Wednesday, July 6, 2022

Acetaminophen toxicity with tobacco

Q: Acetaminophen toxicity corelates in direct proportion with tobacco consumption (means higher the cigarettes per day higher the chances of toxicity)?

A) True
B) false

Answer: B

Although tobacco is an independent risk factor for acetaminophen toxicity, it has no direct correlation with the amount of tobacco or number of cigarettes per day. Even a small amount of tobacco consumption can increase acetaminophen toxicity. This is due to the fact that tobacco smoke contains CYP1A2 inducers which increases oxidative metabolism. 

A large number of smokers are simultaneously regular users of alcohol which further increases the risk of mortality.



1. Dong SX, Ping ZZ, Xiao WZ, et al. Effect of active and passive cigarette smoking on CYP1A2-mediated phenacetin disposition in Chinese subjects. Ther Drug Monit 1998; 20:371.

2. Seo KW, Park M, Kim JG, et al. Effects of benzothiazole on the xenobiotic metabolizing enzymes and metabolism of acetaminophen. J Appl Toxicol 2000; 20:427.

3. Schmidt LE, Dalhoff K. The impact of current tobacco use on the outcome of paracetamol poisoning. Aliment Pharmacol Ther 2003; 18:979.

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