search for



KCI

Crossref

Cross mark

Cited-by

Fundref

TDM

View (65) Download (66) CrossRef (0)
Sex-Based Difference in Smoking Effects on Hematologic Parameters
J Korean Soc Res Nicotine Tob 2022; 13(3): 83-92
Published online September 30, 2022
© 2022 The Korean Society for Research on Nicotine and Tobacco.

Yoo Bin Seo1, Eon Sook Lee2*, Hyuk Jin Kwon2

1Department of Family Medicine, Wonkwang University Sanbon Hospital, Gunpo, 2Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
Correspondence to: *援먯떊옄竊 씠뼵닕
씤젣븰援 씪궛諛깅퀝썝 媛젙쓽븰怨
E-mail: leejeny@paik.ac.kr
Received September 15, 2022; Revised September 26, 2022; Accepted September 26, 2022.
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, dis-tribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: Previous studies have established an association between smoking and increased hemoglobin or white blood cell counts. However, the sex-based difference in the association is unknown although female smokers are known to have a higher risk of cardiovascular disease than male smokers. We evaluated the association between smoking and hematologic parameters in male and female participants separately.
Methods: Data of 22,501 adults from the seventh and eighth Korea National Health and Nutrition Examination Surveys (2016-2019) were analyzed. Smoking status was evaluated by self-reports or urine cotinine. Four hematologic parameters of hemoglobin, hematocrit, white blood cell counts, and platelet counts were measured. Polycythemia was defined by the World Health Organization criteria of increased hemoglobin level (竊16.5 g/dL in men, 竊16.0 g/dL in women). The association between smoking and hematologic parameters was assessed using multivariate regression analysis or logistic regression analysis. Adjusted variables were age, education, income, body mass index, exercise, alcohol, and chronic disease. All analyses were performed on each male and female participant.
Results: All hematologic parameters were highest in current smokers, both male and female. The hemoglobin and WBC count levels increased linearly with increasing smoking amounts in male and female participants. However, only men were found to have an association between polycythemia and smoking (odds ratio, 1.567; 95% confidence interval, 1.334-1.841).
Conclusion: The level of hemoglobin and WBC counts increased with the amount of smoking in current smokers, which is a consistent finding in both sexes. However, the polycythemia risk of smoking differs by sex.
Keywords : Smoking; Hematologic parameter; Hemoglobin; WBC counts; Sex-based difference
References
  1. WHO. Tobacco: WHO; 2021 [updated 26 July 2021; cited 2022. 03.11].
  2. National Center for Chronic Disease P, Health Promotion Office on S, Health. Reports of the Surgeon General. The health consequences of smoking—50 years of progress: a report of the surgeon general. Atlanta (GA): Centers for Disease Control and Prevention (US); 2014.
  3. Griesshammer M, Kiladjian JJ, Besses C. Thromboembolic events in polycythemia vera. Ann Hematol. 2019; 98(5): 1071-82.
    Pubmed KoreaMed CrossRef
  4. Guglielmelli P, Vannucchi AM. Current management strategies for polycythemia vera and essential thrombocythemia. Blood Rev. 2020; 42: 100714.
    Pubmed CrossRef
  5. Barbui T, Carobbio A, Rumi E, Finazzi G, Gisslinger H, Rodeghiero F, et al. In contemporary patients with polycythemia vera, rates of thrombosis and risk factors delineate a new clinical epidemiology. Blood. 2014; 124(19): 3021-3.
    Pubmed CrossRef
  6. Marchioli R, Finazzi G, Landolfi R, Kutti J, Gisslinger H, Patrono C, et al. Vascular and neoplastic risk in a large cohort of patients with polycythemia vera. J Clin Oncol. 2005; 23(10): 2224-32.
    Pubmed CrossRef
  7. Higuchi T, Omata F, Tsuchihashi K, Higashioka K, Koyamada R, Okada S. Current cigarette smoking is a reversible cause of elevated white blood cell count: Cross-sectional and longitudinal studies. Prev Med Rep. 2016; 4: 417-22.
    Pubmed KoreaMed CrossRef
