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There were similar rates of mild adverse events (e.g., nausea, restlessness, insomnia, irritability) across groups in trials of cytisine based on our initial overview.22 However, an updated Cochrane review on cytisine42 suggested there may be a small increase in adverse events, which could constitute a small harm (4 RCTs, n = 4052

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Despite its federal status as an illegal substance, 24 states and D.C