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 At least two U.S. experts are not convinced, however.
The study was conducted by Dr. Kari Syrjanen who, along with five
coauthors, works in Helsinki for Biohit Oyj, the company that funded
the study and markets the lozenge as Acetium.
L-cysteine is an amino acid that eliminates acetaldehyde, a compound
in cigarettes believed to play a role in tobacco addiction by
enhancing the brain’s responses to nicotine.
The research team recruited close to 2,000 cigarette smokers online
and randomly assigned about half to use the L-cysteine lozenge with
every single cigarette they smoked for six months, and the other
half to use a dummy lozenge.
All participants kept an electronic diary, recording the number of
cigarettes smoked and how much they enjoyed smoking each one.
Altogether, 753 people followed the directions for the entire study,
and another 944 followed the directions most of the time, according
to the report in Anticancer Research.
Over six months, 331 people who finished the whole study quit
smoking: 181 (18.2 percent) who took the L-cysteine lozenge and 150
(15 percent) who took the placebo.
Among those who adhered strictly to the directions, 170 (45.3
percent) who took the L-cysteine lozenge quit smoking compared with
134 (35.4 percent) who took the placebo.
Less smoking pleasure and “smoking sensations changed” were given as
strong reasons for quitting. Six percent of participants in the
study reported adverse events (although the researchers didn’t
collect the details), and the rate was about the same in both
groups.
Dr. Scott Sherman, codirector of the Section on Tobacco, Alcohol,
and Drug Use at NYU Langone Medical Center in New York called the
study “promising” but said the lozenge “is not ready for prime
time.”
The results are “modest,” he told Reuters Health by email. The
researchers didn’t compare the lozenge to other smoking-cessation
treatments, he noted, and it’s not clear if it would have worked as
well if participants weren’t required to complete the daily diary.
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The lozenge isn’t available in the U.S., and other formulations of
L-cysteine might not work as well as the one that was tested,
Sherman noted. “If the manufacturer wanted to sell the product in
the U.S. and claim that it helps with quitting smoking, it would
need to be approved and regulated by the Food and Drug
Administration,” he said.
Martha Tingen, director of the Tobacco Control Initiative at Augusta
University in Georgia, also noted study limitations, including the
fact that one-third of the people who originally enrolled didn't
actually participate.
Also, she pointed out in an email to Reuters Health, “The study was
based solely on self report. There was no face-to-face and no one
checked participants’ blood, saliva or expelled air to see if they
actually decreased or quit smoking.”
Most successful smoking-cessation interventions also include
behavior counseling, she added. “If you have somebody you’re
accountable to, it makes you feel better.”
Sherman said if one of his relatives wanted to quit smoking, “I
would tell them to use one of the seven medications demonstrated in
(the U.S.) to be effective - nicotine replacement (patch, gum,
lozenge, inhaler and nasal spray), bupropion and varenicline - in
conjunction with a call to Quitline (1-800-QUIT-NOW), as that
remains the best way to quit smoking.”
His preference? “The combination of a nicotine patch plus either
nicotine gum or lozenge, particularly since they are available over
the counter.”
The authors and Biohit representatives did not reply to requests for
comment.
SOURCE: http://bit.ly/2sNh8MR Anticancer Research, July 2017.
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