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Ask Oz and Roizen: The Link Between Smoking and Drinking, and the Dangers of Cipro

Ask Oz and Roizen: The Link Between Smoking and Drinking, and the Dangers of Cipro

Our experts discuss how to avoid health risks associated with addictions and antibiotics.

Q: My friend said she had to quit drinking, so she could quit smoking. I don’t understand what she’s talking about. Is there science there or is it all in her head? —Beth C., Armonk, NY

A: There’s a scientific link between alcohol and nicotine metabolism. And your friend is smart to do whatever it takes to help her quit.

As you may know, Dr. Mike and his Wellness Center folks dedicate a lot of time to helping people breathe free (quitting inhaled nicotine products, including cigarettes and e-cigs) because it’s so difficult to quit once you’re hooked. Today, according to the FDA, over 7,000 chemicals exist in cigarettes, and a ton in vaped ones too!

Getting away from those toxins improves skin and heart health, protects your brain and reduces your risk for cancers and lung diseases. But back to your question . . .

We’ve known for a while that people with higher nicotine metabolism ratios (the faster you metabolize nicotine, the faster you’ll crave another cigarette) are likely to smoke more and have a harder time quitting, even after using patches and other smoking-cessation techniques.

Well it turns out that drinking alcohol speeds up nicotine metabolism, making you want to smoke more! Reduce alcohol intake and you tamp down your urge to smoke! (With the way cigarettes are engineered today, it may be a design feature that alcohol consumption lights a fire under nicotine metabolism.)

A recent collaborative research effort from Oregon State University, University of Toronto and University of Guelph in Ontario has shown that lowering a person's nicotine metabolism rate through reduced drinking could provide an edge when trying to stop smoking. The researchers explain it this way: “The reduction in alcohol use and nicotine metabolic rate (NMR) in men provides indirect support for alcohol [intake] increasing NMR.”

So, your friend is spot on. We hope she’s doing well and continues to breathe free.

Q: I had a urinary tract infection about a year ago and went to the emergency department to get treated. They gave me Cipro, which cleared it up, but I had stomach problems afterwards. Then I heard it’s toxic for the liver, nerves and the heart. Why would they give this to you in the ER? —Mary D., Tucson, AZ

A: If you find yourself in the emergency department with a respiratory or urinary tract infection, the first-line antibiotic that doctors or nurse practitioners will probably dispense is ciproflaxin (Cipro). It’s the most popular antibiotic in the class of fluoroquinolones and docs choose them in situations where they don’t know exactly what bacteria is causing the problem, because they work. They’re broad-spectrum, which means they can treat a whole range of infections.

However, they’ve been known to cause serious problems. Six years ago, the FDA warned that fluoroquinolones may cause sudden, serious and potentially permanent nerve damage. Since then they’ve also warned about tendon, muscle and joint damage. Add to that an NIH warning of toxic liver damage if they’re taken for one to four weeks.

And now we have the latest FDA warning: This class of antibiotics can cause fatal heart damage in patients who have “aortic aneurysm or are at risk for an aortic aneurysm.” That includes folks with peripheral atherosclerotic vascular diseases such as PAD (peripheral artery disease), hypertension, certain genetic conditions and the elderly. When you consider that about 75 million American adults—about one in three—have hypertension, that alone puts a lot of people at risk if they take antibiotics such as Cipro.

Our advice? If you’re presented with Cipro in the ER, ask about effective antibiotics that are not fluoroquinolones. You could even ask for a second opinion from an infectious disease specialist. In some situations, the benefits of Cipro and its cousins far outweigh the risks; in others, you want to find an alternative. Which options you have all depends on what kind of infection brought you to the ER.

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