REVIEW article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1606150
This article is part of the Research TopicAdvancements and Strategies in Predicting and Managing Clinical Drug-Drug InteractionsView all 3 articles
A scoping review about smoking, smoking cessation and their effects on anti-tuberculosis agents: insights into drug metabolisms, safety, and effectiveness
Provisionally accepted
Carlo Maria Bellanca1
Simone Pietro Polosa2
Egle Augello1
Giulia Di Benedetto1*
Chiara Burgaletto1
Anna Flavia Cantone1
Gabriella Gaudio1Giuseppe Nunnari1
Davide Campagna1Jennifer M Nailes3
Hamza Shahbaz4
Reza Kurniawan Tanuwihardja5Anant Mohan6Manuela Ceccarelli7
Renato Bernardini1
Andrea Marino1
Giuseppina Cantarella1- 1University of Catania, Catania, Italy
- 2University College London, London, England, United Kingdom
- 3University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, National Capital Region, Philippines
- 4Jinnah Hospital, Lahore, Punjab, Pakistan
- 5Rotinsulu Lung Hospital, Bandung, West Java, Indonesia
- 6All India Institute of Medical Sciences, New Delhi, National Capital Territory of Delhi, India
- 7Kore University of Enna, Enna, Sicily, Italy
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The World Health Organization (WHO) ranks tuberculosis (TB) as one of the top 10 causes of deaths worldwide. Notably, tobacco smoking represents a significant promoting factor in TB progression, being associated with poorer treatment outcomes, delayed conversion to negative smear or culture, and higher dropout rates from treatment plans. Remarkably, high rates of smoking and TB frequently overlaps in the same countries, warranting the need for targeted public health interventions. Prioritising smoking cessation is essential for smokers with TB, as sustained abstinence has been associated with reduced mortality and a more successful cure. This review examines the intricate relationship between cigarette smoking, smoking cessation therapies and anti-TB drugs, focusing on the impact of tobacco smoking compounds on liver detoxifying systems, such as influence of polycyclic aromatic hydrocarbons (PAHs) on hepatic cytochrome P450 (CYP450) enzymes mostly, and on metabolism of antituberculous medications. Integrating smoking cessation and TB treatment programmes must also take into account potential drug-drug interactions between smoking cessation medications and anti-TB drugs, a critical area for patient safety and effective TB management. This review article aims to provide healthcare professionals with the knowledge to better support TB patients who smoke or are intending to quit, to ensure tailored and effective treatment strategies, while highlighting gaps in current research and advocating for further studies to fill these gaps.
Keywords: cytochrome P450, drug-drug interactions, adverse drug reactions, antibiotics, Nicotine, Smoking Cessation
Received: 07 Apr 2025; Accepted: 26 Jun 2025.
Copyright: © 2025 Bellanca, Polosa, Augello, Di Benedetto, Burgaletto, Cantone, Gaudio, Nunnari, Campagna, Nailes, Shahbaz, Tanuwihardja, Mohan, Ceccarelli, Bernardini, Marino and Cantarella. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Giulia Di Benedetto, University of Catania, Catania, Italy
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.