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31 Effects of smoking and smoking cessation on drug metabolism Chemicals in tobacco smoke accelerate the metabolism of many commonly used drugs by inducing the cytochrome P450 enzyme CYP1A2

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Additionally, ER stress in AECII cells inhibited PINK1-mediated mitophagy, leading to extracellular release of mtDNA, which activated toll-like receptor 9 (TLR9) and triggered transforming growth factor- (TGF-) secretion, further increasing susceptibility to pulmonary fibrosis ( Nuclear factor E2-related factor 2 (Nrf2) acts as an anti-OS sensor that activates antioxidant responses within cells and is a crucial regulator of mitophagy, thereby inhibiting fibrosis by maintaining mitochondrial mass and function

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The most common substance used was marijuana (34%), followed by intravenous drugs (29%) and heavy alcohol use (intake of two or more drinks per day) (17%)