Each year, in France, tobacco is responsible for 75,000 deaths. Today, there are still 15 million smokers in France. Many would like to quit without succeeding. A new drug is available in Spain: it would allow you to quit smoking in just 25 days.
There are many tools to quit smoking: patches, chewing gum, hypnosis… Despite this, it is often extremely difficult to quit permanently and it can take many weeks or even months. It is usually necessary to try again several times before achieving this. A new drug promises to help smokers quit in just 25 days.
This molecule, cystisine is a partial agonist capable of binding to the nicotinic acetylcholine receptor. It has already been shown to double the chances of quitting smoking at six months versus a placebo. How effective is it compared to a nicotine substitute? This is what the authors of a study published in the prestigious New England Journal of Medecine (NEJM).
What was the design of the study?
A trial was conducted in New Zealand among 1,310 adult smokers who wanted to quit. One group received cystisine for 25 days while the other group received nicotine replacement therapy for eight weeks. These were administered in the form of patches, along with chewing gum. Psychological support by telephone was offered to the participants. The primary endpoint was complete smoking cessation at one month.
Cystisine more effective than nicotine substitutes
After one month of treatment, 40% of patients receiving cystisine (264 out of 655) had stopped smoking against only 31% (203 out of 655) of those receiving nicotine substitutes. The results obtained with cystisine versus nicotine substitutes were also better at one week, two months and even at six months, more than five months after stopping treatment.
Few adverse effects but contraindications
While there were more adverse effects in the cystisine group (288 events among 204 participants) than in the nicotine replacement group (174 events among 134 participants), these were not serious. These included nausea, vomiting and sleep disturbances.
On the other hand, this molecule has several contraindications, which limits the number of eligible patients: unstable angina pectoris, recent myocardial infarction, arrhythmias, recent cerebrovascular accident (CVA), pregnancy and breastfeeding, taking an oral contraceptive , taking treatment for epilepsy or tuberculosis.
Cystisine is already available in Spain and is even reimbursed. The conditions for obtaining it: having already tried to quit smoking without success and smoking more than 10 cigarettes a day. On the other hand, it is not yet marketed in France.