NICE Recommends Cytisine (Cytisinicline) Within The Treatments "More Likely" To Help Smokers Quit in Newly Updated Guidance

LONDON, Feb. 4, 2025 /PRNewswire/ -- Proven smoking cessation treatment, Cytisine (also known as cytisinicline), has been classified among the "more likely" interventions to result in successful quitting for UK smokers in the latest version of The National Institute for Health and Care Excellence (NICE) tobacco guidelines (NG209).⁽¹⁾

NICE's update mandates that local commissioners and providers of healthcare in England make Cytisine (cytisinicline) available as a treatment option alongside other established smoking cessation therapies, giving frontline healthcare professionals an additional treatment option in the fight against the ongoing smoking-related health crisis.⁽¹⁾

"Cytisine is a real game-changer for smoking cessation," said Beverley Bostock, Advanced Nurse Practitioner, Mann Cottage Surgery, Gloucestershire. "Cytisine offers a short treatment duration compared to many other available treatments, and has a proven track record, making it a practical and effective option. With NICE's updated guidelines in place, clinicians will freely be able to provide this treatment option, where appropriate, to support more individuals in breaking free from smoking."

The update to the NICE tobacco guidelines was instigated by the UK launch of Cytisine in January 2024 and included a review of the clinical and cost-effectiveness evidence, which confirmed Cytisine's position as a first line treatment option for smoking cessation.⁽¹⁾

"We can now add Cytisine to the list of treatments that, when combined with support from a trained professional, can help individuals to be smoke-free," said Professor Matthew Evison, Consultant Chest Physician at Wythenshawe Hospital. "Cytisine has a treatment duration of just 25 days and can be administered with a single prescription, meaning no need for repeat prescriptions or appointments for more tablets. Having more treatment options available, and making it easier for people who smoke to access them, will help ensure more people can be smoke-free, reducing the risk of illness and premature death."

Smoking remains a leading public health challenge in the UK, contributing to around 80,000 deaths annually and imposing a £21.8 billion economic burden.⁽²⁾ Tobacco is the most preventable cause of ill health and death in the UK and, if further action is not taken, nearly half a million more people may die from smoking by 2030.^(2),(3)

"Smoking is the leading cause of premature, preventable death in the UK," said Dr Gillian Lowrey, Respiratory Consultant at University Hospitals of Derby and Burton. "Cytisine gives healthcare professionals an additional stop smoking option to prescribe to patients, particularly those who want to avoid continued nicotine use. Many people prefer oral medications for convenience and Cytisine give them options."

Those wishing to quit smoking are encouraged to visit their local stop smoking services or speak with a healthcare professional to discuss treatment options.

UK-CYT-226
Date of Preparation: January 2025

Notes to Editors:

• NICE Guidance NG209: https://www.nice.org.uk/guidance/ng209
• Spokespersons are available for interview on request

About Cytisine

Cytisine (cytisinicline) is a prescription medication for smoking cessation, launched in the UK in January 2024. Its active ingredient, a plant alkaloid derived from the Cytisus laburnum plant, mimics nicotine, helping to reduce cravings and withdrawal symptoms while diminishing the pleasure of smoking.^(4),(5)

Cytisine has been widely used in Eastern Europe for decades and is associated with a well-documented safety profile.^(4),(6),(7) Since its introduction to the UK in January 2024, Cytisine has been recommended by AWMSG for use within NHS Wales for smoking cessation and reduction of nicotine cravings in smokers willing to stop smoking.⁽⁸⁾ Cytisine has been recommended as a first choice stop smoking aid by the National Centre for Smoking Cessation and Training (NCSCT) in the latest version of 'Local Stop Smoking Services and support: commissioning, delivery and monitoring guidance', a comprehensive resource to support intelligence and evidence led decision making for smoking cessation.⁽⁹⁾ The British Thoracic Society (BTS) included Cytisine as an effective nicotine analogue medication for tobacco dependency in its new framework for clinicians to help patients address their tobacco dependence during a hospital stay.⁽¹⁰⁾

Why the NICE Committee Made the Recommendation⁽¹⁾

"The committee for the 2025 update to this guideline agreed to include cytisinicline, a medicinally licensed product, in the recommendations. Although the evidence base for cytisinicline ranged from moderate to very low quality, it was found to be effective in helping people to stop smoking when combined with behavioural support. It was found to be more effective than placebo or NRT, and there was no difference identified for the effectiveness of cytisinicline compared with varenicline.

