Abstract
Chronic exposure to tobacco smoke leads to chronic low-grade systemic inflammation; however, little is known about the dose-dependent toxic effect of objective tobacco smoking on systemic inflammation. We examined the dose-dependent toxic effect of cotinine-verified tobacco smoking on leukocyte count in a representative sample of Korean adults, including 8655 men and 10,432 women aged 19–65 years from the Korean National Health and Nutrition Examination Survey. The participants were categorized into five groups by the level of urine cotinine (Ucot) as follows: A non-smoker group (<50.00 ng/mL) and four quartile groups for smokers for both men and women. The odds ratios (ORs) and 95% confidence intervals (CIs) for sex-specific high leukocyte count (≥75th percentile) were calculated across five groups of Ucot concentrations using multiple logistic regression analyses. The mean values of leukocyte count gradually increased according to the grade of Ucot concentration in both sexes. The ORs (95% CIs) for high leukocyte count in the 4th Ucot quartile concentrations versus the non-smokers were 4.09 (3.39–4.94) for men and 3.91 (2.82–5.41) for women after adjusting for confounding variables. The present study confirmed the dose-response toxic effect of tobacco smoking on chronic low-grade systemic inflammation.
Highlights
Tobacco smoking is a major risk factor for morbidity and mortality from cardiovascular disease (CVD) [1], which is increasingly viewed as inflammatory disease [2]
Previous studies have reported that several inflammatory markers are increased in current smokers, most studies used a self-reported questionnaire such as smoking status or the average number of cigarettes smoked per day [9,10,11]
Citizens were informed that they had been randomly selected as a household to voluntarily participate in a nationally representative survey conducted by the Korean Ministry of Health and Welfare (KCDC) and that they had the right to refuse to participate in accordance with the National Health Enhancement Act supported by the National Statistics Law of Korea
Summary
Tobacco smoking is a major risk factor for morbidity and mortality from cardiovascular disease (CVD) [1], which is increasingly viewed as inflammatory disease [2]. Leukocyte count is a simple, easy to obtain, and economical marker of systemic inflammation for clinical practice. A higher leukocyte count, even within the normal range, has been associated with increased incidence risk of hypertension, type 2 diabetes mellitus, CVD, all-cause mortality risk, and cancers [2,3,4,5]. Previous studies have reported that several inflammatory markers are increased in current smokers, most studies used a self-reported questionnaire such as smoking status (never, ex-smoker, and current smokers) or the average number of cigarettes smoked per day [9,10,11]
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