Cytisinicline: The New Drug for Quitting Vaping

If you vape and you’ve tried to quit, you’ve probably noticed something: every medication, every patch, every programme was designed for smokers. Not for you.

That might be about to change. Cytisinicline — a plant-derived drug currently in clinical trials — just became the first pharmacological treatment tested specifically for e-cigarette cessation. A Phase 2 trial published in JAMA Internal Medicine in 2025 showed a 31.8% continuous abstinence rate among e-cigarette users at 12 weeks. The placebo group? 9.4%.

Those numbers matter. Not because they’re perfect — they’re not — but because they represent the first time researchers have asked the obvious question: what if vapers need their own drug?

Here’s everything we know so far, what it means for you, and what it doesn’t.

The Vaping Cessation Problem

There are approximately 10.2 million adult e-cigarette users in the United States alone. Among young adults aged 18–24, vaping rates have doubled since 2020. And the data on quitting is grim: in multiple surveys, over 70% of regular vapers say they want to stop. Fewer than 5% use any approved cessation aid. The quit rate without support hovers in the single digits.

Why? Because nothing was built for them.

The FDA has approved three categories of smoking cessation treatment: nicotine replacement therapy (NRT), bupropion (Zyban), and varenicline (Chantix). All three were developed and tested in cigarette smokers. Their labels say “smoking cessation.” Their dosing assumes cigarette-level nicotine delivery. Their trials excluded e-cigarette users.

If you’re a vaper who’s spoken to a GP about quitting, you’ve likely been offered one of these options with a shrug and a “it should work for vaping too.” And maybe it does. But “should” isn’t evidence. Until recently, no one had bothered to find out.

For a full breakdown of every NRT option currently available, read our nicotine replacement therapy guide.

What Is Cytisinicline?

Cytisinicline (also known as cytisine) is a naturally occurring alkaloid found in the seeds of the Cytisus laburnum tree — the common laburnum, that yellow-flowered tree you see in parks across Europe. It’s been used as a smoking cessation aid in Eastern Europe since the 1960s. Bulgaria, Poland, and other countries have sold it over the counter for decades under the brand name Tabex.

Pharmacologically, cytisinicline is a partial agonist at the alpha-4-beta-2 nicotinic acetylcholine receptor. If that sounds familiar, it should — it’s the same mechanism as varenicline (Chantix). Both drugs sit on the same receptor, partially activating it to reduce cravings while simultaneously blocking nicotine from binding.

Think of it this way: the receptor is a lock. Nicotine is the key that opens it fully, flooding your brain with dopamine. Cytisinicline is a key that fits the lock but only turns it partway. You get enough dopamine to take the edge off withdrawal, but not enough to feel the rewarding “hit” that keeps you addicted. And while cytisinicline is sitting in the lock, actual nicotine can’t get in. If you slip up and vape, the reward is muted.

If you want to understand the receptor science in detail — how nicotine hijacks your brain’s reward system and why quitting feels so difficult — we’ve covered the full neuroscience in what nicotine does to your brain.

The difference between cytisinicline and varenicline is mostly practical. Cytisinicline has a shorter half-life (roughly 4.8 hours versus 17 hours for varenicline), which means it clears the body faster. Its side-effect profile appears milder in trials to date. And — importantly for the conversation about access — it’s derived from a plant, making it cheaper to produce than a fully synthetic molecule.

The Phase 2 Trial: What the Data Actually Shows

In 2025, Rigotti et al. published the results of a randomised, double-blind, placebo-controlled Phase 2 trial in JAMA Internal Medicine. It was the first clinical trial of any pharmacological treatment designed specifically for e-cigarette cessation.

Here are the key numbers:

Participants: 160 adult e-cigarette users (daily use for at least one year, motivated to quit)

Intervention: 3mg cytisinicline taken orally, three times daily, for 12 weeks. Plus brief behavioural counselling for all participants (both drug and placebo groups).

Primary outcome (biochemically verified continuous abstinence, weeks 9–12):

Group	Quit rate
Cytisinicline	31.8%
Placebo	9.4%

Odds ratio: 4.35 (95% CI: 1.86–10.19)

That’s a statistically significant difference. The cytisinicline group was more than four times as likely to be abstinent at 12 weeks compared to placebo.

What the trial got right

• Biochemical verification. Abstinence was confirmed using exhaled carbon monoxide and urinary cotinine — objective measures, not self-report. This is critical. Self-reported quit rates are notoriously inflated.
• E-cigarette-specific population. Participants were primary e-cigarette users, not dual users or former smokers who switched. This is the population that actually needs a vaping-specific treatment.
• Placebo control with counselling. Both groups received behavioural support, isolating the drug’s pharmacological effect.

