Semaglutide May Help People With Type 2 Diabetes Quit Smoking

• Semaglutide, the active ingredient in GLP-1 drugs Ozempic and Wegovy, may help people quit smoking, a new study found.
• Smokers with type 2 diabetes who took semaglutide were less likely to have a medical encounter related to their tobacco use.
• More research is needed before semaglutide can be prescribed for smoking cessation, including randomized controlled trials (RCTs).

Semaglutide, the active ingredient in the anti-diabetes drug Ozempic and anti-obesity medication Wegovy , can help people lose weight and reduce their risk of serious heart problems .

Now, research suggests that semaglutide may also help people quit smoking.

The study, published July 30 in the Annals of Internal Medicine , examined the association of semaglutide with tobacco use disorder-related healthcare measures in people with comorbid type 2 diabetes (T2D) and tobacco use disorder (TUD).

The researchers found that smokers with type 2 diabetes who used semaglutide were less likely to have a medical encounter related to smoking over the following 12 months compared to people who used other anti-diabetes medications.

The medical encounters that researchers looked at included:

• being diagnosed with tobacco use disorder
• being prescribed a medication to help with smoking cessation
• having smoking cessation counseling during the study period

For their analysis, researchers examined health records for 222,942 smokers with type 2 diabetes who used seven types of anti-diabetes medications. Of these, 5,967 subjects were new users of semaglutide.

When comparing groups of patients, researchers found that the differences between semaglutide and the other medications mostly occurred within 30 days of people starting the prescription drug.

The results were also similar for people with and without a diagnosis of obesity.

Jimmy Johannes, MD , an internist, pulmonologist, and critical care medicine specialist at MemorialCare Long Beach Medical Center in Long Beach, CA, said the results were “interesting” but cautioned that more research is needed.

“Smoking cessation is a challenge, and the current available treatments could use some improvement,” he told Healthline. “So if, in fact, semaglutide can help with smoking cessation, that would be great.”

GLP-1 drugs may reduce alcohol cravings, substance use

Although additional studies are needed, other research supports the potential use of semaglutide and other GLP-1 receptor agonist drugs for reducing people’s desire to smoke cigarettes, drink alcohol , or use other drugs.

A 2023 study published in Scientific Reports found that semaglutide and tirzepatide may decrease cravings and reduce alcohol consumption in people with obesity. However, this was not a randomized controlled trial (RCT).

In one part of the study, researchers analyzed Reddit posts related to Wegovy, Ozempic or other GLP-1 receptor agonist drugs. The other part of the study involved a survey of people taking semaglutide or the GLP-1 drug tirzepatide.

Another 2023 study in the Journal of the Endocrine Society — this one a 12-week clinical trial  — found that smokers taking the GLP-1 drug dulaglutide drank less alcohol than those who took a non-acting placebo. However, they didn’t smoke less.

Smaller studies have also looked at the use of GLP-1 drugs for reducing cravings and the use of cocaine and opioids , with mixed results.

How GLP-1 drugs might work for addiction

How GLP-1 drugs reduce cravings in people with addiction is not well understood, but the authors of the new paper offer one possibility.

“The mechanisms underlying the observed lower-risk associations of semaglutide with [tobacco use disorder]-related measures are unclear,” they wrote in the paper.

“But preclinical studies suggest that they likely reflect the involvement of GLP-1 receptors in modulating the brain’s reward and aversive systems,” they said.

When you have an experience that makes you feel good — whether it’s eating certain foods, socializing, drinking alcohol, or using nicotine — the brain’s reward center is activated, causing the release of dopamine , a neurotransmitter.

This rush of dopamine signals to the brain that it should pay attention to and remember this activity, which encourages us to repeat it.

Drugs such as cocaine and nicotine lead to a much larger surge of dopamine, which strongly reinforces the link between consuming the drug and the pleasure that results.

However, not every activity that causes a release of dopamine is addictive. And addiction is more complex than just the release of dopamine.

GLP-1 drugs may reduce the release of dopamine in response to certain drugs, and reduce cravings for those drugs, the authors of the study wrote. They point to research done in rodents related to nicotine addiction.

However, with nicotine, GLP-1 drugs may also work in another way.

“The reduction in body weight associated with [semaglutide] might have also contributed to the reduced risk for [tobacco use disorder]-related measures because fear of weight gain on smoking cessation contributes to smoking and relapse,” they wrote.

Other smoking cessation treatments available

Johannes said additional studies will be needed to know whether semaglutide is an effective and safe treatment for smoking cessation.

“This is mainly an association study, using medical records,” he said. “This gives us a clue that there might be a connection, but randomized controlled studies would be the best way to discover whether semaglutide can actually help people quit smoking.”

The side effects of semaglutide are well understood and include:

• abdominal pain
• constipation
• diarrhea
• nausea and vomiting

These could deter some people from using this drug to quit smoking.

Proven treatments are already available to help people quit smoking, including counseling and medications such as the nicotine patch and gum, and prescription drugs varenicline and buproprion.

Many people, though, still find it difficult to quit smoking.

“Even with medications and nicotine replacement therapy , it can be very difficult for some people to stop smoking, in part because they may not be ready to stop or may not want to stop right then,” said Johannes.

“So we could use some better treatments,” he said.

Takeaway

Researchers reviewed health records for over 220,000 smokers with type 2 diabetes who received a new prescription for the GLP-1 receptor agonist semaglutide or seven other anti-diabetes medications.

People prescribed semaglutide were less likely to have a medical encounter related to their smoking compared to patients prescribed one of the other drugs. These encounters included being prescribed a smoking cessation medication or quit smoking counseling.

This is an observational study, so randomized controlled trials will be needed to know if semaglutide is an effective and safe treatment for smoking cessation. Other research, though, suggests that GLP-1 drugs may reduce cravings and use of alcohol.