Abstract
Smokers have higher levels of C-Reactive Protein (CRP) compared to never smokers. The role of smoking cessation on CRP is still under debate. Using data from two screening studies conducted in Italy in 2000–2010 on 3050 heavy smokers (including 777 ex-smokers), we estimated multivariate odds ratios (OR) for high CRP (i.e. ≥2 mg/L) according to smoking status. Moreover, in a longitudinal analysis based on 975 current smokers, with a second measurement of CRP after an average study period of 3.4 years, we estimated the changes in CRP according to smoking cessation. Prevalence of high CRP at baseline was 35.8% among ex-smokers and 41.1% among current smokers (significant OR for ex- vs. current smokers: 0.79). After four years since smoking cessation, CRP levels significantly decreased with increasing years of cessation (significant OR for ex-smokers since more than 8 years: 0.55). In the longitudinal analysis, no significant reduction in CRP was found for time since smoking cessation (ORs: 1.21, 1.04, and 0.91 for ex-smokers since 1 year, 2–3 years, and ≥4 years, respectively). In the largest prospective study available so far, we found that smoking cessation has a favourable effect on CRP, but this benefit is not evident in the short-term.
Highlights
Smoking cessation has been shown to induce immediate reduction in the levels of several inflammation markers[15,23]
Median values of C-Reactive Protein (CRP) decreased with increasing time since stopping, being 1.49 mg/L (IQR: 0.73–3.36) in ex-smokers since 1–3 years, 1.35 mg/L (IQR: 0.77–2.77) in 4–7 years and 1.22 mg/L (IQR: 0.73–2.24) in those having stopped since more than 8 years (Table 2)
We confirm that ex-smokers have significantly lower levels of CRP than current smokers[19]
Summary
Smoking cessation has been shown to induce immediate reduction in the levels of several inflammation markers[15,23]. Levels as compared to current smokers[11,13,16,19,20,21,22], the reductions being, significant only after several years since cessation (i.e., 5 to 20 years)[11,13,19,20,21,22]. A few additional studies with repeated CRP measurements included a relatively limited number of smokers and considered periods of a few weeks[15,23,24,27] up to one year[28] since smoking cessation. To provide additional information on the issue, we analyzed data from two large studies, which provided CRP levels among samples of heavy smokers before and after smoking cessation, allowing us to compare variations in CRP levels among successful smoking quitters. This study represents the largest prospective study on the issue, and the sole study able to evaluate the role of smoking cessation on CRP levels over more than one year
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