BACKGROUND: Nicotine withdrawal symptoms are intense and last more than a month. Additionally, heavy smokers cannot usually quit in 5 days in order to follow cytisine’s proposed scheme of administration in the smoking cessation process. In our study, we aimed to evaluate smoking abstinence results with the use of cytisine for an extended period more than 25 days combined with intense behavioural support in a smoking cessation clinic.
METHODS: 60 smokers (22 males and 38 females) without kidney nor liver failure, aged 52.58±12.69, 52.54±40 pack years, Fagerstrom nicotine dependence 6 (IQR5-8) used cytisine administered free of charge. Cytisine was administered in a daily dose of 9mg until smoking cessation was achieved (usually between day 14-21) in highly addicted smokers with history >30 py. 9mg was continued for an additional week and then reduced gradually for a total period of two months. Intense behavioural support was additionally given in five sessions. 46.9% of participants had a prior unsuccessful quit attempt.
RESULTS: 45 out of 60 smokers (75%), who used cytisine for 2 months had succesfull smoking abstinence rates. The drug was well tolerated [vival dreams (3.3%), diarrhea (3.3%), frequent urination (3.3%), nausea (3%), vomiting (3%)]. 61.5% of smokers had comorbidities (30.7% COPD, 38.5% asthma, 31.2 % hypertension, 25% hyperlipidemia, 25% anxiety, 31.2% depression).
CONCLUSIONS: Cytisine is highly effective when used in a dosage of 9mg in smokers that are highly addicted and is well tolerated. An extended regimen for more than 25 days, could be given in smokers without renal failure under smoking cessation experts guidance. There is urgent need for further studies in order to guide health care professionals in the use of cytisine for effective smoking cessation.