When compared to placebo or no medication, and NRT, those taking cytisinicline were at higher risk of nausea and insomnia. But when varenicline was compared to cytisinicline, those taking varenicline were at greater risk of experiencing nausea. However, the absolute numbers for these differences were small and the committee. Noted that side effects like nausea and headache can also be symptoms of nicotine withdrawal. The available cost-effectiveness evidence, although limited, showed that cytisinicline, as with other stop smoking interventions, is likely to be cost-effective.

The committee also acknowledged that, because of the high costs and severe consequences of smoking-related diseases, most interventions that are clinically effective in smoking cessation, are cost-effective. When recommending cytisinicline the committee acknowledged the limited evidence in various population subgroups, particularly groups affected by health inequalities. The committee discussed adding a research recommendation on this area but agreed that the existing research recommendations in the guideline on stop smoking interventions for under-served groups and support for people with mental health conditions to stop smoking covered key gaps in the evidence."

About NICE Guidance NG209⁽¹⁾

The first version of NICE guideline [NG209] "Tobacco: preventing uptake, promoting quitting and treating dependence" was published in 2021. The 2025 update reflects Cytisine's inclusion as a recommended treatment option following its UK launch and a comprehensive review of clinical evidence.

NICE's update mandates that local commissioners and providers of healthcare in England make Cytisine (cytisinicline) available as a treatment option alongside other established smoking cessation therapies, giving frontline healthcare professionals an additional treatment option in the fight against the ongoing smoking-related health crisis.⁽¹⁾

Consilient Health  

Consilient Health is a medium-sized pharmaceutical company with a rich heritage of commercialising products in complex markets and in therapeutic areas such as women's health, endocrinology, bone health and urology among others. Since its establishment in 2005, its growth trajectory has been founded on forging robust partnerships with pharmaceutical manufacturers, ensuring market access, and adeptly marketing and distributing prescription healthcare products across Europe.

With the introduction of Cytisine into the smoking cessation market, Consilient Health hopes to facilitate a meaningful step towards reducing the burden of smoking on public health. Consilient Health is committed to supporting healthcare professionals with effective options and striving to improve outcomes for people seeking to quit smoking.

References:

1.  National Institute for Health and Care Excellence (NICE) Tobacco: preventing uptake, promoting quitting and treating dependence (NG209). February 2025 https://www.nice.org.uk/guidance/ng209 [Last Accessed: February 2025]

2.  UK Department of Health and Social Care. The Tobacco and Vapes Bill: What You Need to Know. Health Media Blog, 5 November 2024. Cited at: https://healthmedia.blog.gov.uk/2024/11/05/the-tobacco-and-vapes-bill-what-you-need-to-know [Last Accessed: February 2025]

3.  UK Government. The Khan Review. www.gov.uk/government/publications/the-khan-review-making-smoking-obsolete [Last Accessed: February 2025]

4.  Cytisine Summary of Product Characteristics (SmPC) Cited at: www.medicines.org.uk/emc/product/15789/smpc#gref [Last Accessed: February 2025]

5.  Livingstone-Banks J et al. Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Reviews 2023, Issue 5. Art. No.: CD006103.

6.  Prochaska JJ, Das S, Benowitz NL. Cytisine, the world's oldest smoking cessation aid. BMJ. 2013 Aug 23;347:f5198. doi: 10.1136/bmj.f5198. PMID: 23974638.

7.  Karnieg T et al. Cytisine for smoking cessation. CMAJ: 2018 Cited at: www.cmaj.ca/content/190/19/e596

8.  All Wales Medicines Strategy Group. All Wales Guide: Pharmacotherapy for smoking cessation, Feb 2018 (updated Nov 2024) Cited at: https://awttc.nhs.wales/files/guidelines-and-pils/all-wales-guide-pharmacotherapy-for-smoking-cessation-pdf/ [Last accessed: February 2025]

9.  NCSCT. Local Stop Smoking Services and support: commissioning, delivery and monitoring guidance. Cited at: https://www.ncsct.co.uk/publications/commissioning-delivery-monitoring [Last accessed: January 2025]

10.  Agrawal S, Evison M, Ananth S, et al. Medical management of inpatients with tobacco dependency. Thorax 2024;79 (suppl 1):3–11