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What is it?

Tobacco is derived from the tobacco plant, with the active ingredient being nicotine. It speeds up the messages between the brain and the body – basically it gets us to stepping. Toxic by-products like tar and carbon monoxide are released when tobacco is smoked.

Tobacco is most commonly inhaled by smoking it. This can be from cigarettes, cigars or a pipe. It can be chewed or vaped. It can be absorbed into the skin through nicotine patches – but no one is walking around the smoking area in a bar asking for a nicotine patch. Patches are used by people trying to quit smoking.

What are the effects?

  • Mild stimulation
  • Increased heart rate
  • Increased ability to concentrate
  • Relaxation
  • Temporary reduction in the urge to smoke
  • Coughing
  • Dizziness, headaches,
  • Bad breath
  • Tingling or numbness in fingers and toes
  • Reduced appetite, stomach cramps and vomiting
  • Stroke
  • Eye diseases, like blindness and cataracts
  • Birth defects, if the foetus is exposed to cigarettes
  • Yellow teeth and gum disease
  • Aneurisms
  • Coronary heart disease
  • Pneumonia
  • Various respiratory diseases, like coughing fits and asthma
  • Diabetes
  • Reduced fertility
  • Ectopic pregnancies (pregnancies in the fallopian tube)
  • Hip fractures
  • Difficulty getting an erection
  • Rheumatoid arthritis
  • Reduced immune function, basically getting regular colds or the flu
  • Cancers


While we can’t overdose on tobacco, we can experience nicotine poisoning – and it’s just as bad as it sounds. It occurs when we have too much of it in our body. It usually happens in two stages, and the symptoms typically last an hour or two for mild poisoning and up to 24 hours for severe poisoning.

Knowing the signs of overdose helps keeps us and others safe, and when we might need to call an ambulance. Watch out for these symptoms and call 000 in an emergency:


Slower heartbeat


Shallow breathing


Lower blood pressure




Loss of muscle control

Mixing with other drugs

The effects of mixing tobacco with other drugs – including over the counter or prescribed medications can be unpredictable and dangerous. Do not mix tobacco with the following medications because it may increase the risk of death:


Contraceptive Pill

To discover more about the specific interactions between tobacco and other drugs, refer to the Australian Drug Foundation.

HIV Medications

The interactions between tobacco and antiretroviral medications are not well known. There’s currently no evidence to suggest that tobacco use directly reduces the efficacy of antiretroviral medications. If some new research comes to light, then we’ll update this section and let you know.

The interactions between tobacco and PrEP and PEP are not well known. There’s currently no evidence to suggest that tobacco use directly interacts with these medications or reduces their efficacy. We’ll keep looking and update you if any new research comes to light.

To learn about the interactions between specific HIV medications and tobacco head to Liverpool HIV Drug Interactions Checker.


There’s currently no evidence to suggest that nicotine use directly reduces the efficacy of HRT. We’ll keep looking and update this information if something new comes to light.

Feminising hormones and anti-androgens can alter the experience of stimulants generally, and this includes tobacco. It can result in experiencing amplified effects including excess sweating, rapid heart rate and dehydration, and this is more likely with low testosterone levels.

Progesterone can contribute to an inflammation of the airways and potentially increases the risk of asthma, which is then compounded by smoking.

Oestradiol and smoking tobacco may contribute to deep vein thrombosis, so best to chat with a healthcare professional to help manage and mitigate the risk.

Both testosterone and smoking tobacco can contribute to a condition known as polycythaemia (a high concentration of red blood cells) which may feel like fatigue, weakness, dizziness, or shortness of breath. Chat with a doctor to keep an eye out for any blood work.

Testosterone can increase irritability, and restlessness and impact our emotions, so we may find changes in our response when taking stimulants, such as increased sweating and heart rate, and our experiences of irritability and mood swings.

The smoking cessation chemical Bupropion is contraindicated for use with Testosterone – so before quitting smoking, it’s best to chat with a professional about what will work best.

For more information about tobacco head to the Australian Drug Foundation or TripSit.

The information given on this page is not medical advice and should not be relied upon in that way.