This herbal pill would be the most effective for quitting smoking

Do you want to take advantage of this start of the year to quit smoking? The subject might interest you. A natural organic compound found in plants, called cytisine, would be an interesting option to help you with withdrawal. A new study which puts this alternative at the heart of the subject.

Twice as effective as a placebo

A meta-analysis published in the journal Addiction in October 2023 revealed that cytisine more than doubles the chances of successfully quitting smoking compared to a placebo (the analysis covered 8 studies including 6,000 people).

The analysis also focused on two studies comparing cytisine and nicotine substitutes. “Modest” results were obtained in favor of the compound.

Three trials compared this compound to varenicline, with no clear benefit for cytisine. Finally, this molecule has been shown to be safe and to have no serious side effects.

In a recent subject for Doctissimo, Alice Denoize, tobacco specialist, explained the mode of action of this molecule: “Cytisine is the same type of product as varenicline, used in Champix, whose characteristic is to block nicotinic receptors. As the nicotine can no longer clip into the reward area, there is no longer any pleasure felt because there is no longer any dopamine“.

Recognized for its effects, but not marketed in France

The compound is not new, however. This was first synthesized in Bulgaria in 1964 under the name Tabex, a smoking cessation aid. In the years that followed, it spread to neighboring countries in Europe and Asia where it is still sold today. In 2017, Polish pharmaceutical company Aflofarm sold cytisine under the name Desmoxan, available by prescription only, and Canada approved the over-the-counter version Cravv.

However, the substance has still not been approved in the United States or in France. One of the main obstacles to the approval of cytisine in the United States would be financial. “For new medical products or drugs to be approved and sold in the United States, a pharmaceutical company must support them. But because cytisine occurs in nature, a drugmaker has no way to patent this compound” can we read on the Daily mail from January 2.

The barrier would be of the same order in France according to the opinion of Henri-Jean Aubin, head of the Addictology research team at INSERM, who already spoke on the subject in 2015. “The pharmaceutical industries are not interested in this molecule because it is not very profitable: its marketing in France would only generate low profits.“.

An answer tomorrow to the smoking problem?

If the product is not magic (no substance is), researchers nevertheless judge that cytisine is an important weapon against the scourge of smoking:

“Our study strengthens the evidence that cytisine is an effective and inexpensive aid for quitting smoking. This could be very useful in reducing smoking in countries [à revenu faible ou intermédiaire] where cost-effective smoking cessation medications are urgently needed. In the whole world, smoking is considered the leading cause of preventable death. Cytisine has the potential to be one of the big answers to this problem” estimates Dr Omar De Santi, lead author of this latest study.

As a reminder, in France alone, smoking remains the leading cause of avoidable mortality, responsible for more than 75,000 deaths each year.

With or without this molecule, Alice Denoize also recalled in Doctissimo, stopping addiction must be undertaken in its entirety and act in several stages:

• Take the time to prepare, that is to say, to understand why we smoke, what our addiction is, in what context it appears;
• Take nicotine replacement to avoid physical dependence initially, in order to remain calm to take care of the rest;
• Do the work to understand your reflexes, the associations, everything that we put behind the cigarette to deal with our conditioning that has sometimes followed us for years.