Smoking Health Risks and Warfarin
By: Alere Staff
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The risks of smoking cigarettes and how they affect the health of your lungs, skin and mouth are well-known. What you may not be aware of is that smoking actually harms nearly every organ of the body; tobacco smoke alone contains a deadly concoction of more than 7,000 chemicals with about 70 known to cause cancer.1 Cigarette smoking health side effects account for one of every five deaths each year as well as being the leading preventable cause of death in the United States.2 |
Research has shown that smoking cigarettes can also cause stroke and coronary heart disease, both of which are also among the leading causes of death in the United States.2
Smoking and Heart Health
A smoker is more likely than a non-smoker to develop stroke and coronary heart disease. For both conditions, smoking increases your risk by two to four times.2 Stroke risk increases because the act of smoking damages your blood vessels, making them thicken and grow narrower, reducing their ability to circulate blood and causing higher blood pressures.2 Smoking also increases heart disease and the chances of you experiencing a heart attack. Inhaled carbon monoxide is transferred to your bloodstream, decreasing the amount of oxygen carried in the red blood cells and increasing the amount of cholesterol build-up. This build-up can cause the arteries to harden, leading to a higher chance of heart disease and heart attack.3 The build-up can also increase clot formation and reduce the blood flow to your legs and skin, all of which can be prevented by not smoking.2
You don’t have to be a smoker to have cigarette smoke affect your health. If you are someone who lives around other smokers, secondhand smoke has been shown to also cause heart disease. Breathing in secondhand smoke has immediate harmful effects on your heart and blood vessels.4 The CDC estimates that secondhand smoke alone caused nearly 34,000 deaths related to heart disease each year during the years of 2005 to 2009, all of whom were adult nonsmokers within the United States.4 So while you yourself may not smoke, if you are a patient already managing a heart condition, living with and around smokers may have a harmful affect.
Smoking, Nicotine and Warfarin
Warfarin therapy is an effective agent in preventing stroke and the complications of cardiac events. However, if you both take warfarin and have a smoking habit, your risk of complications and cardiac events increases. Nicotine acts as a stimulant, increasing a person’s heart rate and the heart’s ability to contract. If you already have a heart condition, this can further harm that condition, putting you at risk for warfarin therapy complications. Another issue is that nicotine and other chemicals absorbed into the body through cigarette smoke can have an effect on the enzymes in the liver. In response, the liver makes more enzymes to eliminate the toxic substances while eliminating other things in the body like warfarin.5 This can result in the need for a warfarin dosage adjustment. While nicotine, one of the main ingredients in cigarettes, has no reported interaction with warfarin, the ingredient can still have an effect on your warfarin therapy.
Stopping Smoking
You may feel that quitting a habit like smoking is impossible. Nicotine is the most likely cause of cigarette addiction and you are not alone in fighting it. More people in the United States are addicted to nicotine than with any other drug and if you feel that quitting is more easier said than done, you’re correct. Research suggests that nicotine may be just as addictive as heroin, cocaine or alcohol.1 However, quitting a dependence on cigarettes can and does happen and you can never be too old to quit the habit. According to the CDC, today there are more former smokers than there are current smokers.1
The following treatments have proven effective for quitting:1
- Counseling in person or over the phone.
- Nicotine replacement products such as over-the-counter nicotine patches, gum and lozenges or prescription nicotine patches, inhalers or nasal sprays.
- Prescription non-nicotine medications such as bupropion SR (also known as the Zyban® medication) and varenicline (also known as the Chantix® drug).
Quitting smoking is a smart yet serious undertaking that should not be something you do on your own. Combining one or more of the different methods can make your chances of successfully quitting higher. Quitting is worth it too as it allows your body to start healing and lowers your risks for more serious heart complications.2
If you are a patient on warfarin, it is important to include your managing physician if you decide to quit smoking. Your INR results may need to be monitored closely during this time and while there is little evidence of an interaction with either the Chantix® medication or the Zyban® medication, it is important to keep an eye on your INR levels as your body undergoes the withdrawals and changes.6,7
What About E-Cigarettes?
