Want to quit smoking? A new pill may be coming, thanks to NJ researchers.


Cigarette sales rose during the height of the COVID-19 pandemic — the first increase in 20 years.

Meanwhile, millions in New Jersey continue to smoke. In fact, 10.8% of residents in 2020 were found to be smokers, according to AmericasHealthRankings.org.

For those wanting to quit, options are limited. There’s the gum. The patch. Lozenges. There’s Chantix (varenicline), a drug introduced in the mid-2000s. But besides vaping products, which are not considered a safe alternative, nothing new has been offered hope in years.

Researchers based in Princeton are hoping to change that.

They are studying a drug, cytisinicline, currently in a Phase 3 trial, that they think can help daily smokers quit without the depression that usually follows nicotine withdrawal.

The need might be greater than normal after the pandemic changed smoking habits. Some people, feeling stressed or anxious, began smoking or started again, experts say. Others, fearing complications from the coronavirus, quit. And still others continued their usual smoking habits.

“So kind of a mixed bag,” said Dr. Sanjay Varma, of Global Medical Institutes in Princeton, an investigative medical research company.

But for Varma, something else stuck out.

There was a “27% decrease in the number of folks that tried to seek out help to stop smoking because of the pandemic,” he said.

Varma and his team are studying cytisinicline — a plant-based alkaloid that’s “similar in structure to nicotine” that comes in tablet or capsule form. It works by blocking the receptors in the brain that nicotine binds to. But it also aims to do something else: reduce the depressive symptoms that can arise with similar agonist/antagonist drugs.

“The meds out there,” Varma said, but “there’s side effects.”

Cytisinicline trials have begun, and he is optimism. It is already an established smoking cessation treatment in parts of Europe.

“It will partially stimulate the nicotine receptor so that the patient still gets some level of protection against nicotine withdrawal,” Varma explained. “And it also blocks the receptor so that the patient can’t get too much of the high from nicotine.

“So it’s a dual mechanism — allows a person to tolerate nicotine withdrawal better, crave less, but at the same time, not experience the positive sensations of too much nicotine.”

Thereby, allowing the person to “ease off the nicotine,” he says.

One of the worst parts of quitting is the depression that often arises from stopping smoking, even when taking receptor-blocking drugs. Varma says one of the advantages of cytisinicline — and what he believes will separate it from other cessation drugs — is it doesn’t impact serotonin as much, thereby reducing the chances of depressive symptoms while quitting.

“Serotonin, when affected, can cause some side effects that can be unpleasant: dreams, nightmares, nausea, vomiting … So the hope is with this new compound, that we reduce those side effects,” Varma explained.

In the study, researchers are trying to ensure patients remain abstinent for at least four weeks. They will continue to follow the patients for an additional six months.

Cytisinicline is being studied throughout the country in a randomized, placebo-controlled Phase 3 clinical trial. The study, known as ORCA-3, is recruiting adults in the US In New Jersey, the study is being conducted in Princeton.

Varma stressed that supportive therapy is offered while patients are receiving either the drug or a placebo. He said there is a weekly follow-up, which he called “one of the strengths” of the study.

“You get to see a doctor, get a physical exam,” Varma said.

Participants must be 18 and older and smoke at least 10 cigarettes a day.

And there needs to be an intention to quit, Varma noted, after they tried to stop smoking at least once on their own with medication.

For more information, visit www.GMInstitutes.com.

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Spencer Kent may be reached at [email protected].


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