Ozempic (semaglutide) is a GLP-1 receptor agonist licensed in the UK for type 2 diabetes management, not for smoking cessation. Whilst emerging research explores whether GLP-1 medications might influence addictive behaviours through brain reward pathways, robust clinical evidence supporting Ozempic for smoking cessation remains absent. Using Ozempic for this purpose would be off-label, unsupported by NICE guidance, and potentially expose patients to medication risks without proven benefit. The NHS offers comprehensive, evidence-based smoking cessation treatments including nicotine replacement therapy, varenicline, bupropion, and behavioural support—all with established efficacy and safety profiles. Anyone wishing to quit smoking should consult their GP or NHS Stop Smoking Service.

What Is Ozempic and How Does It Work?

Ozempic (semaglutide) is a prescription medication licensed in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA) for the treatment of type 2 diabetes mellitus. It belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of a naturally occurring hormone that regulates blood sugar levels and appetite.

The medication is administered as a once-weekly subcutaneous injection and functions through several mechanisms. Primarily, semaglutide stimulates insulin secretion from pancreatic beta cells in a glucose-dependent manner, meaning it only triggers insulin release when blood glucose levels are elevated. This generally reduces the risk of hypoglycaemia compared to some other diabetes medications, though the risk increases when used alongside insulin or sulfonylureas, which may require dose adjustments of these medications. Additionally, it suppresses glucagon secretion (a hormone that raises blood sugar), slows gastric emptying, and acts on appetite centres in the brain to promote satiety and reduce food intake.

Whilst Ozempic has gained considerable attention for its effects on weight management—leading to the approval of a higher-dose formulation called Wegovy specifically for obesity treatment—it is not currently licensed for smoking cessation in the UK or elsewhere. The medication's primary indications remain glycaemic control in type 2 diabetes and, for patients with established cardiovascular disease, reducing the risk of major adverse cardiovascular events.

Recent interest in GLP-1 receptor agonists for smoking cessation has emerged from preliminary research suggesting these medications might influence reward pathways in the brain. However, it is crucial to understand that any use of Ozempic for smoking cessation would be considered off-label—meaning outside its approved therapeutic indications—and is not supported by current UK clinical guidelines or regulatory approvals.

It should be noted that semaglutide is not recommended during pregnancy or breastfeeding, and women of childbearing potential should use effective contraception when taking the medication. A washout period is recommended before planned pregnancy.

Evidence and Research on GLP-1 Medications for Quitting Smoking

Emerging research has begun exploring whether GLP-1 receptor agonists like semaglutide might have a role in reducing addictive behaviours, including smoking. The theoretical basis for this investigation centres on the mesolimbic dopamine reward pathway, which is implicated in both food intake regulation and substance use disorders, including nicotine addiction.

Several preclinical studies in animal models have suggested that GLP-1 receptor agonists may reduce nicotine-seeking behaviour and attenuate the rewarding effects of nicotine. These findings have prompted interest in whether similar effects might translate to humans attempting to quit smoking. Some preliminary observational data have suggested potential associations between GLP-1 medications and smoking behaviours, but these findings remain limited and inconclusive.

However, it is essential to emphasise that robust clinical trial evidence specifically examining GLP-1 receptor agonists for smoking cessation remains limited. Most available data comes from secondary analyses of trials designed for other purposes, retrospective database studies, or small pilot investigations. These study designs cannot establish causation and are subject to numerous confounding factors—for instance, individuals motivated to manage their diabetes or weight may also be more motivated to address other health behaviours like smoking.

As of current guidance, there is no official link established between Ozempic or other GLP-1 medications and smoking cessation efficacy that would support their use for this indication. The European Medicines Agency (EMA) and MHRA have not approved semaglutide for smoking cessation, and NICE guidelines (NG209) do not recommend GLP-1 receptor agonists as a treatment option for tobacco dependence. Future randomised controlled trials may provide clearer evidence, but clinicians and patients should be aware that the current evidence base does not support using these medications specifically to quit smoking outside of research settings.

NICE-Recommended Treatments for Stopping Smoking

The NHS offers a comprehensive range of evidence-based smoking cessation interventions that have been rigorously evaluated and are recommended by NICE (NG209). These treatments significantly increase the likelihood of successfully quitting compared to willpower alone, and they are available through NHS Stop Smoking Services, GP surgeries, and community pharmacies across the UK.

