NEW data has shed light on the potential benefits of semaglutide, a medication primarily used to treat type 2 diabetes mellitus (T2DM) and obesity, in addressing tobacco use disorders (TUDs). Reports of reduced smoking desire in patients using semaglutide have sparked interest in its broader applications for tobacco addiction. In a recent study, researchers from Case Western Reserve University School of Medicine, Cleveland, Ohio, USA, explored the association between semaglutide and TUD-related healthcare measures in patients with T2DM and TUD.
The authors emulated target trials using a nationwide database of electronic health records in the United States from 1 December 2017 to 31 March 2023. The study compared 222,942 new users of various antidiabetes medications, including 5,967 users of semaglutide. These medications included insulins, metformin, dipeptidyl-peptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, sulfonylureas, thiazolidinediones, and other glucagon-like peptide receptor agonists (GLP-1RAs). Researchers focused on three key TUD-related healthcare measures: medical encounters for TUD diagnosis, smoking cessation medication prescriptions, and smoking cessation counselling, all within a 12-month follow-up period.
Semaglutide users showed a significantly lower risk of medical encounters for TUD diagnosis compared to those using other antidiabetes medications. The most substantial reduction was observed compared to insulin users, with a hazard ratio (HR) of 0.68 (95% confidence interval [CI], 0.63 to 0.74). At the same time, the comparison with other GLP-1RAs also showed a statistically significant reduction (HR, 0.88 [CI, 0.81 to 0.96]). Additionally, semaglutide was linked to fewer smoking cessation medication prescriptions and counselling sessions.
The benefits of semaglutide were consistent across patients with and without obesity. For most comparisons, the differences emerged within 30 days of starting the medication. Missing data on current smoking behaviour, medication adherence, residual confounding, body mass index and documentation bias were identified as potential biases.
Researchers concluded that semaglutide was associated with lower risks for TUD-related healthcare measures in patients with comorbid T2DM and TUD compared to other antidiabetes medications, including other GLP-1RAs. These findings highlight the need for clinical trials to evaluate further semaglutide’s potential in treating tobacco use disorders.
Laith Gergi, EMJ
Reference
Wang W et al. Association of semaglutide with tobacco use disorder in patients with type 2 diabetes: target trial emulation using real-world data. Annals of Internal Medicine. 20244;DOI/10.7326/M23-2718.
