A scoping review about smoking, smoking cessation and their effects on anti-tuberculosis agents: insights into drug metabolisms, safety, and effectiveness

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 hig...

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Main Authors: Carlo Maria Bellanca, Simone Pietro Polosa, Egle Augello, Giulia Di Benedetto, Chiara Burgaletto, Anna Flavia Cantone, Gabriella Gaudio, Giuseppe Nunnari, Davide Campagna, Jennifer M. Nailes, Hamza Shahbaz, Reza Kurniawan Tanuwihardja, Anant Mohan, Manuela Ceccarelli, Renato Bernardini, Andrea Marino, Giuseppina Cantarella
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1606150/full
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author Carlo Maria Bellanca
Carlo Maria Bellanca
Carlo Maria Bellanca
Simone Pietro Polosa
Egle Augello
Egle Augello
Giulia Di Benedetto
Giulia Di Benedetto
Chiara Burgaletto
Anna Flavia Cantone
Gabriella Gaudio
Giuseppe Nunnari
Davide Campagna
Davide Campagna
Davide Campagna
Jennifer M. Nailes
Hamza Shahbaz
Hamza Shahbaz
Reza Kurniawan Tanuwihardja
Anant Mohan
Manuela Ceccarelli
Renato Bernardini
Renato Bernardini
Andrea Marino
Giuseppina Cantarella
author_facet Carlo Maria Bellanca
Carlo Maria Bellanca
Carlo Maria Bellanca
Simone Pietro Polosa
Egle Augello
Egle Augello
Giulia Di Benedetto
Giulia Di Benedetto
Chiara Burgaletto
Anna Flavia Cantone
Gabriella Gaudio
Giuseppe Nunnari
Davide Campagna
Davide Campagna
Davide Campagna
Jennifer M. Nailes
Hamza Shahbaz
Hamza Shahbaz
Reza Kurniawan Tanuwihardja
Anant Mohan
Manuela Ceccarelli
Renato Bernardini
Renato Bernardini
Andrea Marino
Giuseppina Cantarella
author_sort Carlo Maria Bellanca
collection DOAJ
description 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.
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spelling doaj-art-ad6d3c8b723b41fb87c60a52bfe406502025-08-20T02:40:29ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-07-011610.3389/fphar.2025.16061501606150A scoping review about smoking, smoking cessation and their effects on anti-tuberculosis agents: insights into drug metabolisms, safety, and effectivenessCarlo Maria Bellanca0Carlo Maria Bellanca1Carlo Maria Bellanca2Simone Pietro Polosa3Egle Augello4Egle Augello5Giulia Di Benedetto6Giulia Di Benedetto7Chiara Burgaletto8Anna Flavia Cantone9Gabriella Gaudio10Giuseppe Nunnari11Davide Campagna12Davide Campagna13Davide Campagna14Jennifer M. Nailes15Hamza Shahbaz16Hamza Shahbaz17Reza Kurniawan Tanuwihardja18Anant Mohan19Manuela Ceccarelli20Renato Bernardini21Renato Bernardini22Andrea Marino23Giuseppina Cantarella24Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, ItalyClinical Toxicology Unit, University Hospital of Catania, Catania, ItalyDepartment of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, ItalyDepartment of Biochemical Engineering, University College London, London, United KingdomDepartment of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, ItalyClinical Toxicology Unit, University Hospital of Catania, Catania, ItalyDepartment of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, ItalyClinical Toxicology Unit, University Hospital of Catania, Catania, ItalyDepartment of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, ItalyDepartment of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, ItalyDepartment of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, ItalyUnit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, ARNAS Garibaldi Hospital of Catania, Catania, ItalyCenter of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, ItalyUnitá Operativa Complessa (UOC) Medicina e Chirurgia d'Accettazione e Urgenza (MCAU), University Teaching Hospital “Policlinico-Vittorio Emanuele”, University of Catania, Catania, ItalyDepartment of Clinical and Experimental Medicine, University of Catania, Catania, ItalyDepartment of Preventive and Community Medicine, University of The East Ramon Magsaysay Memorial Medical Centre, Quezon City, Philippines0Pulmonology Department, Jinnah Hospital, Lahore, Pakistan1Department of Pulmonology, Allama Iqbal Medical College, Lahore, Pakistan2Departemen Pulmonologi dan Kedokteran Respirasi, Dr. H.A. Rotinsulu Lung Hospital, Bandung, Indonesia3Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, India4Unit of Infectious Diseases, Department of Medicine and Surgery, “Kore” University of Enna, Enna, ItalyDepartment of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, ItalyClinical Toxicology Unit, University Hospital of Catania, Catania, ItalyUnit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, ARNAS Garibaldi Hospital of Catania, Catania, ItalyDepartment of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, ItalyThe 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.https://www.frontiersin.org/articles/10.3389/fphar.2025.1606150/fullcytochrome P450drug-drug interactionsadverse drug reactionsantibioticsnicotinesmoking cessation
spellingShingle Carlo Maria Bellanca
Carlo Maria Bellanca
Carlo Maria Bellanca
Simone Pietro Polosa
Egle Augello
Egle Augello
Giulia Di Benedetto
Giulia Di Benedetto
Chiara Burgaletto
Anna Flavia Cantone
Gabriella Gaudio
Giuseppe Nunnari
Davide Campagna
Davide Campagna
Davide Campagna
Jennifer M. Nailes
Hamza Shahbaz
Hamza Shahbaz
Reza Kurniawan Tanuwihardja
Anant Mohan
Manuela Ceccarelli
Renato Bernardini
Renato Bernardini
Andrea Marino
Giuseppina Cantarella
A scoping review about smoking, smoking cessation and their effects on anti-tuberculosis agents: insights into drug metabolisms, safety, and effectiveness
Frontiers in Pharmacology
cytochrome P450
drug-drug interactions
adverse drug reactions
antibiotics
nicotine
smoking cessation
title A scoping review about smoking, smoking cessation and their effects on anti-tuberculosis agents: insights into drug metabolisms, safety, and effectiveness
title_full A scoping review about smoking, smoking cessation and their effects on anti-tuberculosis agents: insights into drug metabolisms, safety, and effectiveness
title_fullStr A scoping review about smoking, smoking cessation and their effects on anti-tuberculosis agents: insights into drug metabolisms, safety, and effectiveness
title_full_unstemmed A scoping review about smoking, smoking cessation and their effects on anti-tuberculosis agents: insights into drug metabolisms, safety, and effectiveness
title_short A scoping review about smoking, smoking cessation and their effects on anti-tuberculosis agents: insights into drug metabolisms, safety, and effectiveness
title_sort scoping review about smoking smoking cessation and their effects on anti tuberculosis agents insights into drug metabolisms safety and effectiveness
topic cytochrome P450
drug-drug interactions
adverse drug reactions
antibiotics
nicotine
smoking cessation
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1606150/full
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