Innovaciones en la cesación tabáquica: el papel de la citisiniclina

Abstract

Tobacco use is one of the leading causes of disease, disability, and death worldwide. Achieving smoking cessation without pharmacological assistance is extremely challenging due to the highly addictive nature of tobacco. The goal of pharmacotherapy for nicotine addiction is to reduce withdrawal symptoms and nicotine's reinforcing effects with minimal side effects. Several effective medications are available to help people quit smoking, including nicotine replacement therapy (NRT), bupropion, varenicline, nortriptyline, and cytisinicline, among others. Cytisinicline has gained popularity in Spain, supported by funding from the Ministry of Health, making it more accessible through the public health system. Cytisinicline is administered orally and does not undergo significant hepatic metabolism, reducing the risk of drug interactions. Its most common side effects are gastrointestinal symptoms, which usually resolve spontaneously. Clinical trials have demonstrated its efficacy in smoking cessation. A clinical trial in Australia compared cytisinicline with varenicline, showing similar abstinence rates but with better tolerability for cytisinicline. Other studies and meta-analyses have also demonstrated the superiority of cytisinicline over NRT and placebo. Given its effectiveness, favorable side effect profile, and low cost, cytisinicline is a promising option. Combining it with behavioral support, such as cognitive-behavioral therapy (CBT) and motivational interviewing, enhances outcomes.