Quitting smoking and gaining weight travel together, and the fear of the second keeps people at the first. So a drug that suppresses appetite and touches reward pathways is an obvious thing to try. Two randomized trials have tried it. A meta-analysis pooled them this year, and the answer on quitting is that nobody knows yet. [1]
What the pooled number says
Across 337 participants, the odds ratio for abstinence was 1.36 against placebo or standard care. The confidence interval ran from 0.55 to 3.35 and the p-value was 0.51. An interval that spans 1.0 is consistent with the drug making quitting harder and with it making quitting three times likelier. Heterogeneity between the two trials was 66.93%, which means they did not agree with each other either. The review graded the certainty of this result very low.
That is not a disappointing result. It is an absent one. The screen found 751 records and 26 full texts, and only two trials met the criteria — so the honest summary is that the question has barely been asked. The distinction matters when somebody is deciding what to spend, which is the same problem the PCOS page runs into from the other direction.
The weight finding is a different finding
Post-cessation body weight did move. The weighted mean difference was 4.14 kg, with an interval from 7.22 to 1.05, and BMI fell by 1.77 kg/m² on an interval of 2.20 to 1.34. Both exclude zero. Heterogeneity was low on both — 19.93% on weight and 0.0% on BMI. The authors read these as support for the drug as an adjunct, addressing the weight-related relapse risk rather than the nicotine.
Read carefully, that is the drug doing the thing it is already approved to do, in people who happen to be quitting. It is a reason to expect less weight gain. It is not yet a reason to expect a quit. And it only holds while somebody keeps taking the drug, which most people do not do for a year.
What it would cost to find out
A buyer testing this on themselves is buying the ordinary product at the ordinary rate. The median published figure for the injection on this roster is $179 a month, or $2,148 across a year if the dose and the rate both hold — two conditions most sellers decline to commit to. Against a null result, that is the full price of a maybe.
Compare that to what the alternatives cost. Varenicline and nicotine replacement are cheap, generic and carry decades of trial evidence for this exact indication. A GLP-1 prescribed for quitting is an expensive first line against two established ones. You can put the monthly figure next to a twelve-month total in the cost calculator before deciding whether the maybe is worth it.
What would change this
The review asks for larger and longer trials using newer agents, which is the correct ask. Both included trials predate the current generation of drugs. A properly powered trial of semaglutide or tirzepatide against varenicline would settle it. Until one reports, anybody selling this drug for smoking is selling an interval that contains nothing.