Tobacco Use, the Missing Cause of Drug Interaction: A Narrative Literature Review

Cigarette smoke and nicotine interact with drugs by affecting the absorption, distribution, metabolism, or elimination of other drugs, causing a change in drug response. Therefore, smokers usually need higher doses of medications. Articles were searched through advanced search in ScienceDirect, PubMed, Google Scholar, and SciELO databases. Finally, ۲۸ articles were used in this study. We found that drugs may interact with each other when taking multiple medications, but these interactions are not always related to medications. Sometimes these interactions result from drugs reacting with food, beverages, and tobacco. Smokers have to take more doses of the drug for treatment in the long run, which can cause more side effects. In the long run, the person’s body becomes resistant to the drug and the dose has to be increased. Overuse of the drug causes the person to suffer more emotional and physical symptoms. Cigarettes can also have pharmacokinetic effects on some drugs (clozapine, olanzapine, and haloperidol). Tobacco causes nausea and the drug does not work well enough. In severe cases, the drug has to be injected intravenously, which makes the treatment much more difficult. Therefore, according to the studies, the patient’s history of smoking and alcohol consumption should be studied and medications should be prescribed according to it in order to treat in the best way.