  8. S AL, Lakshmanan A, P GK, A S. Effect of intensity of cigarette smoking on haematological and lipid parameters. J Clin Diagn Res. 2014; 8(7): Bc11-3.
    Pubmed KoreaMed CrossRef
  9. Wannamethee SG, Lowe GD, Shaper AG, Rumley A, Lennon L, Whincup PH. Associations between cigarette smoking, pipe/cigar smoking, and smoking cessation, and haemostatic and inflammatory markers for cardiovascular disease. Eur Heart J. 2005; 26(17): 1765-73.
    Pubmed CrossRef
  10. Pedersen KM, Çolak Y, Ellervik C, Hasselbalch HC, Bojesen SE, Nordestgaard BG. Smoking and Increased White and Red Blood Cells. Arterioscler Thromb Vasc Biol. 2019; 39(5): 965-77.
    Pubmed CrossRef
  11. Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2018; 9(6): 7204-18.
    Pubmed KoreaMed CrossRef
  12. STASTICS KOREA. Current Smoking rate [Internet]. Korea Disease Control and Prevention Agency; 2022 [updated 2022.04.12.; cited 2022. 04.20.].
  13. Green MS, Peled I, Najenson T. Gender differences in platelet count and its association with cigarette smoking in a large cohort in Israel. J Clin Epidemiol. 1992; 45(1): 77-84.
    CrossRef
  14. Malenica M, Prnjavorac B, Bego T, Dujic T, Semiz S, Skrbo S, et al. Effect of Cigarette Smoking on Haematological Parameters in Healthy Population. Med Arch. 2017; 71(2): 132-6.
    Pubmed KoreaMed CrossRef
  15. Smith MR, Kinmonth AL, Luben RN, Bingham S, Day NE, Wareham NJ, et al. Smoking status and differential white cell count in men and women in the EPIC-Norfolk population. Atherosclerosis. 2003; 169(2): 331-7.
    CrossRef
  16. Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, et al. The Physical Activity Guidelines for Americans. Jama. 2018; 320(19): 2020-8.
    Pubmed KoreaMed CrossRef
  17. Lee W, Chang Y, Shin H, Ryu S. Self-reported and cotinine-verified smoking and increased risk of incident hearing loss. Sci Rep. 2021; 11(1): 8103.
    Pubmed KoreaMed CrossRef
  18. Zieli흦ska-Danch W, Wardas W, Sobczak A, Szo흢tysek-Bo흢dys I. Estimation of urinary cotinine cut-off points distinguishing nonsmokers, passive and active smokers. Biomarkers. 2007; 12(5): 484-96.
    Pubmed CrossRef
  19. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, revised 4th edition, Swerdlow SH, Campo E, Harris NL, et al. (Eds), International Agency for Research on Cancer (IARC), Lyon 2017. 2017.
  20. Weaver LK. Clinical practice. Carbon monoxide poisoning. N Engl J Med. 2009; 360(12): 1217-25.
    Pubmed CrossRef
  21. Thakur KT, Westover MB. Cerebral infarction due to smoker’s polycythemia. BMJ Case Rep. 2011; 2011.
    Pubmed KoreaMed CrossRef
  22. Vasiljevic Z, Scarpone M, Bergami M, Yoon J, van der Schaar M, Krljanac G, et al. Smoking and sex differences in first manifestation of cardiovascular disease. Atherosclerosis. 2021; 330: 43-51.
    Pubmed CrossRef
  23. Peres FS, Barreto SM, Camelo LV, Ribeiro ALP, Vidigal PG, Duncan BB, et al. Time from smoking cessation and inflammatory markers: new evidence from a cross-sectional analysis of ELSA-Brasil. Nicotine Tob Res. 2017; 19(7): 852-8.
    Pubmed CrossRef
  24. Huxley RR, Woodward M. Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies. Lancet. 2011; 378(9799): 1297-305.
    CrossRef
  25. Eisenga MF, Kieneker LM, Touw DJ, Nolte IM, van der Meer P, Huls G, et al. Active smoking and hematocrit and fasting circulating erythropoietin concentrations in the general population. Mayo Clin Proc. 2018; 93(3): 337-43.
    Pubmed CrossRef
  26. Zhang J, DeMeo DL, Silverman EK, Make BJ, Wade RC, Wells JM, et al. Secondary polycythemia in chronic obstructive pulmonary disease: prevalence and risk factors. BMC Pulm Med. 2021; 21(1): 235.
    Pubmed KoreaMed CrossRef
  27. Park MB, Kim CB, Nam EW, Hong KS. Does South Korea have hidden female smokers: discrepancies in smoking rates between self-reports and urinary cotinine level. BMC Womens Health. 2014; 14: 156.
    Pubmed KoreaMed CrossRef
  28. Triandafilidis Z, Ussher JM, Perz J, Huppatz K. An intersectional analysis of women셲 experiences of smoking-related stigma. Qual Health Res. 2017; 27(10): 1445-60.
    Pubmed CrossRef