La citisina nel trattamento del disturbo da uso di tabacco: un trattamento efficace e sicuro per il controllo del craving

Journal title MISSION
Author/s Marco Riglietta, Linda Daffini, Paola Banalotti, Sara Caminada, Fabrizio Cheli, Francesca Chiara, Grazia Carbone, Paolo Donadoni, Paolo Fumagalli, Roberta Marenzi, Liliana Praticò, Margherita Rossi
Publishing Year 2026 Issue 2025/72
Language Italian Pages 7 P. 35-41 File size 0 KB
DOI 10.3280/mis72-2025oa21255
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Tobacco smoking is a leading cause of morbidity and mortality worldwide, and chronic use is recognized as a pathology in its own right: tobacco use disorder.

The most effective approach to quitting smoking combines behavioral support with pharmacological therapy. Medications aim to control withdrawal symptoms but, above all, reduce craving, which remains the hallmark of addiction.

Addiction develops over years, during which the brain's neurological mechanisms change, altering the response to stimuli and modifying memory pathways.

As with other addictions (opiates or alcohol), pharmacological treatment must allow for a sufficiently long period of time to restore balance to the altered circuits.

Cytisine represents a highly attractive therapeutic option with a well-established history in Eastern European countries. Cytisine acts as a partial agonist of α4β2 nicotinic acetylcholine receptors. This means that: It binds to these receptors in the brain with a very high affinity, weakly stimulating them, producing sufficient amounts of dopamine to alleviate withdrawal symptoms and craving. At the same time, it blocks the binding of nicotine derived from smoking, reducing or eliminating the sensation of pleasure and gratification the smoker derives from smoking. 

To date, prescribing behavior follows patterns that cannot be shared given the chronicity of the disease: it is essential to change the treatment approach and evaluate the effectiveness of treatment based on more appropriate parameters, such as the reduction of craving and the disappearance/reduction of withdrawal symptoms.

Keywords: cytisine;addictive behaviour centre;smoking cessation centre;addiction therapy;smoking therapy

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Marco Riglietta, Linda Daffini, Paola Banalotti, Sara Caminada, Fabrizio Cheli, Francesca Chiara, Grazia Carbone, Paolo Donadoni, Paolo Fumagalli, Roberta Marenzi, Liliana Praticò, Margherita Rossi, La citisina nel trattamento del disturbo da uso di tabacco: un trattamento efficace e sicuro per il controllo del craving in "MISSION" 72/2025, pp 35-41, DOI: 10.3280/mis72-2025oa21255