TRAINING
Welcome to the Cytisine Training & Resources section, where we aim to provide useful resources to support your understanding and use of Cytisine to help you as you work to support people on their journey to quit smoking.
Explore the available education and training resources:
- Product Information Videos - short videos outlining Cytisine and its clinical features and key prescribing information.
- Key Resources - a selection of key resources, including a quick-reference prescribing guide and patient dose card.
- Frequently Asked Questions - answers to frequently asked questions about Cytisine
For more information, contact Consilient Health here:
Cytisine PRODUCT INFORMATION VIDEOS
KEY Cytisine RESOURCES
Cytisine Prescribing Factsheet
An A4 quick reference guide covering key information for anyone recommending or prescribing Cytisine. Download a pdf here or contact us and we’ll send a printed version.
Cytisine Dosing Guide and Patient Leaflet
A leaflet for patients taking Cytisine with a
handy dosing table to help them track their treatment. Contact us to order printed copies or download a pdf here.
UPDATES
ASH webinar: Varenicline and Cytisine
ASH, an independent public health charity, ran a webinar on varenicline & cytisine on the 16th of December 2024. You can find a link to the webinar hosted on the ASH website, as well as a short summary below. Click here to watch the webinar -- On 16th December 2024, ASH hosted a Smokefree NHS Network online event on the smoking cessation medications varenicline and cytisine. The webinar provided an overview of varenicline and cytisine, a case study from Greater Manchester on their use in trusts and a summary of the NCSCT training materials and briefings on these medications. There were also presentations from the Specialist Pharmacy Service who have published a new Patient Group Direction (PGD) template for varenicline and will be publishing one for cytisine early next year and Fresh who are working with local authorities and pharmacy colleagues to develop a regional PGD Pharmacy supply service for varenicline & cytisine, in the community. -- We would like to thank ASH for giving permission to share this link. Please note that ASH is an independent organisation and the inclusion of this link does not imply any endorsement or affiliation between Consilient Health and ASH.
UK-CYT-253 April 2025
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Cytisine now an option recommended by NICE!
NICE guideline NG209 has been updated to include Cytisine (also known as cytisinicline).¹ Cytisine has been classified as among the "more likely" interventions to result in successful quitting for UK smokers in the updated NICE NG209 guidelines.¹ The NICE Guidelines mandate that healthcare providers ensure Cytisine is made available to smokers as a treatment option alongside other current therapies. To read the full updated guidance Click here Cytisine, an effective treatment and supported by decades of use in Eastern Europe, is now endorsed by NICE giving healthcare professionals an additional option for smoking cessation1-4 1. NICE NG209. Tobacco: preventing uptake, promoting quitting and treating dependence. https://www.nice.org.uk/guidance/ng209 2. Cytisine Summary of Product Characteristics. https://www.medicines.org.uk/emc/product/15789/ 3. 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. 4. Karnieg T et al. Cytisine for smoking cessation. CMAJ: 2018 Cited at: https://www.cmaj.ca/content/190/19/e596
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Smoking cessation webinar: 17th September 2024
Consilient Health ran a smoking cessation webinar on the topic of: Now is the time: Seizing new opportunities to treat tobacco dependence! You can find a link to the recording of the webinar and the slides below: Webinar recording Webinar slides The webinar took place on the 17th of September 2024. We had two excellent speakers in Professor Matthew Evison and Louise Ross. The webinar was designed for healthcare professionals looking to make a significant impact in their smoking cessation services. With the availability of a range of treatments, coupled with increased government funding, there has never been a better time to enhance your practice. We have discussed the role of different interventions and provided practical advice on how to leverage these developments for maximum patient benefit. This webinar has been organised and funded by Consilient Heath (UK) Ltd and is intended for UK healthcare professionals and other relevant decision makers involved in the delivery of smoking cessation services. Please be informed that product information was discussed at this event.
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AWMSG recommends Cytisine as an option for smoking cessation
Following a directed appraisal by All Wales Medicines Strategy Group, Cytisine (cytisinicline) is recommended as an option for use within NHS Wales for smoking cessation and reduction of nicotine cravings in smokers who are willing to stop smoking. Click here to access
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Cytisine added to BNF
Cytisine monograph now available in the British National Formulary under 'cytisinicline'. Click the link below to access the BNF page on Cytisine. Click here to access
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NICE guidelines update to include Cytisine
NICE has made the decision to add Cytisine to smoking cessation guideline NG209 following an exceptional review published February 2024. The update "2024 exceptional surveillance of tobacco: preventing uptake, promoting quitting and treating dependence" will focus on the inclusion of cytisine as a medicinally licensed product to be used as a stop-smoking intervention. The guideline currently states that varenicline, nicotine-containing e‑cigarettes and nicotine replacement therapies (NRT) are more likely to result in people successfully stopping smoking. The available evidence confirms that cytisine has a comparable effect, safety and cost to these recommended products. Click here to access
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Cytisine now in Drug Tariff
Cytisine is now available in the Drug Tariff under 'cytisinicline' from June 2024. Please click the link below to access the NHS Drug Tariff website where you can download or view the most recent Drug Tariff. Click here to access
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RESOURCES
ASH webinar: Varenicline and Cytisine
This link does not imply any endorsement or affiliation with ASH.
