Semaglutide, the active ingredient in diabetes and weight-loss drugs Ozempic and Wegovy, may be linked to improved smoking cessation, a study published Monday suggests.
Compared to those who use Type 2 diabetes drugs like metformin and insulin, as well as glucagon-like peptide-1 (GLP-1) receptor agonists, semaglutide users had a lower chance of accessing health care for tobacco use disorders. They were also less likely to seek counseling and medication for smoking cessation.
The differences in smoking cessation habits users experienced taking semaglutide versus other antidiabetic drugs were most significant within the first 30 days of semaglutide prescription.
“These findings suggest the need for clinical trials to evaluate semaglutide’s potential for TUD (tobacco use disorder) treatment,” the authors wrote.
The authors speculated that the semaglutide may have reduced people’s pleasure in smoking while increasing their aversion to nicotine, the addictive drug in tobacco.
Significant Risk Reduction
The study, published in Annals of Internal Medicine, compared over 222,000 new anti-diabetes medication users, of which around 6,000 were prescribed semaglutide.
All users had a prior diagnosis of smoking use disorder.
The authors found that semaglutide prescription was associated with not accessing health care, counseling, and medication for smoking cessation.
Semaglutide is a GLP-1 drug; it mimics the hormone GLP-1, which occurs naturally in the body. GLP-1 promotes insulin release, reduces blood sugar levels, and has been shown to reduce appetite and promote satiety.
The association with smoking cessation was particularly significant compared to other non-GLP-1 antidiabetic drugs, such as insulin, metformin, sodium-glucose cotransporters, sulfonylureas, and the like.
Compared to users taking these drugs, semaglutide users were between 18 percent and 40 percent less likely to seek smoking cessation help.
The difference between other GLP-1 drugs and semaglutide was weaker but still significant, with about a 12 percent reduction in the risk of needing smoking cessation services.
Since semaglutide and other GLP-1 drugs all act on the same receptor in the body, the authors were surprised to find a difference in their risk reduction.
Ms. Xu, who has a doctorate in biomedical informatics, said it is still unknown why semaglutide was linked to lower risks of tobacco abuse than other GLP-1RA drugs.
Semaglutide and Tobacco Abuse: 2 Possible Reasons
The authors did not investigate how semaglutide could have increased smoking cessation but speculated that it may have reduced the amount of pleasure smokers get from smoking.They pointed to animal studies showing that semaglutide acts on the habenula, a pea-sized region in the brain responsible for emotional and sensory processing.
Rats given semaglutide experienced less reward from nicotine and a stronger dislike of nicotine. The authors theorized that the same effect may have occurred in their study participants.
“I call the habenula the Debbie Downer center of the brain; people who are depressed have an activated habenula,” Dr. Roger McIntyre, a professor of psychiatry and pharmacology at the University of Toronto, told The Epoch Times.
Dr. McIntyre, who was not involved in the study, mentioned that apart from causing users to experience less pleasure during smoking, semaglutide may have also decreased people’s cravings or anticipation of tobacco.
“In the world of neuroscience and reward … it’s called reward salience; how much reward do you attach to something?” he said, adding that both pathways may have been at play in this study.
Smoking Cessation and Weight Gain
Over 80 percent of people who stop smoking will experience weight gain, and this is a major reason many people cannot quit smoking, Dr. McIntyre told The Epoch Times.He said that the findings are very compelling because they can address two potential factors that prevent people from quitting: nicotine addiction and anticipated weight gain.
“Once they [people] start smoking cigarettes, they learn that smoking is affecting their weight,” Dr. McIntyre said. “They don’t gain weight as easily, [but if] they don’t smoke for a weekend or for a few days, they are gaining weight very quickly.”
Semaglutide acts on GLP-1 receptors to deter weight gain. It can also help patients keep weight off while taking the medication.
Limitations and Drug Side Effects
The authors said that it is possible that patients who took semaglutide accessed health care less often for smoking cessation not because they stopped smoking but because they gave up quitting smoking.Common side effects of semaglutide include nausea, vomiting, diarrhea, stomachache, and constipation.
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