London: A pill developed in Bulgaria during the Soviet era shows promise for helping millions of smokers cheaply and safely kick the habit, the first big study of it shows.It could become a new weapon to combat smoking in poor countries, but it is unclear whether it will ever reach the market in the U.S. or Western Europe.The drug, cytisine, is now used just in Eastern Europe, where smokers usually take the pill for three or four weeks. Generic versions cost as little as $5 to $17 a month, compared with about $100 for an eight-week supply of nicotine patches or about $300 for a 12-week supply of Pfizer Inc.`s Chantix pill — common treatments in rich countries to help smokers quit.Cytisine "is so cheap that even in developing countries, if you can afford to smoke, you can afford to stop," said Dr. Robert West of University College London. He led the study, published in Thursday`s New England Journal of Medicine.Cytisine, sold as Tabex by Sopharma AD, a Bulgaria-based company, is derived from laburnum seeds, which contain a natural nicotine substitute. West said it was discovered when much of the Soviet Union`s drug research was farmed out to Bulgaria. Russian soldiers referred to it as "fake tobacco," West said.New research suggests the drug can triple smokers` chances of being off cigarettes after one year compared with those taking a dummy pill.It has been sold in Eastern Europe for about 40 years but has not been approved in Western Europe or the United States. Extab, a Sopharma subsidiary, has bought worldwide rights to sell it and plans to market it cheaply in developing countries like China and India.Some experts are unsure it will ever make it to Western markets without larger trials — and without a big pharmaceutical stepping in to pay for them."It is possible that extensive bureaucracy and overcautious regulations will prevent its use in the U.S. and Europe," said Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary University Hospital in London. Hajek said if a big drugmaker got involved, the price would probably jump.About 95 percent of smokers who try to quit without help fail within six months, and more than two- thirds of the world`s 1 billion smokers live in developing countries. Smoking is the world`s leading cause of preventable death.
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