UK-CYT-251 April 2025
Cytisine Prescribing Factsheet
Please find the Cytisine prescribing factsheet.
UK-CYT-152l November 2024
Cytisine Dosing Guide and Patient Leaflet (Print)
Please find the Cytisine Dosing Guide and Patient Leaflet (Print).
UK-CYT-152k July 2024
Cytisine Dosing Guide and Patient Leaflet (Digital)
Please find the Cytisine Dosing Guide and Patient Leaflet (Digital).
UK-CYT-152j July 2024
NCSCT Commissioning Guidance
NCSCT Local Stop Smoking Services and support guidance, April 2024.
UK-CYT-152i July 2024
Cytisine Clinical Evidence Summary
Please find the Cytisine clinical evidence summary.
UK-CYT-152h July 2024
Cytisine Product Presentation
Please find the Cytisine Product Presentation.
UK-CYT-152g July 2024
NCSCT Cytisine briefing
National Centre for Smoking Cessation and Training briefing on Cytisine.
UK-CYT-152i July 2024
Link to recent BTS guidance
BTS Medical management of inpatients with tobacco dependency, March 2024.
UK-CYT-152e July 2024
BNF Cytisine monograph
Cytisine monograph now available in the BNF under 'cytisincline'.
UK-CYT-152d July 2024
Cytisine Summary of Product Characteristics (SmPC)
Full Summary of Product Characteristics of Cytisine (SmPC) is available here.
UK-CYT-152c July 2024
Cytisine Patient Information Leaflet (PIL)
Full Patient Information Leaflet (PIL) is available here.
UK-CYT-152b July 2024
Link to Drug Tariff
Cytisine is now available in the Drug Tariff under 'cytisinicline' from June 2024.
UK-CYT-152a July 2024
FREQUENTLY ASKED QUESTIONS (FAQs)
Is CYTISINE the same as cytisinicline?
Yes, CYTISINE and cytisinicline are the same. Although the generic name (INN) CYTISINE has been widely used for many decades, more recently the WHO proposed changing this to cytisinicline. You may therefore find it listed under “CYTISINE”, “cytisinicline”, or both.
Is CYTISINE available? Can CYTISINE be prescribed on an FP10?
CYTISINE is a Prescription Only Medicine (POM) and is available now in the UK. CYTISINE comes as 1.5mg tablets in a pack of 100 – sufficient for a complete 25-day treatment course. Pharmacies can obtain CYTISINE via all mainline and selected short-line wholesalers. CYTISINE can be prescribed on an FP10.
Are dosing instructions printed on tablet foil strip?
CYTISINE is supplied with 2 foil strips of 50 tablets; 100 tablets is enough for a complete 25-day course. There are no dosing instructions printed on the foil strips, however, each pack is provided with a Patient Information Leaflet detailing how to take the medication.
Also, Consilient Health has created a supplementary Patient Leaflet & Dosing Guide. This includes a chart that allows patients to mark-off when they have taken each dose throughout the full 25-day treatment course. These can be supplied by Consilient Health (contact us here to request copies or to download as a pdf from our website.)
Why are there age restrictions on CYTISINE in those over 65 or under 18?
Due to limited clinical experience based on the clinical trial data available at the time CYTISINE was licensed, the safety and efficacy of CYTISINE in these age groups has not been established and is therefore not recommended.
Is there a specific degree of renal or hepatic impairment at which CYTISINE should not be used?
The SPC states that, due to lack of clinical experience, CYTISINE is not recommended in patients with renal or hepatic impairment. As the SPC does not specify a particular level of hepatic or renal impairment, this implies any impairment.
What is considered a “recent” myocardial infarction or stroke?
The CYTISINE SPC contraindicates use in patients with a history of “recent myocardial infarction” or “recent stroke”. However, “recent” is not defined in the SPC as the information was not collected during the original clinical trials, so a specific time period cannot be advised.