Electronic cigarettes, also known as e-cigarettes, are battery-operated products designed to deliver nicotine, flavor and other chemicals into your body. They turn the nicotine and other chemicals into a vapor that is inhaled by the user. Proponents of e-cigarette use often claim that e-cigarettes can help people quit smoking and aren’t as harmful as regular cigarettes. However, while other nicotine-containing smoking cessation products like inhalers and drugs are regulated by the Food and Drug Administration (FDA), e-cigarettes have yet to be watched on the federal level.8 So while the potential long-term benefits, risks and interactions with drugs like warfarin are currently unknown, it is important to keep an eye on how e-cigarettes can affect your INR.
Smoking cigarettes has shown to be a major risk factor for all sorts of illnesses and conditions. Even just living in the vicinity of smokers can be hazardous to your health. Don’t let this preventable practice harm your heart and speak with your physician about what you can do to either stay healthy or quit.
References:
- Centers for Disease Control and Prevention. Quitting Smoking. www.CDC.gov. February 17, 2016. Retrieved from: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/quitting/index.htm.
- Centers for Disease Control and Prevention. Health Effects of Cigarette Smoking. www.CDC.gov. February 17, 2016. Retrieved from: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm.
- U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004.
- Centers for Disease Control and Prevention. Secondhand Smoke (SHS) Facts. www.CDC.gov. February 17, 2016. Retrieved from the website: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/index.htm.
- Pirmohamed, M. Drug metabolism. Medicine. Clinical pharmacology. Volume 36, Issue 7, July 2008, Pages 355–359.
- Burstein, A., et al. Lack of Pharmacokinetic and Pharmacodynamic Interactions Between a Smoking Cessation Therapy, Varenicline, and Warfarin: An In Vivo and In Vitro Study. The Journal of Clinical Pharmacology. Vol 47, Issue 11. Pg 1421-1429, Nov 2007.
- Sansone, R.A. and Sansone, L.A. Warfarin and Antidepressants - Happiness without Hemorrhaging. Psychiatry (Edgmont). 6(7): 24–29. July, 2009.
- Centers for Disease Control and Prevention. E-cigarettes: An Emerging Public Health Challenge. www.CDC.gov. October 7, 2016. Retrieved from the website: http://www.cdc.gov/cdcgrandrounds/archives/2015/october2015.htm.
Chantix is a trademark of Pfizer. Alere is not affiliated or associated with the Pfizer company.
Zyban is a trademark of the GlaxoSmithKline group of companies. Alere is not affiliated or associated with the GlaxoSmithKline group of companies.
Warfarin & You
-
General Information
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Health Conditions
- Anemia and Warfarin
- Cancer, Chemotherapy and Warfarin
- Going Back to Warfarin After Pregnancy
- Great News for Patients with Atrial Fibrillation
- Great News for Patients with DVT or PE
- Heart Failure, Atrial Fibrillation and Warfarin
- Inactivity and Your Risk of Stroke
- Mechanical Heart Valve
- Neutropenia and Warfarin
- Unexpected Results - Understanding Your Hematocrit
- Spotting a Blood Clot
- Stroke Awareness Month
- Stroke in Women and Dietary Flavonoids
- Strokes on the Rise But Risk Can Be Prevented
- Study Reveals Heart Attacks in Women Strike without Pain
- The Liver, Liver Disease and Warfarin
- Unexpected Results - Anemia and Your INR
- Unexpected Results – Lupus and APA
- What is Atrial Fibrillation?
- What is Factor V Leiden?
- Your Pulse and Your INR
- Stroke Signs and Symptoms
- Dialysis Increasing the Incidence of Atrial Fibrillation
- Managing Alzheimer's and Warfarin
- Pertussis (Whooping Cough) and Warfarin
- Heart Failure and Warfarin
- Raynaud's Disease and Home INR Testing
- Tools Used to Diagnose Heart Disease
- What is VAD?
