Dulaglutide, a GLP-1 receptor agonist, is effective at facilitating nicotine abstinence, reducing seeking behaviors, help losing weight and lowering glucose levels. 3 Semaglutide, another GLP-1 analog, has shown a similar therapeutic effect on tobacco users, with or without obesity, within a month. 2 Weekly cognitive behavioral therapy, while prescribing these drugs, is more effective in achieving smoking abstinence compared to varenicline with psychotherapy. 4 Since discontinuation of GLP-1 medications is associated with regaining weight similar to a placebo group, this remains a major medical concern. 3, 4
The table below illustrates several GLP-1 receptor agonists. It lists their effects on smoking cessation and post-cessation weight management.
Name
Table: Medication Profiles
Smoking abstinence effect
1. |
exenatide |
↑ quit rate, also |
|
|
with nicotine |
|
|
replacement therapy 1 |
2. |
dulaglutide |
facilitates abstinence |
|
|
and ↓ nicotine |
|
|
seeking behavior 3 |
Post-cessation weight loss effect
↓ weight gain vs placebo 1
significant ↓ in later weight gain 3
3. |
semaglutide |
↓ smoking 6 |
significant ↓ in later |
|
|
|
weight gain 2 |
4. |
liraglutide |
↓ nicotine |
|
|
self‐administration |
|
|
in preclinical data 7 |
↓ withdrawalinduced hyperphagia and weight gain in preclinical data 7
5. |
tirzepatide |
↓ nicotine craving 2 |
↑ weight‐loss |
|
|
|
efficacy in metabolic |
|
|
|
syndrome 2 |
6. albigutalide no data no data 7. lixisenatide no data no data
Prescribing GLP-1 analogs yields positive patient outcomes in diminishing nicotine dependence. These medications may provide a therapeutic intervention for diminishing obesity and / or nicotine addiction. However, regaining weight after discontinuation of these medicines remains a clinical problem. Clinical trials should explore how these drugs might further help with these two health issues.
While the authors have had only one clinical encounter where GLP-1 receptor agonists prescribed for weight loss helped someone attenuate nicotine addiction, this preliminary information is worthwhile disseminating. These drugs are already widely popular and in great demand for treating patients with diabetes mellitus and obesity-related conditions.
Louisville Medicine already published a recent article about applying these medications during alcohol addiction, this is thus presented as a companion piece. We wish to alert the medical community to this new potential therapeutic option. Pharmacotherapies that curb addiction might become an additional option for physicians in treating patients and promoting public health. Clinical experience and investigative medicine will determine the most appropriate future use of GLP-1 receptor agonists. References
1
Lee S, Li M, Le GH, et al. Glucagon-like peptide-1 receptor agonists( GLP-1RAs) as treatment for nicotine cessation in psychiatric populations: a systematic review. Ann Gen Psychiatry. 2024; 23( 1): 45. doi: 10.1186 / s12991-024-00527-9. Accessed October 22, 2025.
2
O’ Keefe JH, Franco WG, O’ Keefe EL. Anti-Consumption Agents: Tirzepatide and Semaglutide for Treating Obesity-Related Diseases and Addictions, and Improving Life Expectancy. Prog Cardiovasc Dis. 2025; 89:102-112. doi: 10.1016 / j. pcad. 2024.12.010
3
Yammine L, Green CE, Kosten TR, et al. Exenatide Adjunct to Nicotine Patch Facilitates Smoking Cessation and May Reduce Post-Cessation Weight Gain: A Pilot Randomized Controlled Trial. Nicotine Tob Res. 2021; 23( 10): 1682-1690. doi: 10.1093 / ntr / ntab066. Accessed October 22, 2025
4
Jordan CJ, Xi ZX. Discovery and development of varenicline for smoking cessation. Expert Opin Drug Discov. 2018; 13( 7): 671-683. doi: 10.1080 / 17460441.201 8.1458090
5
Lengsfeld S, Burkard T, Meienberg A, et al. Effect of dulaglutide in promoting abstinence during smoking cessation: a single-centre, randomized, double-blind, placebo-controlled, parallel group trial. EClinicalMedicine. 2023; 57:101865. doi: 10.1016 / j. eclinm. 2023.101865 Accessed November 12, 2025
6
Wang W, Volkow ND, Berger NA, et al. Association of Semaglutide With Tobacco Use Disorder in Patients With Type 2 Diabetes: Target Trial Emulation Using Real-World Data. Ann Intern Med. 2024; 177( 8): 1016-1027. doi: 10.7326 / M23-2718
7
Herman RJ, Hayes MR, Audrain-McGovern J, et al. Liraglutide attenuates nicotine self-administration as well as nicotine seeking and hyperphagia during withdrawal in male and female rats. Psychopharmacology( Berl). 2023; 240( 6): 1373-1386. doi: 10.1007 / s00213-023-06376-w
Dr. Lippmann is a retired psychiatry professor from the University of Louisville School of Medicine. Subsequently, he regularly provides primary medical care practice at the Family Community Clinic, clinically mentors lots of students, residents and international medical graduate physicians and teaches scientific medical writing seminars.
Oghenevese Jefia is a Nigerian born medical doctor. Right now, she is a research coordinator at the Infectious Diseases Department of the University of Louisville. She hopes to begin her residency in Internal Medicine in the near future.( non-member)
Pratiksha Paudel is a medical graduate from Nepal and a research coordinator in the Division of Infectious Diseases at the University of Louisville. Her research interests focus on exploring the potential role of GLP-1 receptors in oncologic processes. She is an aspiring internal medicine physician with a strong interest in hematology-oncology and is committed to advancing patient care through both clinical practice and meaningful contributions to oncology research.( non-member)
Sarah Charania is a medical school graduate from Pakistan currently working as a research coordinator at University of Louisville at the Infectious Disease department. She is an Emergency Medicine residency aspirant and wants to pursue global emergency medicine providing care to under privileged communities across the globe.( non-member)
March 2026 21