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Dose-Dependent Toxic Effect of Cotinine-Verified Tobacco Smoking on Systemic Inflammation in Apparently Healthy Men and Women: A Nationwide Population-Based Study

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  • Won-Jun Choi

    (Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 06273, Korea
    Department of Medicine, Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea)

  • Ji-Won Lee

    (Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 06273, Korea)

  • A Ra Cho

    (Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 06273, Korea)

  • Yong-Jae Lee

    (Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 06273, Korea)

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.

Suggested Citation

  • Won-Jun Choi & Ji-Won Lee & A Ra Cho & Yong-Jae Lee, 2019. "Dose-Dependent Toxic Effect of Cotinine-Verified Tobacco Smoking on Systemic Inflammation in Apparently Healthy Men and Women: A Nationwide Population-Based Study," IJERPH, MDPI, vol. 16(3), pages 1-11, February.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:3:p:503-:d:204943
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    References listed on IDEAS

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    1. Sungroul Kim, 2016. "Overview of Cotinine Cutoff Values for Smoking Status Classification," IJERPH, MDPI, vol. 13(12), pages 1-15, December.
    2. Peter Libby, 2002. "Inflammation in atherosclerosis," Nature, Nature, vol. 420(6917), pages 868-874, December.
    3. Jarvis, M.J. & Russell, M.A.H. & Benowitz, N.L. & Feyerabend, C., 1988. "Elimination of cotinine from body fluids: Implications for noninvasive measurement of tobacco smoke exposure," American Journal of Public Health, American Public Health Association, vol. 78(6), pages 696-698.
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