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Smoking Cessation Drug Underused Despite Proven Efficacy
1 Jan
Summary
- Varenicline, a key smoking cessation drug, was withdrawn due to impurities.
- Cytisine, a plant-based alternative, is available but shockingly underused.
- Low awareness and complex dosing may hinder cytisine's adoption by smokers.
Varenicline, once the most effective single drug for quitting smoking, was removed from the UK market in 2021 because of unsafe impurity levels. This withdrawal led to an estimated 1,890 additional preventable deaths annually in the UK, as fewer individuals successfully quit.
Cytisine, a plant-derived product with a long history of use in Eastern Europe, has since been licensed in the UK, becoming available from January 2024. Evidence suggests cytisine is as effective as varenicline and may offer better tolerability and appeal to those preferring natural treatments.
Despite its availability, cytisine remains critically underused, with only 0.2% of quitters using it since January 2024. This low uptake is attributed to factors such as its complex dosing regimen, potential overshadowing by vaping cessation discussions, and a significant lack of awareness among smokers, GPs, and pharmacists. Concerns about its cost and a newness factor may also contribute to hesitancy in prescribing.
