A plant-derived smoking cessation aid called cytisine is showing impressive results in older adults — a group that has historically been underrepresented in cessation research. Presented at the World Conference on Lung Cancer 2026 in Seoul, a sub-analysis of Italy's RISP study found that 49% of adults aged 65 and older who took cytisine for 40 days quit smoking, versus just 8% who received counseling alone. Even those who didn't fully quit were more likely to cut back significantly.

The findings are notable because cytisine's current European labeling discourages use in adults over 65, citing limited data and concerns about drug interactions. But in this cohort — where over 80% were on at least one other medication and nearly half had hypertension — adverse events were mild (nausea, headache, and insomnia) and no serious safety signals emerged.

Key Takeaways:

• Quit rate with cytisine: 49% vs. 8% with counseling alone (aOR 12.65, P<.0001)
• Older adults on cytisine were also more likely to reduce tobacco use without fully quitting: 26.4% vs. 12.5%
• All adverse events were grade 1; no link found between side effects and comorbidities or concomitant medications
• FDA received a New Drug Application for cytisine; resubmission expected Q4 2026, with potential approval in early 2027

Why it matters: Smoking remains a leading cause of preventable death, and older adults are among the hardest to treat. These results could prompt regulators and clinicians to reconsider age-based restrictions on cytisine — and open the door to a widely accessible, affordable cessation option for a vulnerable population.