Drug Interactions with Tobacco Smoking

  title={Drug Interactions with Tobacco Smoking},
  author={Shoshana Zevin and Neal L. Benowitz},
  journal={Clinical Pharmacokinetics},
Cigarette smoking remains highly prevalent in most countries. It can affect drug therapy by both pharmacokinetic and pharmacodynamic mechanisms. Enzymes induced by tobacco smoking may also increase the risk of cancer by enhancing the metabolic activation of carcinogens.Polycyclic aromatic hydrocarbons in tobacco smoke are believed to be responsible for the induction of cytochrome P450 (CYP) 1A1, CYP1A2 and possibly CYP2E1. CYP1A1 is primarily an extrahepatic enzyme found in lung and placenta… 
Drug interactions with smoking.
  • L. Kroon
  • Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2007
PURPOSE The mechanisms for drug interactions with smoking and clinically significant pharmacokinetic and pharmacodynamic drug interactions with smoking are reviewed. SUMMARY Polycyclic aromatic
Cytochromes P450: Roles in the Biotransformation of Chemicals in Cigarette Smoke and Impact of Smoking Cessation on Concurrent Drug Therapy
The impact of smoking and smoking cessation on therapy with toxic drugs that undergo CYP-mediated elimination is reviewed and dose reductions and close therapeutic monitoring for such drugs are recommended in patients who cease smoking.
Effect of nicotine on cytochrome P450 1A2 activity.
The hypothesis that nicotine induces CYP1A2-mediated metabolism of caffeine to paraxanthine, a well-established probe reaction of CYP 1A2 activity in humans in vivo is tested.
Smoking in Patients Receiving Psychotropic Medications
Clinicians should consider smoking as an important factor in the disposition of these drugs, as smoking can affect the pharmacokinetic and pharmacodynamic properties of many psychotropic drugs.
Effects of Cigarette Smoking on Metabolism and Effectiveness of Systemic Therapy for Lung Cancer
Systemic therapy for lung cancer has a narrow therapeutic index such that small changes in plasma concentrations or exposure in smokers may result in suboptimal therapy and poor outcomes.
Impact of smoking on metabolic changes and effectiveness of drugs used for lung cancer.
  • F. Perlík
  • Medicine
    Central European journal of public health
  • 2020
The evaluated studies show that continued smoking after lung cancer diagnosis is related to poor prognosis, reduced survival, risk of second primary malignancies, and increased cancer recurrence.
Metabolism and Disposition Kinetics of Nicotine
Current knowledge about the metabolism and disposition kinetics of nicotine, some other naturally occurring tobacco alkaloids, and nicotine analogs that are under development as potential therapeutic agents are reviewed.
CYP1A2 and tobacco interaction: a major pharmacokinetic challenge during smoking cessation
Pharmacologists can now adopt adaptive pharmacological approaches to complement patient-specific clinical information about smoking cessation by considering pharmacokinetic risk and establish an unprecedented list of CYP1A2 substrates that should guide in the care of patients initiating smoking cessation.
The ability of polycyclic aromatic hydrocarbons to alter physiological factors underlying drug disposition
The pharmacokinetic properties of PAH, the possible mechanisms by which they can alter drug disposition, and specific examples are discussed.
Nicotine and Tobacco
People who smoke, or people who stop smoking, may require dosage adjustments when using some medications including acetaminophen, caffeine, imipramine, oxazepam, pentazocine, propranolol, theophylline, insulin, adrenergic antagonists, and adrenergic agonists.


Expression of CYP1A1 gene in patients with lung cancer: evidence for cigarette smoke-induced gene expression in normal lung tissue and for altered gene regulation in primary pulmonary carcinomas.
CYP1A1 gene expression in normal lung tissue and primary pulmonary carcinoma tissue obtained at thoracotomy from 56 patients with lung cancer is defined and expression became undetectable in all patients who had stopped smoking more than 6 weeks prior to study.
Recent Developments in the Study of the Effects of Cigarette Smoking on Clinical Pharmacokinetics and Clinical Pharmacodynamics
  • L. Miller
  • Medicine, Biology
    Clinical pharmacokinetics
  • 1989
The overriding pharmacokinetic effect is increased drug metabolism through the induction of liver enzymes, which may account for reduced drowsiness in smokers receiving chlorpromazine and benzodiazepines, compared with non-smokers.
Cigarettes and drug therapy: pharmacokinetic and pharmacodynamic considerations.
Cigarette smoking-induced alterations in drug absorption, distribution, metabolism, excretion, and effectiveness are reviewed. Drug therapy can be affected pharmacokinetically by polyaromatic
High inducibility of mouse renal CYP2E1 gene by tobacco smoke and its possible effect on DNA single strand breaks.
Results indicated an increase of single strand breaks of DNA in kidney from treated mice which paralleled the high inducibility of the CYP2E1, which was induced by tobacco smoke.
Effect of cigarette smoke on hepatic and pulmonary cytochromes P450 in mouse: evidence for CYP2E1 induction in lung.
Immunoquantification of lung and liver microsomes of male NMRI mice suggests that CYP2E1, which is known to be expressed in human lung, could actively participate in pulmonary carcinogenesis induced by cigarette smoke.
Effect of cigarette smoke on UDP-glucuronosyltransferase activity and cytochrome P450 content in liver, lung and kidney microsomes in mice.
Cigarette smoke greatly affected both glucuronidation activity and the hydroxylation reactions supported by CYPs in mouse liver and lung, and the UGT activities toward phenols were low in lung, when compared with those measured in liver or kidney.
Role of cytochrome P4501A2 in chemical carcinogenesis: implications for human variability in expression and enzyme activity.
A thorough understanding of the functions and regulation of the CYP1A2 gene may ultimately lead to new methods for preventing or intervening in the development of certain chemically-related human cancers.
Determination of CYP1A2 and NAT2 phenotypes in human populations by analysis of caffeine urinary metabolites.
A metabolic phenotyping procedure that can be used to determine concomitantly the hepatic CYP1A2 and NAT2 phenotypes is described and it is confirmed the valid use of the urinary molar ratio of AFMU/1-methylxanthine, even in alkaline urines.
Smoking and peripheral type of cancer are related to high levels of pulmonary cytochrome P450IA in lung cancer patients
The data suggest that the smokers who have an inducible cytochrome P450IA are especially at increased risk of developing lung cancer of the peripheral adenocarcinomatous type.