Effects of Omega-3 Fatty Acid Supplementation on Tobacco Craving and Dependence: A Systematic Review and Meta-analysis

Abstract Purpose of Review Tobacco use remains a leading cause of preventable morbidity and mortality worldwide, and current cessation strategies often yield suboptimal long-term success. Omega-3 fatty acids possess anti-inflammatory and neuroprotective properties that may modulate craving and dependence mechanisms in nicotine addiction. We conducted a systematic review and meta-analysis on randomized controlled trials (RCTs) published through September 2025 evaluating omega-3 fatty acid supplementation versus placebo in adult tobacco users. Recent Findings Five RCTs ( n = 350 randomized participants) met inclusion criteria, and pooled analysis showed that omega-3 supplementation significantly reduced craving (SMD − 0.93, 95% CI − 1.69 to − 0.17, p = 0.02) and nicotine dependence (SMD − 1.14, 95% CI − 2.19 to − 0.09, p = 0.03). No significant reduction in cigarettes per day was observed (SMD − 0.56, 95% CI − 1.45 to 0.34, p = 0.23). Biochemical outcomes showed improved antioxidant capacity and reduced oxidative stress markers. Adverse events were mild and comparable to placebo. Summary Omega-3 supplementation may reduce tobacco craving and dependence and is safe and well tolerated, though its effect on actual smoking behavior remains unclear, highlighting the need for larger, long-term trials.