Cytisine Use Vs Nicotine Replacement Therapy in Relapsed Smokers with Heart Disease: Feasibility Results from a Pilot Randomized Trial
Bibliographic record
Abstract
Background: Cytisine use has proven efficacy for smoking cessation. We plan to investigate whether cytisine use is effective for relapse recovery and conducted a pilot randomized trial to assess the feasibility of a definitive trial. Methods: A 2-group, single-site pilot randomized controlled trial was conducted. Adults with heart disease, who were actively enrolled in a smoking-cessation program and had relapsed to smoking, were randomly assigned to receive cytisine or combination nicotine replacement therapy for 25 days. Primary outcomes were rates of participant recruitment and treatment adherence, compared to targets. Secondary outcomes included end-of-treatment abstinence and treatment effects on cigarettes smoked per day and tobacco-withdrawal symptoms. Results: Over the course of 18 months, we screened 62 relapsed smokers, identifying 32 (52%) who were eligible. We recruited 13 participants (41% of eligible), of whom 9 (69%) completed the study. A total of 5 of 13 participants (38.5%) used study medication on ≥ 80% of the days during the treatment period (50.0% in the cytisine group vs 28.6% in the nicotine replacement therapy group). At 25 days, 1 quitter was present in the cytisine group, and no quitters were present in the nicotine replacement therapy group (16.7% vs 0%). Cigarettes smoked per day decreased over the course of treatment. Conclusions: Modifications to trial design, trial processes, and intervention delivery are required to make a definitive trial useful. To increase recruitment level, we will use a pragmatic design embedded within typical cessation-program practices, conduct a multisite study, and expand eligibility to include participants with other clinical conditions. To increase treatment adherence, we will use simplified dosing for cytisine. Sample size for the definitive trial will be based on the number needed to determine a clinically meaningful change in long-term abstinence. Clincial Trial Registration: NCT04286295.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.021 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".