The pattern keeps repeating. Someone starts semaglutide for weight loss. A few weeks in, they notice the food noise has quieted. Then, almost as an afterthought, they mention something else: the cigarettes lost their pull too.
It's not a universal experience. Not everyone on a GLP-1 notices any change in their smoking habits. But the reports are consistent enough, and frequent enough, that researchers have started paying serious attention.
The real-world evidence
The strongest human evidence comes from a large study that tracked over 222,000 new users of diabetes medications. Those prescribed semaglutide had significantly fewer medical encounters related to tobacco use disorder compared to people on insulin (hazard ratio 0.68) and even compared to people on other GLP-1 medications (hazard ratio 0.88). They also needed fewer smoking cessation prescriptions and less counselling. The effects appeared quickly — within 30 days of starting treatment (Wang et al., 2024).
That's a notable finding. Not a small pilot study — a quarter of a million patients, with semaglutide standing out even within its own drug class.
Separately, reviews of observational data have linked GLP-1 medications to spontaneous reductions in nicotine use as part of the broader "anti-consumption" effect on brain reward pathways. The same mechanism that quiets food cravings and reduces alcohol interest appears to extend to nicotine (O'Keefe et al., 2025).
Earlier clinical trials with older GLP-1s
The most positive interventional data comes from trials using exenatide, an older GLP-1 medication. In a randomised pilot trial of 84 overweight smokers using nicotine patches, those who also received exenatide achieved higher 7-day abstinence rates (46.3% versus 26.8%), experienced reduced cravings and withdrawal symptoms, and gained 5.6 fewer pounds during the quit attempt than the control group.
That last point matters enormously. One of the biggest barriers to quitting smoking is the weight gain that typically follows. A medication that simultaneously supports cessation and prevents post-quit weight gain addresses two problems at once — a combination that existing cessation medications can't offer.
How it works in the brain
The mechanism connects directly to what we know about "food noise" reduction.
GLP-1 receptors are present in the mesolimbic dopamine system — the brain's reward and motivation centre. This is the same circuitry that nicotine hijacks to create addiction. When GLP-1 medications reduce the reward signal for food, they appear to reduce it for nicotine as well.
Animal studies have mapped this out in detail. Semaglutide dose-dependently reduced nicotine self-administration in rodent models, and also attenuated the rewarding properties of nicotine — measured through conditioned place preference, a standard test of how much an animal "likes" a substance. A comprehensive systematic review found that GLP-1 medications reduced nicotine seeking, mitigated withdrawal symptoms, and attenuated craving in animal models, with effects on reward-region dopamine signalling (Lee et al., 2024).
Tirzepatide has shown similar effects. Preclinical data demonstrates reduced alcohol and potentially nicotine-related reward behaviours through dopamine modulation — suggesting this may be a class-wide effect of GLP-1 receptor activation, not specific to any single medication.
What this means practically
If you're on a GLP-1 medication and you smoke, here's the balanced picture.
You may notice reduced cravings or interest in cigarettes. Many people do. If that happens, it's worth leaning into — talk to your doctor about whether this could be a good time to attempt a quit, potentially supported by established cessation tools like nicotine replacement therapy, counselling, or varenicline. The GLP-1 could provide a tailwind that makes the attempt more likely to succeed.
You may notice no change at all. That's equally normal. Individual responses to GLP-1 medications vary enormously, and the anti-nicotine effect appears less consistent than the appetite suppression or even the alcohol reduction.
Either way, GLP-1 medications are not approved for smoking cessation. The dedicated human trials are still small, and larger studies are actively recruiting — including a University of North Carolina trial specifically investigating semaglutide's impact on nicotine intake (NCT05530577).
What we can say with confidence is that the biological mechanism is plausible, the real-world data is promising, and the overlap between food reward, alcohol reward, and nicotine reward pathways gives a coherent explanation for why so many people report the same thing: when the food noise went quiet, the cigarettes followed.
Key Studies & References
We base this guide on the strongest available peer-reviewed research so you can see exactly where the information comes from. Here are the most relevant and impactful studies we referenced:
-
Wang et al. (2024) — Large target trial emulation of over 222,000 patients showing semaglutide was associated with significantly fewer tobacco use disorder medical encounters compared to insulin (HR 0.68) and even compared to other GLP-1 medications (HR 0.88), with effects appearing within 30 days. Read the full study in Annals of Internal Medicine
-
O'Keefe et al. (2025) — Review positioning GLP-1 medications as potential "anti-consumption" agents, linking spontaneous nicotine reduction to the same reward pathway modulation that quiets food cravings and reduces alcohol interest. Read the review on PubMed
-
Lee et al. (2024) — Comprehensive systematic review of preclinical evidence showing GLP-1 medications reduced nicotine self-administration and seeking in animal models, mitigated craving and withdrawal symptoms, and attenuated post-cessation weight gain. Read the systematic review on PubMed
-
Ahmed et al. (2026) — Up-to-date narrative review synthesising clinical and preclinical evidence for GLP-1 medications in smoking cessation, comparing effectiveness across different drugs in the class and calling for larger dedicated human trials. Read the review on PMC
These studies suggest a plausible biological mechanism and consistent real-world signal, though dedicated large-scale human trials specifically testing GLP-1 medications for smoking cessation are still ongoing.
Medical Disclaimer: GLP-1 medications are not approved for smoking cessation. If you're trying to quit smoking, discuss evidence-based cessation strategies with your healthcare provider. This guide is for informational purposes only.