{"entity":{"id":"idea-prev-cytisine-essential-medicine","kind":"idea","name":"Put cytisine, a cheap plant-based quit-smoking pill, on every essential medicines list","aka":[],"tldr":"Cytisine costs a few dollars per course and works about as well as varenicline, but is unavailable in most countries. Global approval and procurement would make quitting affordable.","summary":"Cytisine costs a few dollars per course and works about as well as varenicline, but is unavailable in most countries, so this idea seeks WHO Essential Medicines listing, WHO prequalification and pooled procurement for low- and middle-income countries. Cytisinicline has randomised evidence of efficacy from the ORCA trials and decades of use in Eastern Europe; cost is the barrier to pharmacotherapy in poorer countries, and cytisine removes it. The aim is a several-fold rise in pharmacotherapy-assisted quit attempts. The test is a procurement pilot in three countries with quit-attempt monitoring. Being tested at scale, it addresses the bottlenecks Prevention we already have is not deployed and Most of the world has almost no cancer care.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Prevention we already have is not deployed): Islami et al., Proportion of cancer attributable to modifiable risk factors (CA 2018)","url":"https://doi.org/10.3322/caac.21440"}],"tags":[],"related":[],"cancers":["nsclc"],"sections":["prevention"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-prevention-adoption","b-global-access"],"keyPapers":["paper-islami-ca-cancer-j-clin"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Availability of cytisine at under $10 per course increases pharmacotherapy-assisted quit attempts in low- and middle-income countries five-fold.","rationale":"Cost is the barrier to pharmacotherapy in poorer countries; cytisine removes it.","test":"Run a procurement pilot in three countries with quit-attempt monitoring.","maturity":"being-tested-at-scale","actor":"policy","cost":"small","horizonYears":3},"route":"/ideas/idea-prev-cytisine-essential-medicine/","neighbours":{"cancer":[{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-prevention-adoption","kind":"bottleneck","name":"Prevention we already have is not deployed","route":"/bottlenecks/b-prevention-adoption/"}],"paper":[{"id":"paper-islami-ca-cancer-j-clin","kind":"paper","name":"Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States","route":"/key-papers/paper-islami-ca-cancer-j-clin/"}],"roadmap":[{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"}]}}