Semaglutide for Smoking Cessation in Patients With Diabetes

Inclusion criteria

• Adults (18 years or older) with type 2 diabetes
• Currently residing in Ontario
• Smoke at least five cigarettes per day and willing to reduce or quit smoking within the next 6 months
• Stable HbA1c ≥7.0% - 10% with no more than a 1% change over the last 3 to 6 months.
• Have not used GLP-1 receptor agonists in the past six months.
• Able to provide informed consent

Exclusion criteria

• Pregnant or breastfeeding individuals
• Contraindication to NRT or GLP-1 RA.
• Current daily use of NRT or a GLP1 RA.
• Use of bupropion, cytisine, and varenicline within the last 7 days.
• Use of a DPP-IV inhibitor within the last 7 days.
• Initiation of a new diabetes medication within the last 3 months.
• As per the product monograph, participants with the following diagnoses or disorders will be excluded;
• Personal or family history of medullary thyroid cancer
• Personal or family history of Multiple Endocrine Neoplasia syndrome type 2
• Diabetic ketoacidosis
• Type I diabetes
• Acute pancreatitis or pancreatic cancer
• Acute, chronic or end-stage renal failure
• Tachyarrhythmias
• Unable to engage in follow-up for any reason (for example an acute mental illness, cognitive impairment, unable to speak English or French).
• Other conditions deemed by the study team to interfere with participation or outcomes in the opinion of the study investigator (for example acutely unwell, life expectancy less than 1 year).