- Ashlee Wright went on Ozempic six months ago to manage her insulin resistance and other issues.
- The mom of 4 also unexpectedly quit smoking since Ozempic made cigarettes taste "disgusting."
Ashlee Wright has four boys under age 16, a home, a husband, and a demanding job as a mining coordinator in Utah. Sometimes, she needs a break; and for years, smoking cigarettes provided it.
"Smoking would be kind of my 'time out' at home," said Wright, 35, who smoked between a half pack and a pack a day, usually on her porch.
Then about six months ago, Wright started taking Ozempic, a form of semaglutide used to treat diabetes and increasingly prescribed off-label for weight loss.
Wright said she and her doctor decided to try it off-label to manage her insulin resistance, polycystic ovary syndrome, and reduce her heart-disease risk. The possibility of weight-loss was appealing, too
Wright says the drug, which she pays for out-of-pocket, lowered her blood pressure and cholesterol, lightened her periods, and led to her dropping 45 pounds. It also came with an unexpected side effect: She couldn't finish a single cigarette. "I quit smoking within a few weeks because every time I smoked, it was just disgusting," Wright said.
Wright turned to nicotine gum to manage withdrawals and ice cubes for a tactile replacement. She's also come up with games that challenge her kids to bike to the park to give her a break. "I had to find creative ways to have a little reset instead of going out on the porch and hiding," she said.
Others have reported similar experiences. "I was a causal smoker years! However once I moved to the higher dosage of Ozempic, I had zero urge to smoke and actually haven't smoked in 9 months," one poster wrote on Reddit.
Doctors and scientists aren't surprised. GLP-1 receptor agonists, the class of drugs semaglutide belongs to, are known to dull the desire for highly rewarding substances, be it highly processed foods, alcohol, or cocaine. Nicotine seems to be no different: Studies have shown that the drugs reduce nicotine consumption in rats.
While more research needs to be done in humans, University of Pennsylvania neuropharmacologist Heath Schmidt told Insider he wouldn't be surprised if a configuration of semaglutide is approved to treat substance use disorders within about five years.
Semaglutide could be fighting against smoking on 3 fronts
Researchers say there are several ways GLP-1 receptor agonists may be disrupting the desire to smoke. For Wright, it's the taste. Now cigarettes are "super, super bitter," she said.
Other people on the drug previously told Insider they also found their taste buds changed, making french fries taste like "metal chunks" and doughnuts taste "bitter."
This effect could be related to the fact that both taste cells and the nerve fibers woven through them release GLP-1, the hormone that semaglutide mimics, Lynnette McCluskey, a neuroscience professor at Augusta University who studies taste regeneration, previously told Insider.
"So you're really messing with the signals that are going to the brain, telling you what's in your mouth," McCluskey said. "Once you start messing with all those signals — and it may be different from day to day, or when you took the drug — you really have a lot of potential for dysgeusia, or taste distortions."
Semaglutide also tends to make people nauseous, and too much nicotine can have the same effect, said University of Pennsylvania psychiatry professor Matt Hayes. So it follows that a smokers on the drug relatively effortlessly become nonsmokers as to not exacerbate an already queasy stomach.
And then there's the way semaglutide seems work in the brain's reward system to suppress some "highly motivated" behaviors, like cigarette smoking.
"This same system that regulates intake of food, drugs of abuse, hijacks this system too," Schmidt said. "So it seemed like a natural hypothesis to say, 'If we engage the GLP-1 system, we can reduce drug taking and seeking behaviors as well.'"
The drug may also help prevent weight gain when smokers quit
GLP-1 receptor agonists could be an especially "natural fit" for smokers who want to quit, Schmidt said, since they buffer against one thing that can keep people puffing: Fear of weight gain.
He and colleagues recently found that liraglutide, a sister of semaglutide, not only reduced rats' interest in nicotine and likelihood of "relapsing" after they were addicted, but it also helped prevent weight gain and excessive eating during withdrawal.
But more research needs to be done before semaglutide can approved and marketed for smoking cessation. Researchers at the University of North Carolina are recruiting smokers for such a study now.
And if a semaglutide-like drug does hit the market, it will likely be most effective used in conjunction with other smoking cessation techniques like nicotine patches or gum, Hayes told Insider.
The biggest challenge for the field, Hayes said, "is going to be getting the insurance companies to say, 'OK,we're gonna reimburse this."
Researchers are studying other addictions semaglutide could help beat
Hayes said he suspects scientists will eventually figure out which types of addictions are best treated with which types of GLP-1 receptor agonists.
"I wouldn't be surprised if we start to find that this is really good for cocaine and nicotine, it's OK for substance X, Y, or Z, but this other one, we need to keep working on something else," said Hayes. The more they learn about that reward system, "the more we're finding the devil's in the details," he added.
But the class of drugs is particularly exciting to researchers in large part because it doesn't seem to work by suppressing all motivation, but just by dulling the desire for artificial rewards. Online, people report losing interest in porn, for example, but research suggests there's no loss of interest in sex. "It's not ubiquitous in its nature of suppressing pleasure," Hayes said.
Plus, the side effects — albeit sometimes extremely uncomfortable — don't seem to affect the heart or other vital organs in life-threatening ways.
"This sort of drug is this gift that keeps on giving," Hayes said.