PMC

Percent increase in mean serum AAG concentrations in smokers (n = 4,586) compared to nonsmokers (n = 1489). Adapted from Lind, et al.

Representative pharmacokinetic processes associated with tobacco smoking and their effects on drug disposition. CYP450 enzymes such as CYP1A1 (in lung) and glucuronosyltransferases such as UGT1A1 (in liver) are induced by exposure to tobacco smoke and lead to detoxification of parent drugs or active metabolites in the examples shown. Upregulation of alpha-1-acid glycoprotein (AAG) hepatic production as a result of inflammatory response to cancer and cigarette smoking results in increased protein bound drug and altered disposition.