This pragmatic, open‐label, randomised, community‐based non‐inferiority trial was conducted to ascertain if cytisine demonstrated at least as efficacious as varenicline in supporting smoking abstinence for ≥ 6 months in New Zealand indigenous Māori or <em>whānau</em> (extended‐family) of Māori, due to the high smoking prevalence in this group. Overall 679 participants were randomized 1:1 to a prescription for 12 weeks of cytisine or varenicline, combined with low‐intensity cessation behavioral support from the prescribing doctor and community stop‐smoking services or a research assistant. Findings revealed that among New Zealand indigenous Māori or <em>whānau</em> (extended‐family) of Māori, cytisine proved to be at least as effective as varenicline for supporting smoking abstinence with significantly fewer adverse events. Verified continuous abstinence rates 6 months after the quit date were 12.1% for cytisine vs 7.9% for varenicline. Self-reported adverse events over 6 months were seen significantly more often in the varenicline group vs the cytisine group, with headache, nausea, and difficulty sleeping being the common ones.