The use of CYTISINE is a clinical decision for the prescriber who is familiar with the patient’s underlying condition. CYTISINE can be used in patients with certain cardiovascular conditions, i.e. “ischemic heart disease, heart failure, hypertension, pheochromocytoma, atherosclerosis and other peripheral vascular diseases”, however, the SPC states that it should be used with caution.
How does CYTISINE fit into a 12 week stop smoking service programme?
Intervention and support throughout a smoker’s quit journey from a healthcare professional can have a significant positive impact on the chances of successfully quitting1. Therefore, the support provided through a 12 week stop smoking programme, irrespective of the treatment provided, is an important factor.
CYTISINE, which has a treatment duration of just 25-days, can easily be incorporated into a 12 week stop smoking programme. Treatment with CYTISINE can be initiated at the start of the programme, with the smoker stopping smoking by day 5, and treatment continuing until day 25. The support provided through the stop smoking service, such as face-to-face appointments, group meetings or phone calls, can carry on as normal for the full 12 weeks.
1. West R, Papadakis S. Stop smoking services: increased chances of quitting. 2019 National Centre for Smoking Cessation and Training (NCSCT) Available at: https://www.ncsct.co.uk/publications/Stop_smoking_services_impact_on_quitting Accessed Jan 2025.
What is “the quit rate” for CYTISINE?
It is difficult to give a single, definitive number for “the quit rate” as the data varies depending on the setting of the smoking cessation service or clinical trial design, how “quitting” is defined, when quit rate is measured, and what support the smoker is offered on their quit journey.
For example, the NSCST “Local Stop Smoking Services and support: commissioning, delivery and monitoring guidance” (April 2024) provides the following estimates for other treatments, with different types of support and at different time periods1:
CYTISINE (given as a 25-day treatment course) has been shown:
- In an open-label trial, to be superior to combination NRT; CYTISINE was associated with a higher frequency of self-reported adverse events (Walker et al 2014)2 For more information click here
- Was inferior to varenicline given for 84 days; CYTISINE was associated with lower frequency of adverse events (Courtney et al 2021, Oreskovic et al 2023)3,4
1. NCSCT. https://www.ncsct.co.uk/publications/commissioning-delivery-monitoring Accessed Jan 2025
2. Walker N et al. N Engl J Med 2014;371:2353-62
3. Courtney RJ et al. JAMA 2021 326(1)56-64
4. Oreskovic T et al. Nicotine Tob Res. 2023 Aug 19;25(9):1547-1555.
Can CYTISINE be used to help stop vaping?
CYTISINE is indicted for smoking cessation and reduction of nicotine cravings in smokers who are willing to stop smoking; the treatment goal of CYTISINE is the permanent cessation of the nicotine containing products use.
The CYTISINE clinical trials did not include people that used e-cigarettes or vapes, and therefore use in this population cannot be recommended.
Can NRT and CYTISINE be used concurrently?
The concurrent use of CYTISINE and Nicotine Replacement Therapy (NRT) is not specifically addressed in the CYTISINE Summary of Product Characteristics (SPC) and a search of the published literature did not reveal clinical studies trialling the simultaneous use of both treatments.
The SPC does advise that: “Smoking should be stopped no later than on the 5th day of treatment. Smoking should not be continued during treatment as this may aggravate adverse reactions. Patient should be aware, that the simultaneous administration of the drug and smoking or use of products containing nicotine could lead to aggravated adverse reactions of nicotine.”
Therefore, the use of NRT would not be recommended after day 5 of treatment with CYTISINE.
Can you use vapes / e-cigarettes with CYTISINE?
This is not specifically addressed in the CYTISINE SPC, however, it does advise that: “Smoking should be stopped no later than on the 5th day of treatment. Smoking should not be continued during treatment as this may aggravate adverse reactions. Patients should be aware, that the simultaneous administration of the drug and smoking or use of products containing nicotine could lead to aggravated adverse reactions of nicotine.”
The concurrent use of vapes / e-cigarettes with CYTISINE would therefore not be recommended.
Can a patient continue with CYTISINE after 25 days if they still have cravings?
The SPC does not allow for patients to continue treatment beyond 25 days. The CYTISINE SPC does state that, in case of treatment failure, the treatment should be discontinued and may be resumed after 2 to 3 months.
The management of a patient after they have completed treatment with CYTISINE remains a clinical decision for the healthcare professional in discussion with the patient.
What if a patient forgets to take a tablet?
The Patient Information Leaflet (PIL) advises that patients should “not take a double dose to make up for a forgotten dose”. A PIL is provided, in each pack of CYTISINE.
