GLP-1S FOR TREATMENT OF TOBACCO AND ALCOHOL DEPENDENCE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RCTS AND EXPERIMENTS
Author(s)
Gemma Taylor, PhD1, Daniel Titheradge, PhD2, Chloe Burke, PhD2, Shiying Jia, PhD2, Beyza Cihan, BSc3, Isabel Faulkner, MSc4, Kushala Abeysekera, PhD2, Matthew Hickman, PhD2, Kyla Thomas, PhD2.
1Bristol, United Kingdom, 2University of Bristol, Bristol, United Kingdom, 3King's College London, London, United Kingdom, 4University of Manchester, Manchester, United Kingdom.
1Bristol, United Kingdom, 2University of Bristol, Bristol, United Kingdom, 3King's College London, London, United Kingdom, 4University of Manchester, Manchester, United Kingdom.
OBJECTIVES: Smoking and alcohol use cause >10 million deaths worldwide annually. Existing treatments for smoking cessation and alcohol use disorder remain limited. Glucagon-like peptide-1 receptor agonists (GLP-1s), used for diabetes and weight loss, target reward pathways implicated in addiction and may reduce nicotine and alcohol use. We evaluated GLP-1 receptor agonists’ effects on smoking and alcohol behaviours, using evidence from clinical trials and animal studies.
METHODS: This review followed Cochrane and PRISMA guidelines and was registered on PROSPERO (ID: CRD420251155420). We included human RCTs and controlled in-vivo animal studies of GLP-1 receptor agonists for smoking or alcohol outcomes. Databases were searched from inception. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Random-effects meta-analyses estimated effect sizes, with heterogeneity, sensitivity analyses, and GRADE assessment.
RESULTS: A total of 3,113 studies were screened, with 64 studies included comprising 12 clinical trials, 39 animal studies, and 13 ongoing studies. Meta-analyses showed that GLP-1 receptor agonists increased smoking cessation odds (OR=1.32, 95% CI 0.84 to 2.08; k=3), although the effect was not statistically significant. GLP-1s reduced cigarettes smoked per day (SMD=−0.10, 95% CI −0.16 to −0.04; k=4), with similar findings for semaglutide alone (k=3). For alcohol-related outcomes, GLP-1s reduced alcohol consumption (grams/day) (SMD=−0.30, 95% CI −0.63 to 0.04; k=4), with a larger effect for semaglutide (SMD=−0.56, 95% CI −0.82 to −0.30; k=2). Semaglutide also reduced drinks per drinking day (SMD=−0.60, 95% CI −0.91 to −0.28; k=2) and increased days without alcohol consumption (SMD=0.32, 95% CI 0.07 to 0.58; k=2). Animal studies showed that GLP-1 receptor agonists reduced alcohol intake and preference in rodent self-administration models.
CONCLUSIONS: Emerging evidence suggests that GLP-1 receptor agonists reduce smoking and alcohol consumption, but findings are limited by few trials, small sample sizes, and heterogeneity in outcome measures. Larger trials with standardised outcomes are needed.
METHODS: This review followed Cochrane and PRISMA guidelines and was registered on PROSPERO (ID: CRD420251155420). We included human RCTs and controlled in-vivo animal studies of GLP-1 receptor agonists for smoking or alcohol outcomes. Databases were searched from inception. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Random-effects meta-analyses estimated effect sizes, with heterogeneity, sensitivity analyses, and GRADE assessment.
RESULTS: A total of 3,113 studies were screened, with 64 studies included comprising 12 clinical trials, 39 animal studies, and 13 ongoing studies. Meta-analyses showed that GLP-1 receptor agonists increased smoking cessation odds (OR=1.32, 95% CI 0.84 to 2.08; k=3), although the effect was not statistically significant. GLP-1s reduced cigarettes smoked per day (SMD=−0.10, 95% CI −0.16 to −0.04; k=4), with similar findings for semaglutide alone (k=3). For alcohol-related outcomes, GLP-1s reduced alcohol consumption (grams/day) (SMD=−0.30, 95% CI −0.63 to 0.04; k=4), with a larger effect for semaglutide (SMD=−0.56, 95% CI −0.82 to −0.30; k=2). Semaglutide also reduced drinks per drinking day (SMD=−0.60, 95% CI −0.91 to −0.28; k=2) and increased days without alcohol consumption (SMD=0.32, 95% CI 0.07 to 0.58; k=2). Animal studies showed that GLP-1 receptor agonists reduced alcohol intake and preference in rodent self-administration models.
CONCLUSIONS: Emerging evidence suggests that GLP-1 receptor agonists reduce smoking and alcohol consumption, but findings are limited by few trials, small sample sizes, and heterogeneity in outcome measures. Larger trials with standardised outcomes are needed.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO108
Topic
Clinical Outcomes, Epidemiology & Public Health, Methodological & Statistical Research
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), Mental Health (including addiction)