Start the year off right by quitting smoking

Cytisine, an effective and inexpensive nicotine substitute, is not available in France although a recent study shows its effectiveness and good tolerance.

In these times of new resolutions for the new year, Martin Ducret, doctor and journalist at Doctor’s Daily talks to us today about quitting smoking and more particularly about an anti-smoking molecule, cytisine.

franceinfo: Is this inexpensive molecule unavailable in France?

Martin Ducret: Yes, I read a study published in the journal Addictionwhich talks about cytisine – a molecule that was completely unknown to me – which is found in the seeds of a tree with beautiful yellow flowers, the laburnum.

Attention ! Consuming this flower directly can be fatal, but on the other hand the molecule, alone, has an action close to nicotine, since it attaches to the same receptors. This is why it was first used as a substitute for cigarettes during the Second World War – the Russians called it “fake tobacco” – and then as a drug for smoking cessation. This has been the case in Western Europe for decades, in Canada since 2017, but not in the United States, nor in many European countries, such as France.

This lack of marketing of cytisine in these countries seems surprising, when the study you have read shows that this molecule is effective for stopping smoking?

Yes indeed, this publication which is a meta-analysis – that is to say a compilation of the most serious studies on cytisine among hundreds – shows that this molecule, inexpensive and with very few side effects, multiplies by more of two quitting smoking, compared to a placebo.

Cytisine would also be a little more effective than nicotine substitutes, that is to say patches, lozenges, gums, sprays and inhalers containing nicotine. And it would have an effectiveness comparable to varenicline, a drug with a very similar mode of action, sold in France under the name Champix, but currently unavailable due to shortage.

But then why is cytisine not marketed in France?

For financial reasons, it seems. The molecule, unprofitable, does not interest the pharmaceutical industries in our country. However, for Professor Michel Lejoyeux, head of the psychiatry and addictology department at Bichat hospital in Paris, and at Beaujon hospital in Clichy, “cytisine, if it were one day marketed in France, would be an interesting tool in the therapeutic arsenal for smoking cessation.

But be careful, not as a first intention. The most effective combination to date for quitting smoking, Professor Lejoyeux told me, combines nicotine replacement therapy with cognitive-behavioral and motivational therapy.a therapy in the form of exchanges, between patient and doctor, to identify the triggering moments of the desire to smoke, twist beliefs linked to tobacco, and maintain the desire to quit smoking.