This Pill Could Be the Next Tool to Help Smokers Quit

Darius Cohen drives a forklift at a food manufacturing plant in Chicago. It’s a noisy, fast-paced job that for Mr. Cohen, a self-described “stress smoker,” has made it harder to quit.

“I’ve tried gum, patches, snacks,” Mr. Cohen, 35, said, taking a drag. “It’s not hard to stop — it’s hard to stay stopped.”

Cigarettes are notoriously difficult to kick: Even after one year of abstinence, about half of smokers light up again. Most people fail to quit cold turkey. Other approaches, including prescription medications and the nicotine gums and patches that Mr. Cohen tried, come with side effects or don’t satisfy cravings. A recent scientific review identified a little-known plant-based compound called cytisine as one of the more effective options. But while a pill version is used around the world to help people stop smoking, it is not available in the United States.

There is now a small biotech company running clinical trials in the United States in hopes of bringing it to a broader market. If it were approved, cytisine would become the first smoking cessation drug since 2006. While smoking rates have plummeted, tobacco use still causes nearly half a million deaths nationwide each year.

“Relapse rates are just so high, and we have evidence that cytisine helps,” said Jonathan Livingstone-Banks, a tobacco researcher at the University of Oxford and the lead author of the recent review.

The potential for cytisine

Cytisine is found in the laburnum tree. During World War II, soldiers used the tree’s leaves as a tobacco substitute. The drug was later developed as a pill in Bulgaria in 1964. While cytisine has been used to treat nicotine addiction in Eastern Europe for decades, it’s only more recently that the compound has been considered for smoking cessation in the rest of the world. It was approved in Canada in 2017, and in Britain last year.