Semaglutide users with type 2 diabetes had fewer medical encounters for tobacco use disorder compared to users of other diabetes drugs.
20.8% smoking prevalenceAbout one in five people with type 2 diabetes worldwide still smoke, compounding their cardiovascular risk
What the researchers found
Among people with type 2 diabetes, semaglutide was linked to a lower risk of medical encounters related to tobacco use disorder compared to other diabetes drug classes. The effect was strongest when comparing semaglutide to insulin. It was weakest compared to other GLP-1 receptor agonists, suggesting the effect may be partly a GLP-1 class effect rather than unique to semaglutide.
Semaglutide users also had fewer prescriptions for smoking cessation medications and less counseling for smoking. These patterns held regardless of whether patients were also obese.
Why it matters
About 21% of people with type 2 diabetes smoke, which compounds their already elevated cardiovascular risk. If semaglutide genuinely helps with smoking cessation beyond just weight and glucose control, it could offer a triple benefit: better blood sugar, weight loss, and quitting smoking. GLP-1 receptors exist in brain reward circuits, which provides a plausible mechanism.
The numbers in context
- 20.8% pooled smoking prevalence among people with type 2 diabetes (from meta-analysis of 3.2 million people across 33 countries)
- Semaglutide linked to significantly lower risk of medical encounters for tobacco use disorder vs other drug classes
- Effect strongest vs insulin, weakest vs other GLP-1 receptor agonists
- Findings consistent regardless of obesity status
How the study worked
This was an editorial review summarizing observational data from a large retrospective database study by Wang and colleagues. It compared semaglutide users to matched users of other diabetes drug classes. No randomized controlled trial data on semaglutide and smoking cessation was available at the time of writing.
Who was studied
People with type 2 diabetes who use semaglutide vs other diabetes drugs
What this study cannot tell us
This is an editorial commentary based on observational data, not a clinical trial. The association between semaglutide and reduced tobacco use could reflect confounding factors. People prescribed semaglutide may differ from those on insulin in ways that affect smoking behavior. No randomized evidence confirms that semaglutide directly causes smoking cessation.
How to read the evidence
Rated preliminary: this is an editorial commentary based on observational data, not a controlled trial. The association needs confirmation.
When this study was published
Published in 2024, commenting on recent observational data. No randomized trial yet exists for semaglutide and smoking cessation.
The bigger picture
GLP-1 receptors exist in brain reward circuits involved in addiction. If semaglutide helps with smoking cessation, it would offer a triple benefit for diabetic smokers: better blood sugar, weight loss, and reduced tobacco use.
Questions still open
- Is the smoking benefit specific to semaglutide or shared by all GLP-1 drugs?
- Does semaglutide directly reduce cravings or does weight loss indirectly help?
- Would a randomized trial confirm this association?
Common questions
Can semaglutide help you quit smoking?
Why might a diabetes drug affect smoking?
Read the original research
Semaglutide and smoking cessation in individuals with type 2 diabetes mellitus: there is no smoke without fire!
Expert review of clinical pharmacology, 17(11), 1009-1012
Citation
Popovic, Djordje S; Patoulias, Dimitrios; Koufakis, Theocharis; Karakasis, Paschalis; Ruža, Ieva; Papanas, Nikolaos. (2024). Semaglutide and smoking cessation in individuals with type 2 diabetes mellitus: there is no smoke without fire!. Expert review of clinical pharmacology, 17(11), 1009-1012. https://doi.org/10.1080/17512433.2024.2418398