Cent Eur J Public Health 2026, 34(2):129-134 | DOI: 10.21101/cejph.a8654

Cytisine for smoking cessation in clinical practice: a retrospective analysis of early outcomes in Türkiye

Feyzanur Erdem, Hatice Rümeysa Selvi, Ayşe Didem Esen, Mahnur Mahdum, Begüm Yildirim Erence, Muhammed Nezir Çetin, Erdoğan Öz, Seçil Arica

Family Medicine Department, Istanbul Prof. Dr. Cemil Taşçioğlu City Hospital, Ministry of Health, Istanbul, Türkiye

Objectives: Smoking remains a major global public health problem, and pharmacological therapies are central to cessation strategies. Cytisine, a plant-derived alkaloid, has recently been introduced in Türkiye as a smoking cessation aid. This study aimed to evaluate the early effectiveness and cessation outcomes of cytisine in a Turkish population.

Methods: This retrospective observational study included 289 patients who were prescribed cytisine at a smoking cessation clinic between March and May 2024. Socio-demographic characteristics, smoking history, nicotine dependence, treatment duration, and smoking cessation outcomes at 1 month and 6 months were analysed. Smoking cessation status was self-reported. Analyses were conducted using the intention-to-treat principle, with participants lost to follow-up classified as non-quitters.

Results: Cytisine was prescribed according to the national 25-day tapering regimen, and the actual duration of use was recorded. In the intention-to-treat population, smoking cessation was achieved by 42.6% of participants at 1 month and by 39.8% at 6 months. At both follow-up points, participants who quit smoking were younger and had shorter smoking duration and lower cumulative smoking exposure. Higher educational attainment was associated with greater cessation success, whereas sex, marital status, chronic disease, daily cigarette consumption, smoking exposure, previous quit attempts, and baseline nicotine dependence were not. In multivariable analyses, higher educational level independently reduced the likelihood of cessation failure at 1 month (adjusted odds ratio = 0.52, 95% CI: 0.29-0.96), while longer duration of cytisine use was independently associated with greater smoking cessation success at 6 months, with each additional treatment day increasing the odds of cessation by approximately 15.0% (aOR = 1.15, 95% CI: 1.10-1.19, p < 0.001).

Conclusions: Cytisine showed promising early effectiveness as a smoking cessation aid in Türkiye. Treatment adherence appears to be a key determinant of cessation success, supporting its potential role in national smoking cessation programmes.

Keywords: tobacco cessation, cytisine, pharmacotherapy, primary health care, developing countries, tobacco use disorder, substance related disorder

Received: May 5, 2025; Revised: February 10, 2026; Accepted: February 10, 2026; Published: June 30, 2026  Show citation