Many interactions between tobacco smoke and medications have been identified. Note that in most cases it is the tobacco smoke—not the nicotine—that causes these drug interactions. Tobacco smoke interacts with medications by influencing the absorption, distribution, metabolism, or elimination of other drugs, potentially causing an altered pharmacologic response. Because of these interactions, smokers may require higher doses of medications. Upon cessation, dose reductions might be needed.
Adapted and updated, from Zevin S, Benowitz NL. Drug interactions with tobacco smoking. Clin Pharmacokinet. 1999;36:425-438. Copyright © 1999-2019 The Regents of the University of California
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