What the trial didn’t prove

• Long-term efficacy. The primary endpoint was 12 weeks. We don’t know the 6-month or 12-month quit rate. Most smoking cessation trials show significant relapse between weeks 12 and 52. There’s no reason to assume vaping cessation would be different.
• Optimal dosing. This was a single-dose trial (3mg TID). Phase 3 trials may test different doses and durations.
• Safety at scale. 160 participants is enough to detect efficacy signals but not enough to catch rare adverse events. The most common side effects were nausea (19.5% vs 7.6% placebo), abnormal dreams (13.0% vs 2.5%), and headache (10.4% vs 7.6%). All were mild to moderate. But we need thousands of participants to understand the full safety picture.
• Comparison to other treatments. There was no active comparator arm. We don’t know how cytisinicline stacks up against varenicline, NRT, or behavioural therapy alone for vapers.

This is a Phase 2 trial. It’s a proof of concept. It tells us the drug probably works for vaping cessation and is worth testing at a larger scale. It doesn’t tell us it’s the best option. The distinction matters.

Cytisinicline vs Varenicline: How Do They Compare?

Since cytisinicline and varenicline share the same mechanism, the obvious question is: why not just use varenicline for vapers?

Varenicline is the most effective single-agent pharmacotherapy for smoking cessation. A 2024 Cochrane review found it approximately triples the odds of quitting compared to placebo. It’s well-studied, widely available, and already prescribed off-label for vaping in some clinics.

But there are complications:

Supply issues. Pfizer voluntarily recalled all lots of Chantix in 2021 due to nitrosamine contamination above acceptable levels. While varenicline has since returned to the market in generic form, supply has been inconsistent in multiple countries. Shortages persisted through 2024 in parts of Europe and Australia.

Side effects. Varenicline causes nausea in roughly 30% of users, with about 3% discontinuing due to gastrointestinal symptoms. The FDA’s boxed warning about neuropsychiatric events was removed in 2016 after large-scale safety data (EAGLES trial) showed no increased risk — but the stigma lingers. Many GPs remain hesitant to prescribe it, particularly to younger patients.

Cost and access. Without insurance, varenicline can cost $400–500 for a 12-week course. Cytisinicline, being a plant-derived compound with a simpler manufacturing process, has historically been available in Eastern Europe for a fraction of that price. Achieve Life Sciences (the company developing cytisinicline for Western markets) has stated that affordability is a priority.

No vaping data for varenicline. The 2025 Cochrane review on e-cigarette cessation found “low-certainty evidence” for varenicline in vapers. One small trial showed promise, but the evidence base is thin. Cytisinicline now has the only placebo-controlled trial designed specifically for this population.

None of this means cytisinicline is definitively better. It means the comparison isn’t straightforward, and we need head-to-head trials.

What About Other Pharmacological Options?

Beyond cytisinicline and varenicline, the pharmacological landscape for vaping cessation is sparse:

Bupropion (Zyban/Wellbutrin). An atypical antidepressant that roughly doubles smoking quit rates. Mechanism: dopamine and noradrenaline reuptake inhibition. No trials in e-cigarette users. Sometimes prescribed off-label. Side effects include insomnia, dry mouth, and — rarely — seizures (contraindicated at doses above 450mg/day).

NRT (patches, gum, lozenges). Designed to replace cigarette nicotine with controlled doses. The logic gets circular for vapers: you’re already getting clean nicotine from a vape. Stepping down to a patch might work for some, but the evidence is unproven for e-cigarette users specifically. Our NRT guide covers every form, dosing protocol, and the combination trick that improves success rates.

Behavioural support alone. Text-message programmes like This Is Quitting (developed by Truth Initiative) have the most evidence for young vapers. A 2024 RCT showed they significantly increased 7-day abstinence at 7 months. No medication required. For many vapers — particularly younger ones — behavioural support may be sufficient, especially when combined with going cold turkey.

The honest answer is that we don’t yet have a gold-standard pharmacological treatment for vaping cessation. Cytisinicline is the most promising candidate. But “most promising” and “proven” are not the same thing.

The Regulatory Path Ahead

Cytisinicline is not yet approved by the FDA, EMA, or MHRA for any indication. Achieve Life Sciences is developing it under the brand name Arana for smoking cessation, with Phase 3 trials underway.

The vaping cessation data creates a potential second indication. But regulatory approval requires:

1. Phase 3 confirmation. Larger, multi-site trials with longer follow-up (typically 52 weeks for cessation endpoints).
2. Safety database. The FDA typically wants safety data from at least 1,500 participants before approving a new drug.
3. Manufacturing review. GMP-compliant production at commercial scale.

Realistic timeline? If Phase 3 trials for smoking cessation succeed and the FDA fast-tracks review, approval could come as early as 2027. A separate vaping indication would likely follow — possibly 2028 or later. These timelines are speculative. Drug development is slow and unpredictable.

In Eastern Europe, cytisine (the same molecule, different brand) has been available for decades. It’s sold over the counter in several countries. The safety record from millions of users is broadly reassuring, though the quality of post-marketing surveillance in those markets varies.

What This Means If You’re Trying to Quit Vaping Right Now

You can’t take cytisinicline today. It’s not approved, not available outside of clinical trials (in Western markets), and not something you should try to import from overseas pharmacies.