- Cholesterol - Good vs. Bad
- Menopause, Warfarin and Your INR
- Migraine Treatment and Warfarin
- Tuberculosis and Warfarin
- Remote Monitoring Benefits of Patients with LVAD
- Home Monitoring Reduces Gastrointestinal Bleeding Events for LVAD
- What is DVT?
- Women and Stroke
- How often should I test my INR?
- The Cardiovascular System - Capillaries
- The Cardiovascular System - Your Heart
- The Cardiovascular System – Heart Valves
- The Cardiovascular System – The Arteries
- The Cardiovascular System – The Atria
- The Cardiovascular System – The Ventricles
- The Cardiovascular System – Veins
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Wellness
- Acupuncture and Warfarin
- Another Method to Catch Afib
- Bah Humbug! Avoiding Holiday Stress
- Bone Health - Importance of Vitamin K
- Chiropractic Care and Warfarin
- Diabetes and Warfarin: Balance with Diet
- Does warfarin make you chilly?
- Fido Becoming a Heart’s Best Friend
- Flu Shots & Your INR
- Fluids & Electrolytes
- Get Out and Play - Bowling
- Get Out and Play - Pickleball
- Going to the Dentist While Taking Warfarin
- Healthy Diet: Whole grains
- High Blood Pressure Control and Your Age
- Identifying Dangerous Blood Clots
- Importance of Controlling Blood Pressure While taking Warfarin
- Namaste: Yoga and Your Heart
- New Health Condition: What does that mean for INR & warfarin?
- Outdoor Summer Safety
- Planning Your Next Doctor’s Appointment
- Probiotics and Warfarin
- Prolonged hot weather can influence your INR
- Seasonal Allergies
- Seasonal Allergy Medications & Your INR
- Shingles and Your INR
- Smoking Health Risks and Warfarin
- Stroke & Dental Plaque – A manageable risk
- Tattoos & Warfarin
- The Cost of a Vaccine vs Getting Sick
- The Flu and Your INR
- Treating Heartburn While On Warfarin
- Understanding and Managing Stress
- What’s Your Risk of Stroke?
- Avoid those Winter Blues!
- Insomnia and Over-the-Counter Sleep Aids
- Exercise & Physical Activity
- Get Out and Play: Bocce Ball
- Managing Diabetes and Warfarin
- Volunteering is Good for Your Health
- Pneumonia, the Prevnar 13® Vaccine and Warfarin
- As You Age - Your Heart
- Heat Therapy
- Keeping Healthy Sleep Habits
- Patients Who Receive Lifestyle Text Messages Show Improved Health
- Chikungunya and Your INR
- Air Quality and Your Heart
- Men and Warfarin
- Sitting Exercises
- Heart Rate and Your Health
-
Warfarin FAQ
- Warfarin Now Seems Natural
- Bridging Medication
- Purple Toe Syndrome
- Testing Methods for Your INR
- The Dangers of Being Labeled ‘Stable’
- The “Absolute Truth” about warfarin replacement drugs
- Travel Series: Altitude and Your INR
- Travel Series: Diet considerations in airports
- Travel Series: Helpful Hints for Air travel
- Travel Series: Traveling on Warfarin
- Travel Series: Your Diet
- Warfarin Side Effects
- Women & Warfarin
- Moving to Generic Warfarin Could Affect Your INR
- Warfarin or Dabigatran or Xarelto… the choice is a team decision
- Medications only work when they are taken as directed
- The Cardiovascular System - Your Blood
- The Cardiovascular System - White Blood Cells
- The Cardiovascular System - Platelets
- As You Age - Dexterity, Tremors and Balance
- As You Age - Eyes
- As You Age - Your Skin
- As You Age - Diet and Digestion
- As You Age - Hearing
- Comparing Warfarin to NOACs
- Consider your condition and more when selecting an anticoagulation medication
- Considering the cost of anticoagulation therapy
- Warfarin, NOACs and Reversal Agents
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Health Conditions
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Dietary (Food & Beverage)
- Vitamin K Levels in Foods – Impact of Cooking or Freezing
- Your Holiday Diet
- Your Metabolism
- Your Balanced, Healthy Diet
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Food Interactions
- Aged Garlic Extract and Warfarin
- Asparagus and Warfarin
- Avocado and Warfarin
- Bananas and Warfarin
- Blueberries and Warfarin
- Broccoli Sprouts
- Cabbage and Warfarin
- Celery and Warfarin
- Cereal Safety
- Coconut and Warfarin
- Cooking Oils and Vitamin K
- Cranberry & Warfarin OK Together
- Dandelion leaves & Warfarin
- Dark Chocolate and Warfarin
- Eating Prickly Pear Cactus (Nopal Cactus)
- Edible Seaweed and Vitamin K
- FDA Warns Against Mexican Vanilla
- Finding the TricK in Treats
- Food Substitutions Are a Simple Matter of Taste
- Garlic and Warfarin
- Gnocchi and Warfarin
- Grapefruit and Warfarin
- Greek Yogurt and Warfarin
- Licorice and Warfarin
- Mangoes and Warfarin
- Nut Butters and Warfarin
- Oatmeal and Warfarin
- Olestra (food additive) and Warfarin
- Olestra, a fat substitute - Can it affect your INR?
