Tobacco use continues to cause 5 million preventable deaths worldwide each year. Despite effective treatments being available, these are underutilized and cessation rates remain low. As tobacco use has complex physiological effects, there are multiple opportunities for novel pharmacological agents to play a role in a comprehensive treatment plan. The endocannabinoid system has been linked to the nicotine reward pathways in animal models. Rimonabant, a selective cannabinoid receptor (type 1) blocker, has been shown in some early clinical trials to have some positive effects in increasing abstinence rates of smokers attempting to stop. In addition, smokers who stop smoking with the assistance of rimonabant may gain less weight than those using placebo. However, the results from these few trials have not been entirely consistent and so its role as an aid to smoking cessation remains to be determined.