To my knowledge no one has studied the question. There are good reasons, however, to suspect smokers using antibiotics would lead to more resistance. First, 80% of antibiotics are prescribed by the family physicians who see these smokers, and 60% of antibiotics are for acute respiratory infections, which are increased in this population. Many of these are inappropriately prescribed. Antibiotics are more likely to be given to smokers than to nonsmokers for acute bronchitis and other respiratory infections.

Major risk factors for antibiotic resistance include: patient age > 65, ß-lactam antibiotic therapy within past 3 months, alcoholism (often associated with smoking), immunosuppressive illness, multiple medical comorbidities (also often associated with smoking), and exposure to a child in daycare.

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