Cytisine for smoking cessation: as good as nicotine replacement — and cheap
The smoking cessation drug varenicline (Chantix) works by weakly activating and also blocking nicotine receptors in the brain, simultaneously. This neat trick has the dual effects of reducing tobacco cravings while also blunting the "high" from smoking.
That combination has made Chantix the most successful smoking-cessation therapy on the market, but it costs about $500 for 12 weeks. Chantix sticker shock puts off many smokers who want to quit (even though most are already spending $150/month on cigarettes), if they weren't already scared off by varenicline's black box warning about psychiatric effects.
Like many prescription drugs, varenicline was inspired by a template already existing in nature: cytisine, an alkaloid in the seeds of the golden rain tree, native to central and southern Europe. Like varenicline, cytisine is a partial agonist of nicotinic acetylcholine receptors in the brain. Cytisine has been used as a smoking-cessation aid in the formerly communist states of Eastern Europe for decades, where it costs less than $30 for a 25-day course.
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