Cytisine for Smoking Cessation: Is It Available and Does It Work?

Smoking cessation medications treat nicotine dependence to help you quit. FDA-approved options include over-the-counter nicotine patches, lozenges, and gum. There are also prescription-only options like Chantix (varenicline). And soon, there may be another. Cytisine is an herbal product that’s long been used in other countries to help people quit smoking.

Below is what you need to know about cytisine for smoking cessation. This includes how it works, how it compares with other options, and when it might be available in the U.S.

What is cytisine?

Cytisine (also called cytisinicline) is a naturally occurring chemical found in certain plants. It has a chemical structure that’s similar to nicotine. For more than 50 years, cytisine has been sold in Central and Eastern Europe as a smoking cessation treatment under the brand name Tabex.

In recent years, cytisine has become more widely available. It’s approved for smoking cessation in Canada and the U.K.

Now, the manufacturer Achieve Life Sciences is looking to bring cytisine to the U.S. Researchers have completed two phase 3 clinical trials of cytisine for smoking cessation with positive results. And the company plans to apply for FDA approval.

How does cytisine work for smoking cessation?

Cytisine is a nicotine receptor partial agonist. This means it selectively attaches to nicotine receptors (binding sites) in the body — but not as strongly as nicotine.

Cytisine works by blocking nicotine from attaching to these binding sites. This prevents nicotine from providing a pleasurable feeling, which helps reduce cravings. And because cytisine attaches where nicotine does, it also helps manage nicotine withdrawal symptoms. These symptoms happen when the body suddenly has nothing attached to nicotine binding sites. And they are a common reason why people have trouble quitting smoking.

How well does cytisine work for quitting smoking?

Two clinical trials found cystine is more likely to help people quit smoking than a placebo (a pill with no medication in it). Participants took either a placebo or cytisine for 6 or 12 weeks. Key results from these studies include:

• The first study showed people taking cytisine were six to eight times more likely to quit.

• The second study showed people taking cytisine were three to six times more likely to quit.

• In both studies, people were five to six times more likely to stay nicotine-free after they stopped taking cytisine.

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Keep in mind that all participants received smoking cessation counseling. It’s possible that real-world rates of quitting may be lower without this type of support.

Cytisine was found to be similarly effective in a 2024 review that combined results from six clinical trials. This review found that people taking cytisine were almost three times more likely to quit smoking than those taking a placebo.

How does cytisine compare to other smoking cessation methods?

The available research shows that cytisine may work well for smoking cessation. But it’s also good to know how it compares to treatments that are already available.

Cytisine vs. nicotine replacement therapy

Nicotine replacement treatment (NRT) reduces the urge to smoke by giving your body “clean nicotine,” or nicotine without the other harmful chemicals in tobacco products. NRT comes in several forms, such as patches, lozenges, or gum. Over a period of several weeks, you’ll slowly lower your dosage of nicotine. This helps your body gradually adjust to less nicotine.

One study found cytisine worked better than NRT at helping people quit smoking. It also had a higher likelihood of helping people stay nicotine-free after treatment ended. But people receiving cytisine reported more side effects overall than those using NRT.

Cytisine vs. Chantix

Cytisine and Chantix belong to the same medication class. Head-to-head studies comparing them found that they work similarly well to help people quit smoking. Cytisine and Chantix also have similar side effects. But some studies suggest cytisine may be slightly more likely to cause side effects.

Cytisine vs. bupropion SR

Bupropion sustained-release (SR) is an antidepressant that’s also FDA approved to help people quit smoking. There are no studies available that directly compare cytisine to bupropion SR.

Studies suggest Chantix results in a higher quit rate than bupropion SR. Since Chantix and cytisine work similarly well, it’s possible that cytisine may also work better than bupropion SR. But more studies are needed to say for sure.

What are the risks of cytisine?

Cytisine seems to be safe to take for smoking cessation. The most common side effects reported in clinical trials include:

• Trouble sleeping

• Unusual dreams

• Constipation

• Nausea

• Headaches

• Anxiety

Achieve Life Sciences conducted a long-term safety study to make sure that cytisine would be safe to take over a longer period of time. The manufacturer didn’t find any long-term safety risks during this study.

Is cytisine available in the U.S.?

No, cytisine is not available in the U.S. yet. Based on clinical trial results, Achieve Life Sciences plans to submit cytisine for FDA approval in mid-2025. If the FDA agrees to review it, they could potentially approve cytisine for smoking cessation in 2026.

Does cytisine work for vaping?

Vaping can also cause nicotine dependency. So it makes sense that smoking cessation medications might also help people quit vaping. But there’s not enough research on whether this is true. Currently, there are no medications specifically approved for vaping.

Early research suggests cytisine may also help people quit vaping. If approved, cytisine would become the first FDA-approved vaping cessation medication.

Due to the lack of treatment options, the FDA granted their breakthrough therapy designation to cytisine for vaping cessation. This designation provides benefits to manufacturers to help speed up the research and development process.

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Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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