Cytisine - From ethomedical use to the development as a natural alternative for smoking cessation

Cigarette smoking is the one of the prevalent risk factors for morbidity in the world. The treatment of smoking is rapidly changing. Alternative approaches to the nicotine replacement therapies under evaluation are the non-nicotine nAChR agonists and partial agonists with reduced side effects. There is a continued interest in the pharmaceutical use of nicoline-like substances as smoking cessation drugs. We have examined the development of cytisine, nicotine - like compound, into a successful drug from natural origin used for smoking cessation. The comparison between nicotine and cytisine showed that cytisine strictly resembles nicotine in the chemical structure, receptor binding characteristics and pharmacological effects. In the first part of the review, a history of ethno medical uses of cytisine is described. In the second part, the preclinical and clinical studies of cytisine as a natural alternative for smoking cessation is reviewed.