Based on NIH | Is it safe to smoke after taking Naproxen, or does smoking increase the risk of stomach irritation or bleeding?

It’s generally not considered safe to smoke while taking naproxen. Smoking can increase the risk of stomach irritation, ulcers, and gastrointestinal bleeding associated with naproxen and other NSAIDs (nonsteroidal anti‑inflammatory drugs). The risk appears to be higher if naproxen is used at higher doses or for longer periods, and in people who smoke, drink alcohol, are older, or have poor overall health. ^{[1] [2]} Smoking is specifically listed as a factor that raises the chance of NSAID‑related ulcers and bleeding, which can occur without warning and can be severe. ^{[3] [4]}

Why smoking and naproxen don’t mix

• Naproxen can injure the lining of the esophagus, stomach, and intestines, sometimes leading to ulcers or bleeding. ^{[1] [2]}
• Smoking independently increases the risk of developing peptic ulcers and delays healing, and when combined with NSAIDs, the overall risk of bleeding is higher. ^{[5] [6]}
• Safety communications for NSAIDs highlight smoking as a key risk factor for GI ulcer and bleeding, alongside longer use and higher doses. ^{[7] [8]}

How big is the risk?

Authoritative drug safety information notes that the chance of ulcers or bleeding increases in NSAID users who smoke; in those with a history of ulcers or GI bleeding; with longer duration or higher doses; and with certain interacting medications (like steroids, anticoagulants, SSRIs/SNRIs). ^{[9] [10]} These complications can occur at any time during therapy and may happen without warning symptoms. ^{[1] [3]}

Practical steps to reduce risk

• Avoid smoking while taking naproxen to lower the chance of stomach irritation and bleeding. ^{[7] [8]}
• Use the lowest effective dose for the shortest necessary time. ^{[10] [11]}
• Limit alcohol, which can compound GI bleeding risk with NSAIDs. ^{[1] [12]}
• Ask your clinician whether you need stomach protection (e.g., a proton pump inhibitor) if you have additional risk factors such as prior ulcer, age over 60, or use of steroids/anticoagulants/SSRIs/SNRIs. ^{[5] [9]}
• Seek urgent care if you develop warning signs such as black or tarry stools, vomiting blood, persistent stomach pain, dizziness, or weakness. ^{[1] [2]}

Comparison at a glance

Factor	Effect on GI Risk with Naproxen
Smoking	Increases risk of ulcers/bleeding and can impair healing. [3] [6]
Alcohol	Increases risk of GI bleeding, especially with NSAIDs. [1] [12]
Higher dose/longer duration	Raises risk of GI injury and bleeding. [1] [9]
History of ulcers/GI bleed	Strongly increases bleeding risk with NSAIDs. [9] [4]
Concomitant meds (steroids, anticoagulants, SSRIs/SNRIs)	Further increases bleeding risk. [9] [10]
Older age/poor health	Adds to overall risk. [1] [7]

Bottom line

Smoking after taking naproxen is not advisable because it can further raise the already known risk of stomach irritation, ulcers, and bleeding linked to NSAIDs. ^{[1] [3]} If you must use naproxen and you smoke, consider strategies to quit or at least pause smoking during treatment, use the lowest effective dose for the shortest time, avoid alcohol, and discuss protective options with your clinician. ^{[7] [5]}