic review","Cytisinicline","Tobacco Use Cessation","Smoking Cessation Agents","Quinolizidine Alkaloids","2701 Medicine (miscellaneous)","Tobacco Use Cessation Devices","Treatment Outcome","2738 Psychiatry and Mental health","Humans","Nicotinic Agonists","Randomized Controlled Trials as Topic"],"sdg_mappings":[{"sdg_number":3,"sdg_label":"3. 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