Underused Smoking Cessation Drug Cytisine Shows Promise, Remains Largely Unprescribed in UK
Despite being licensed and available for over a year, a plant-based smoking cessation aid called cytisine remains significantly underutilized in the United Kingdom, raising concerns about preventable deaths linked to smoking.
Cytisine was introduced in January 2024 as an alternative to varenicline, a highly effective drug withdrawn from the UK market in 2021 due to impurities. Research indicated that the absence of varenicline led to approximately 1,890 additional avoidable deaths annually. However, data from NHS stop-smoking services in England reveal that only 0.7 percent of individuals accessing these services were prescribed cytisine in 2024, and current figures show only 0.2 percent of those attempting to quit are using it. This is despite trials demonstrating cytisine’s comparable effectiveness to varenicline, and potentially fewer side effects.
Several factors may contribute to the low uptake, including a more complex dosing schedule – starting with six pills daily and tapering down – and a lack of awareness among both healthcare professionals and the public. The cost of the licensed product in the UK has also risen, negating initial hopes that it would be a low-cost alternative. Smoking remains the leading preventable cause of death in the UK, and access to effective cessation tools is crucial for public health. For more information on the dangers of smoking, visit the Cancer Research UK website.
Varenicline has since been reformulated and reintroduced to the market, but uptake remains low at 1.1 percent of past-year smokers. Health officials are now considering whether to prioritize cytisine as a first-line treatment alongside varenicline, and are exploring ways to increase awareness and confidence in its use. You can learn more about smoking cessation options through the NHS Quit Smoking website.
Researchers are continuing to gather data on cytisine’s long-term effectiveness, and health authorities have indicated they will monitor prescribing trends closely in the coming months.
