# Benefit and Safety of Cytisinicline (cytisine) for Cessation of Nicotine E-cigarette Use

> **NIH NIH R42** · ACHIEVE LIFE SCIENCES, INC. · 2021 · $320,000

## Abstract

ABSTRACT
Nicotine is highly addictive: >95% of unaided attempts at smoking cessation fail by 6 months. Electronic (e)-
cigarettes (vaping) are nicotine-delivery devices that may be useful in some individuals for smoking cessation
but are not FDA-approved as a smoking cessation aid and long-term use may have uncertain health impacts.
Evidence suggests that vaping nicotine may also raise cardiovascular and pulmonary disease risks. Many
experts and professional societies recommend that vapers should also attempt to stop using nicotine e-
cigarettes. However, treatments to aid e-cigarette cessation have yet to be identified or FDA-approved.
This project will test whether cytisine, a partial nAChR agonist that reduces the severity of nicotine withdrawal
symptoms while inhibiting nicotine reward effects in the brain, can promote cessation of e-cigarette use. Prior
trials have shown cytisine’s efficacy for smoking cessation, and it has been marketed as a smoking cessation
aid in Europe for decades. Achieve Life Sciences has recently (past 3 years) expedited the US clinical
development program for cytisine as a smoking cessation aid and now proposes to test for vaping cessation.
This will be the first multicenter, randomized, placebo-controlled Pilot study conducted in daily nicotine e-
cigarette users to evaluate the benefit and safety of cytisine as a vaping cessation aid. The primary objective is
to assess if subjects randomized to 12 weeks of 3 mg cytisine three times a day (TID), vs placebo TID, have a
higher prevalence of biochemically- verified nicotine vaping cessation from Week 9 to Week 12. Secondary
objectives include assessment of cytisine vs placebo regarding: 1. Earlier vaping cessation initiated at Week 3-
6 or Week 6-9; 2. Vaping reduction, measured by weekly quantitative cotinine levels; 3. Testing moderation
effects in efficacy outcomes across subgroups defined by demographic and baseline characteristics. The safety
objective will compare the safety profile of cytisine vs placebo when administered for 12 weeks.
This study will enroll 150 adult subjects (≥18 years) at 8 US sites, who are daily nicotine e-cigarette users and
not current cigarette smokers (confirmed by saliva cotinine and expired carbon monoxide [CO] levels), intending
to quit vaping, and willing to set a quit date 7-14 days from the start of study treatment. Subjects will be randomly
assigned (2:1) to one of two arms: (cytisine 3 mg TID N=100, or identical placebo TID N=50) for 12 weeks study
treatment. All subjects will receive concurrent behavioral support for nicotine/vaping cessation during the study.
Study treatment will be double-blind. Vaping status (abstinence) will be assessed by self-report after the planned
quit target of 7-14 days post-randomization and assessed weekly from Week 2 through Week 12, including
weekly biochemical verification via measurement of salivary cotinine levels. Expired CO levels will be monitored
for smoking relapse. Subjects will be asse...

## Key facts

- **NIH application ID:** 10320201
- **Project number:** 1R42DA054784-01
- **Recipient organization:** ACHIEVE LIFE SCIENCES, INC.
- **Principal Investigator:** Cindy Jacobs
- **Activity code:** R42 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $320,000
- **Award type:** 1
- **Project period:** 2021-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10320201

## Citation

> US National Institutes of Health, RePORTER application 10320201, Benefit and Safety of Cytisinicline (cytisine) for Cessation of Nicotine E-cigarette Use (1R42DA054784-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10320201. Licensed CC0.

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