University of Auckland: Kōwhai chemical helps Māori quit smoking

A chemical found in the kōwhai seems just as good as a more expensive medicine for helping people quit smoking.

A University of Auckland study, funded by the Health Research Council, showed the role cytisine can play in helping Māori kick the habit.

To Māori, it’s another illustration of the rongoā, or medicinal properties, of the kōwhai.

“This is a quitting tool that comes from a plant, instead of a lab,” says Associate Professor Natalie Walker, who ran the study in conjunction with Lakes District Health Board and Brunel University London. “Identifying the potential of the cytisine component of the kōwhai is part of the revitalization of matauranga Māori.”

Hundreds of Māori and whānau Māori, mostly women, took part in the Bay of Plenty, Tokoroa, and Lakes DHB regions. The three main regions were Te Arawa/Taupo, Tauranga Moana/Mātaatua and Taranaki. The people ranged in age from 18 to 82. On average, people were 43 years old and had maintained a smoking habit for 25 years.

“He mihi nui whakaharahara tēnei, i whai wāhi ahau ki te hikoi ngātahi, ki te tautoko hoki i a rātou e aukati ana i te kai hikareti, ka mau te wehi!” said Mary-Kaye Wharakura, a researcher on the study. (“It was a privilege to be on their quit journey each and every step of the way. They were simply awesome!)

Cytisine is cheap, it works, and it suits Māori and their whānau.
Dr Natalie Walker
The study, which ran from 2017 to 2019 and was just published in the international medical journal Addiction, boosts the case for the government to approve the chemical for use in New Zealand.

The study found 12% of those who took the cytisine pills were still not smoking six months later, compared with 8% of those who took varenicline, a smoking cessation medication marketed as Champix and subsidized by the government. People taking cytisine also experienced fewer side effects such as nausea, headache, and difficulty sleeping.

“Varenicline is New Zealand’s best smoking cessation medication available, but also expensive for the government (although it’s low cost for the user),” said Dr Walker. “Cytisine is cheap, it works, and it suits Māori and their whānau.”

In earlier research funded by the Health Research Council, scientists from the University of Auckland showed cytisine was more effective than nicotine replacement therapy, such as nicotine patches, gum or lozenges, at helping people stop smoking.

Cytisine – pronounced ci/ta/zeen and marketed as Tabex — has been a smoking cessation treatment in Central and Eastern European countries since the 1960s but remains relatively unknown in much of the rest of the world.

Identifying the potential of the cytisine component of the kōwhai is part of the revitalization of matauranga Māori.
Both cytisine and varenicline work in the body to reduce the feeling of satisfaction that smoking gives and to stop the unpleasant feelings that come after stopping.

Lakes DHB Chief Executive Nick Saville-Wood says the DHB welcomes the results of this trial, as will many of the local people who volunteered to take part. He says there are a range of effective options to help make quitting easier. “Supporting people to stop smoking is a priority for Lakes DHB and we were pleased to be able to support this study,” he said.

Dr Walker thanked the health workers who supported the study, including staff from smoking cessation agencies Tipu Ora and Hāpainga, and community pharmacists and GPs.