SPC365

Attempted Before, Achieved Now: Cytisinicline in a Structured Smoking Cessation Program

Session: Sessão de Posters 32 - Comportamento, mente e metabolismo
Speaker: João Martins Neves

Congress: CPC 2026
Topic: J. Preventive Cardiology
Theme: 28. Risk Factors and Prevention
Subtheme: 28.5 Tobacco
Session Type: Posters Eletrónicos
FP Number: ---
Authors: João Martins Neves; João Cravo; Alda Jordão; Sílvia Fiuza; Inês Aguiar-Ricardo; Pedro Alves da Silva; Nelson Cunha; Fausto J. Pinto; Ana Abreu
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>&nbsp;Introdution</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Smoking cessation is essential for secondary prevention after cardiovascular events. Although several behavioural strategies and pharmacological therapies are available, their effectiveness remains variable, and the optimal approach to support cessation is still uncertain.</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Purpose</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">To assess the efficacy of a structured smoking cessation program using cytisinicline.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Methods</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">This single-center prospective study included cardiac rehabilitation patients who voluntarily entered a structured smoking cessation program between 2024 and 2025. Nicotine dependence was assessed using the Fagerstr&ouml;m Test. All patients received cytisinicline with or without concomitant nicotine replacement therapy for 25 days and were followed for a mean of 6 months, with medication adherence and smoking status evaluated at baseline and during follow-up.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Results</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">A total of 24 patients were enrolled in the smoking cessation program (mean age 56 &plusmn; 2 years; 21 [88%] male). Coronary artery disease was present in 71% (multivessel 13%); peripheral artery disease in 8%. Hypertension and dyslipidemia occurred in 54% each; diabetes in 29%. Mean smoking duration was 38 &plusmn; 2 years and mean smoking burden was 41 &plusmn; 3 pack-years. Severe nicotine dependence was identified in 9 patients (38%) and 14 (58%) had previously attempted smoking cessation.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Smoking duration was significantly associated with ischemic heart disease (38 vs 29 years, p=0.03) and peripheral artery disease (51 &plusmn; 1.4 vs 36 &plusmn; 11 years, p=0.001). In multivariable analysis, smoking duration remained independently associated with coronary artery disease, with a 14.8% increase in the odds per additional smoking year (OR 1.148; p=0.043), after adjustment for hypertension and diabetes.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">All patients underwent a 25-day regimen of cytisinicline and nicotine replacement therapy, except one who discontinued early due to gastrointestinal side effects. By the end of treatment, 12 (50%) patients achieved complete cessation, 7 (29%) reduced tobacco use and 5 (21%) continued smoking. Over a 7 &plusmn; 1-month follow-up, 3 of the 12 quitters (25%) relapsed, while all 7 patients who reduced consumption maintained this reduction. No significant associations were observed between cessation success and smoking duration, burden, or nicotine dependence. Compared with cardiac rehabilitation patients not enrolled in the structured cessation program (~10% cessation), this program achieved a markedly higher cessation rate of 37%.</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Conclusion</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">:</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">In our cohort, cytisinicline was well tolerated and demonstrated a beneficial effect on smoking cessation. These findings suggest that structured smoking cessation programs can substantially improve cessation rates in high-risk cardiovascular patients.</span></span></span></p>

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