- Papaya & Warfarin
- Parsley and Warfarin
- Pho and Warfarin
- Pomegranate & Warfarin
- Salmon and Warfarin
- Smoothies and Warfarin
- Soy and Warfarin
- Special K® cereal and Warfarin
- Tofu and Warfarin
- Energy Bars and Warfarin
- Sorbet or Sherbet and Warfarin
- Sushi and Warfarin
- Muesli and Warfarin
- Microwave Dinners and Warfarin
- Spinach, Vitamin K and Warfarin
- Template
- Clam Chowder and Warfarin
- Dried Fruits and Warfarin
- Gumbo and Warfarin
- Cauliflower and Warfarin
- Kale and Warfarin
- MSG and Warfarin
- Quinoa and Warfarin
- Cilantro and Warfarin
- Radicchio and Warfarin
- Mushrooms and Warfarin
- Cardamom and Warfarin
- Basil and Warfarin
- Pistachio Nuts and Warfarin
- Potato Chips and Warfarin
- Hummus and Warfarin
- Kiwifruit and Warfarin
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Beverage Interactions
- Drinking Tea & Warfarin
- Alcohol and Warfarin
- Aloe Vera Juice and Warfarin
- Black Tea and Warfarin
- Chamomile & Warfarin
- Coconut Water
- Coffee and Warfarin
- Goji Juice and Warfarin
- Green Tea and Warfarin
- Milk Substitutes for Warfarin Patients
- MonaVie Products and Warfarin
- Wheatgrass and Warfarin
- Wine and Warfarin - Red vs White
- Weight Loss Shakes and Warfarin
- The V8® Beverage and Warfarin
- Meal Replacement Drinks and Warfarin
- Juicing and Warfarin
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Safety & First Aid
- Stop Bleeding Fast with New Topical First Aid Products
- Safety Tips for Winter
- Safety: Weather, Emergencies, & Natural Disasters
- Bone Fractures and Warfarin
- Warfarin and Bruising Risk
- Car Safety
- Common Injuries That Befall Seniors
- Detecting a Safer Home
- Dishwasher Safety
- Felons: A Matter on Hand
- Gardening Safety
- Home Safety: Cutting Edge
- Home Safety: Want to exercise, but worried about your diabetes and INR level?
- Joint Injury - The Shoulder
- Kitchen Safety and Safety Products
- Life Saving Medical ID Jewelry
- Nosebleeds
- Orthostatic Hypotension
- Proper lighting needed for medication identification
- Slipping on Wet Floors
- Staying Hydrated in Summer
- Sunburn and Heat Exhaustion
- The Pitfalls of Holiday Alcohol
- The Sting and Bite of Summertime
- Think Disasters Only Happen to Other People?