So what do you actually do?

Start with what works. Cold turkey remains the most commonly successful method for quitting nicotine, including vaping. It’s uncomfortable — the withdrawal symptoms peak around Days 2–3 and largely subside within two weeks. But it works. No prescriptions, no cost, no waiting for regulatory approval.

Talk to your doctor. If cold turkey hasn’t worked and you want pharmacological support, discuss varenicline or bupropion. Yes, neither is specifically approved for vaping. But your GP can prescribe off-label based on clinical judgement. Bring this article if it helps start the conversation.

Use behavioural tools. The evidence for app-based and text-based cessation support is growing. Tracking your cravings, understanding your triggers, and having a plan for high-risk moments makes a measurable difference. That’s what Cravo is built to do — give you a practical system for getting through the hard days.

Calculate what you’ll save. If motivation is wavering, run the numbers. Our savings calculator shows you exactly how much money you’re burning through vaping. For a pod-a-day user, it’s often over £1,500 a year.

Don’t wait for the perfect tool. The best cessation method is the one you actually use. Cytisinicline might be excellent — the early data is genuinely exciting. But it’s years away from your medicine cabinet. The quit attempt you start today, with imperfect tools, is worth more than the perfect treatment you wait for indefinitely.

Frequently Asked Questions

Is cytisinicline the same as cytisine?

Yes. Cytisinicline is the international non-proprietary name (INN) assigned to the molecule previously known as cytisine. The rename was part of the regulatory process for Western markets. The compound is identical to the cytisine sold as Tabex in Eastern Europe for decades. When you see “cytisine” in older research and “cytisinicline” in newer publications, they’re referring to the same molecule.

Can I buy cytisinicline or cytisine online?

Cytisinicline is not approved for sale in the US, UK, or EU as a cessation aid. Cytisine (as Tabex) is available over the counter in some Eastern European countries and can be found through online pharmacies. However, purchasing unregulated medication from overseas carries risks: uncertain quality, no medical supervision, potential legal issues, and no recourse if something goes wrong. We strongly recommend waiting for approved formulations or discussing alternatives with your doctor.

How does cytisinicline compare to nicotine patches for vaping cessation?

There’s no head-to-head comparison. Nicotine patches have strong evidence for smoking cessation (50–60% improvement in quit rates) but have not been rigorously tested in e-cigarette-only users. Cytisinicline showed a 31.8% quit rate in one Phase 2 trial in vapers. These numbers aren’t directly comparable because the trials used different populations, designs, and endpoints. What we can say is that cytisinicline is the first drug with trial data specifically from vapers.

What are the side effects of cytisinicline?

In the Phase 2 vaping cessation trial, the most common side effects were nausea (19.5%), abnormal dreams (13.0%), headache (10.4%), and insomnia (6.5%). Most were classified as mild to moderate. No serious adverse events were attributed to the drug. However, this data comes from a relatively small trial (160 participants over 12 weeks). Larger and longer trials are needed to establish a complete safety profile.

When will cytisinicline be available?

No confirmed date. Phase 3 trials for smoking cessation are underway through Achieve Life Sciences. If those succeed and FDA review proceeds without major delays, the earliest possible approval for smoking cessation could be 2027. A separate approval for vaping cessation — requiring additional Phase 3 data — would likely follow later. These timelines are estimates and subject to change.

Should I wait for cytisinicline before trying to quit?

No. The best time to quit is now. Cytisinicline is promising but unproven at scale and years away from availability. Every day you continue vaping exposes your lungs to aerosol compounds with uncertain long-term effects, costs you money, and reinforces the neural pathways that make quitting harder. Start with the tools available today — cold turkey, NRT, behavioural support, or prescription medication through your doctor. If cytisinicline is eventually approved, it becomes another option in your toolkit.

The Bigger Picture

For years, the vaping cessation conversation has been dominated by two camps. One says vaping is harmless, so why quit? The other recycles 1990s smoking cessation advice and hopes it transfers. Neither is good enough.

The cytisinicline trial represents something more important than a single drug result. It represents researchers finally treating vaping cessation as its own clinical problem, worthy of its own evidence base. It means someone looked at 10 million vapers wanting to quit and decided they deserved better than hand-me-down treatments.

Whether cytisinicline becomes the standard of care or not, this trial opened a door. More vaping-specific research will follow. Better tools will come.

But you don’t have to wait for them.

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This article is for informational purposes only and does not constitute medical advice. Cytisinicline is an investigational drug not yet approved by the FDA, EMA, or MHRA. Do not start, stop, or change any medication without consulting a qualified healthcare professional. If you are experiencing difficulty quitting vaping or smoking, speak to your GP or a licensed cessation specialist.

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“The measure of a first-rate treatment is not that it works in a controlled trial. It’s that it reaches the people who need it, when they need it. Until cytisinicline is on pharmacy shelves, the most effective cessation tool is the decision you make today.”