Hydrocarbons in tobacco smoke increases the metabolism of certain drugs. Therefore, when someone stops smoking, irrespective of stop smoking medication use, the metabolism of such drugs may slow down, increasing blood levels.
To avoid toxicity, drug levels need to be checked, monitored and adjusted as required.
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Here is a table which includes possible drug interactions and uses for these medications. For any of these medications being taken, the client/patient needs to speak to their GP or other HCP involved in their care to allow closer monitoring of the medication.
Diabetics using insulin should be advised to monitor blood sugar levels regularly when cutting down or quitting tobacco. The advisor can continue to supply NRT products, but should also seek consent from the client to notify their GP or an appropriate healthcare professional about their quit attempt, as well as informing them of any relapses and returning to smoking.
Clients taking warfarin should be advised to monitor their INR (or international normalised ratio) as this may increase after cutting down or quitting smoking. Please advise the client to notify the healthcare professional managing their anticoagulant control about quitting smoking.