- Twigs and Falling
- Water and Pool Safety
- Wet leaves can present a hazard
- Safety & Fall Prevention: Learn How to Fall
- Compression Stockings for DVT (Deep Vein Thrombosis)
- Joint Injury - The Hip
- Look Out for Your Eyes
- Joint Injury - The Elbow
- Nosebleed First Aid and Prevention
- CPR First Aid
- First Aid for Thermal Skin Burns
- Preventing Infection - Proper Care for VAD Drivelines
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Drugs and Other Medications
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Natural Medicines & Vitamins
- Angelica herb & Warfarin
- Arnica, Natural Medicine
- Astragalus and Warfarin
- Bladderwrack Seaweed & Warfarin
- Blond Psyllium and Warfarin
- Bogbeans & Warfarin
- Bromelain and Warfarin
- Caffeine and Warfarin
- Capsicum and Warfarin
- Chlorella and Warfarin
- Chromium and Warfarin
- Cinnamon and Warfarin
- Cod Liver Oil & Warfarin
- Corn Silk & Warfarin
- DHEA and Warfarin
- Does Whey Protein Interact with Warfarin?
- Flaxseed Oil and Warfarin
- Ginger and Warfarin
- Iodine and Warfarin
- Iron and Warfarin
- Krill Oil & Warfarin
- MK-7: The Other Vitamin K
- Melatonin and Warfarin
- Multivitamins and Warfarin
- Omega-3 Fatty Acids and Warfarin
- Primrose Oil and Warfarin
- Safflower & Warfarin
- St. John's Wort and Warfarin
- Vitamin A
- Vitamin C
- Vitamin E
- Clotamin, a Multivitamin without Vitamin K
- Ginseng and Warfarin
- Glucosamine Sulfate and Warfarin
- Using Essential Oils and Warfarin
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Over-the-Counter Medications
- Airborne® supplements and Warfarin
- Alli® Weight Loss Medication & Warfarin
- Cold-EEZE® supplement and Warfarin
- Estroven® supplement and Warfarin
- Over-the-counter Creams and Ointments
- Senokot® Laxative & Warfarin
- Topical Arthritis Pain Medications
- Combination Therapy – Aspirin & Warfarin
- Emergen-C® Supplements and Warfarin
- Emergen-C® Supplements and Warfarin
- Prilosec OTC® and Warfarin
- How Ibuprofen Works
- The Nyquil™ Cold and Flu Medication and Warfarin
- Bismuth Subsalicylate and Warfarin
- The Vicks® VapoRub™ Product and Warfarin
- The Alka-Seltzer® Medication and Warfarin
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Prescription Medications
- Antibiotics and Warfarin
- Antidepressant Medications and Warfarin
- Azithromycin and Warfarin
- Belsomra® and Warfarin
- Casodex & Warfarin
- Cipro Prolonged Release Tablets and Warfarin
- Crestor® and Warfarin
- Dicloxacillin and Warfarin
- Dilantin and Warfarin
- Duavee® and Warfarin
- Duloxetine and Warfarin
- Evista, a controversial choice for warfarin patients
- Farxiga® and Warfarin
- Fluconazole and Warfarin
- GRASTEK® Allergen Extract and Warfarin
- Gefitinib and Warfarin
- Maxifloxacin and Warfarin
- Nalidixic and Warfarin
- New Diabetes Drugs and Warfarin
- Oral Corticosteroids & Warfarin
- Oral chemotherapy's black box for warfarin
- Quinine and Warfarin
- Rabeprazole and Warfarin
- Reclast® medication & Warfarin
- Requip® and Warfarin
- Testosterone and Warfarin
- Wellbutrin and Warfarin
- Yaz® medication & Warfarin
- Alprolix® and Warfarin
- Tamiflu® (Oseltamivir) and Warfarin
- Heparin and Warfarin
- Neurontin® and Warfarin
- A Protonix® Prescription and Warfarin
- Opioids and Warfarin
- Hormone Replacement Therapy and Warfarin
- The Viagra® Medication (Sidenafil) and Warfarin
- Multivitamins and Warfarin
- Your Medications, Best Practices
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Natural Medicines & Vitamins
- News Stories
- WellLife: A guide for living on warfarin
- Talking with Your Doctor