The use of GLP-1 receptor agonists and subsequent risk of nicotine-related events: a cross- sectional study

Smoking remains a significant global health concern, associated with numerous preventable diseases and high mortality rates. Glucagon-like peptide-1 receptor agonists (GLP-1), known for its roles in glucose regulation and appetite control, has emerged as a potential tool in addiction research, particularly for smoking cessation. This study aims to evaluate the impact of GLP-1 on nicotine cravings, exploring their utilization and the subsequent changes in smoking behaviour and user perceptions. This cross-sectional study was conducted across seven hospitals in Riyadh, Saudi Arabia, following STROBE guidelines. Data on GLP-1 utilization were retrieved from electronic medical records from 2013–2023, while information on smoking behaviours was obtained through a structured questionnaire developed for this study and distributed from May to August 2024. Participants included adults who had been using GLP-1 for at least three months. Data analysis focused on evaluating GLP-1 utilization patterns and their association with smoking behaviors. The study included a total of 13,232 patients, with a mean age of 40 ± 13 years and a mean BMI of 32 ± 6 kg/m2. The majority of participants were female (62.85%). Among the prescribed GLP-1, semaglutide was the most frequently used (43.8%). In the second phase of the study, 390 participants were contacted and invited to complete a survey. Among the surveyed participants, 43.5% were current smokers, while 17.4% reported becoming ex-smokers after initiating GLP-1 therapy. GLP-1 use was associated with changes in nicotine cravings, with 24.4% of participants reporting a reduction in cravings. GLP-1 were associated with changes in nicotine cravings and smoking behavior. This study provides preliminary evidence of their role in supporting smoking cessation. Further research is required to confirm these findings, understand the mechanisms involved, and evaluate their long-term impact on smoking-related outcomes.