Nicotine replacement therapy (NRT) remains a cornerstone of smoking cessation support and is available in multiple formulations including patches, gum, lozenges, inhalators, nasal spray, and mouth spray. NRT works by providing controlled doses of nicotine without the harmful toxins found in tobacco smoke, thereby reducing withdrawal symptoms and cravings. NICE recommends offering NRT to all smokers who wish to quit, and combination therapy (such as a patch plus a faster-acting form) is often more effective than single products. NRT is the preferred pharmacological option for pregnant women who smoke.

Varenicline is a prescription medication that works by partially stimulating nicotine receptors in the brain whilst simultaneously blocking nicotine from tobacco from binding to these receptors. This dual action reduces both cravings and the rewarding effects of smoking. Clinical trials have demonstrated varenicline to be one of the most effective pharmacological treatments for smoking cessation. Availability in the UK has fluctuated due to supply issues; patients should check current availability with their healthcare provider.

Bupropion is another prescription option that was originally developed as an antidepressant but has proven efficacy for smoking cessation. It works by affecting neurotransmitters in the brain associated with nicotine addiction and withdrawal. It is contraindicated in certain conditions, including seizure disorders.

Nicotine vaping products (e-cigarettes) are also recommended by NICE as an effective aid to help people quit smoking. While not completely risk-free, they are substantially less harmful than continued smoking and can be particularly helpful for those who have struggled with other methods.

Beyond pharmacotherapy, behavioural support is a critical component of successful smoking cessation. NICE guidance emphasises that combining medication with behavioural interventions—such as counselling, cognitive behavioural therapy techniques, or structured support programmes—substantially improves quit rates. NHS Stop Smoking Services provide free, expert support including one-to-one or group sessions, telephone support, and increasingly, digital interventions.

Anyone wishing to quit smoking should contact their GP, local pharmacy, or NHS Stop Smoking Service to discuss the most appropriate evidence-based treatment plan for their individual circumstances.

Risks and Considerations of Using Ozempic Off-Label

Using Ozempic for smoking cessation would constitute off-label prescribing—the use of a licensed medication for an indication not approved by regulatory authorities. Whilst off-label prescribing is sometimes appropriate in clinical practice when supported by evidence and clinical judgement, it carries specific responsibilities and risks that both prescribers and patients must carefully consider.

Clinical evidence limitations represent the primary concern. Without robust randomised controlled trial data demonstrating efficacy and safety specifically for smoking cessation, there is no assurance that Ozempic would be effective for this purpose or that the benefit-risk profile would be favourable in this context. Patients might be exposed to medication risks without proven therapeutic benefit for their smoking cessation goals.

Ozempic is associated with a range of adverse effects, the most common being gastrointestinal symptoms including nausea, vomiting, diarrhoea, constipation, and abdominal pain. These effects are often dose-dependent and may be particularly pronounced during dose escalation. More serious but less common risks include pancreatitis (seek urgent medical attention for severe, persistent abdominal pain, sometimes radiating to the back), gallbladder disease, and diabetic retinopathy complications (particularly in people with pre-existing retinopathy). The medication carries a warning regarding thyroid C-cell tumours observed in animal studies, though the relevance to humans remains uncertain. When used with insulin or sulfonylureas, there is an increased risk of hypoglycaemia, which may require dose adjustments of these medications.

Cost and access present practical barriers. Ozempic is an expensive medication, and NHS prescribing would be unlikely for an off-label smoking cessation indication when effective, licensed, and cost-effective alternatives exist. Private prescribing would involve substantial out-of-pocket costs without guarantee of benefit.

From a regulatory and safety perspective, off-label prescribing requires clear documentation of informed consent, with patients understanding that the medication is being used outside its licensed indications. While standard pharmacovigilance processes still apply, the dosing regimens and monitoring protocols may not be optimised for smoking cessation purposes.

Patient safety advice: Individuals interested in smoking cessation should consult their GP or NHS Stop Smoking Service to access evidence-based treatments with proven efficacy and established safety profiles. Self-sourcing medications online or using prescriptions intended for other conditions poses significant risks. If someone is currently prescribed Ozempic for diabetes or weight management and wishes to quit smoking, they should discuss this goal with their healthcare provider, who can recommend appropriate, licensed smoking cessation treatments to use alongside their existing therapy. Any suspected side effects should be reported through the MHRA Yellow Card scheme. Any concerns about medication effects or smoking cessation progress should prompt contact with a GP or healthcare professional for proper assessment and guidance.

Frequently Asked Questions