Top
Journal of Dependence

Hematological Profiles and Complete Blood Count Alterations in Smokers

Authors

Files

pdf

Abstract

Objective: The aim of this study was to evaluate the associations between cigarette smoking and hematological parameters in otherwise healthy individuals.

Methods: A total of 109 individuals were included in the study, comprising 49 active smokers and 60 never-smokers. Complete blood count parameters along with related hematological indices were retrospectively evaluated.

Results: A total of 109 participants (49 smokers, 60 non-smokers) were evaluated. In unadjusted analyses, smokers exhibited significantly higher white blood cell (WBC), neutrophil, lymphocyte, eosinophil, and hemoglobin levels (p<0.05). However, after adjusting for sex, only WBC (p=0.002) and lymphocyte (p=0.033) levels remained significantly higher in the smoker group. Correlation analyses showed that cumulative smoking exposure was positively associated with WBC, lymphocyte, and RDW levels (p<0.05). Multivariable linear regression further revealed that cumulative smoking exposure was an independent factor associated with higher leukocyte levels (B=0.004, p=0.009), whereas sex was the primary factor independently associated with red cell distribution width (RDW-SD) (B=−2.555, p<0.001). The inclusion of smoking exposure improved the adjusted R 2   for the WBC model from 0.015 to 0.113.

Conclusion: This study indicates that smoking is significantly associated with variations in hematological parameters and inflammatory markers. After adjusting for confounding factors such as sex, leukocyte and lymphocyte counts remained significantly elevated in smokers. Notably, cumulative smoking exposure was identified as an independent factor of higher leukocyte levels, increasing the adjusted R² of the model from 0.015 to 0.113. These findings suggest that chronic tobacco exposure may contribute to systemic inflammation and alterations in the leukocyte profile.

pdf

References

Beleslin-Cokic, B. B., Cokic, V. P., Yu, X., Weksler, B. B., Schechter, A. N., & Noguchi, C. T. (2004). Erythropoietin and hypoxia stimulate erythropoietin receptor and nitric oxide production by endothelial cells. Blood, 104(7), 2073–2080. https://doi.org/10.1182/blood-2004-02-0744

Campesi, I., Milella, L., Palermo, M., Sotgiu, G., Reggiardo, G., & Franconi, F. (2020). Cigarette smoking affects the differences between male and female phenotypes. American Journal of Translational Research, 12(6), 2998–3010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344104/

Chee, Y. J., Dalan, R., & Cheung, C. (2025). The interplay between immunity, inflammation and endothelial dysfunction. International Journal of Molecular Sciences, 26(4), 1708. https://doi.org/10.3390/ijms26041708

Elisia, I., Lam, V., Cho, B., Hay, M., Li, M. Y., Yeung, M., Bu, L., Jia, W., Norton, N., Lam, S., & Krystal, G. (2020). The effect of smoking on chronic inflammation, immune function and blood cell composition. Scientific Reports, 10(1), 19480. https://doi.org/10.1038/s41598-020-76556-7

El-Mahdy, M. A., Abdelghany, T. M., Hemann, C., Ewees, M. G., Mahgoup, E. M., Eid, M. S., Shalaan, M. T., Alzarie, Y. A., & Zweier, J. L. (2020). Chronic cigarette smoke exposure triggers a vicious cycle of leukocyte and endothelial-mediated oxidant stress that results in vascular dysfunction. American Journal of Physiology-Heart and Circulatory Physiology, 319(1), H51–H65. https://doi.org/10.1152/ajpheart.00657.2019

Erik, H. E., Çoban, T., & Özcebe, L. H. (2025). The relationship between gender and women’s tobacco use: An ecological analysis with country-level data. Thoracic Research and Practice, 26(2), 61–68. https://doi.org/10.4274/ThoracResPract.2024.24072

Gartner, C., & Hall, W. D. (2024). Mixed progress in global tobacco control. PLOS Medicine, 21(4), e1004392. https://doi.org/10.1371/journal.pmed.1004392

Higuchi, T., Omata, F., Tsuchihashi, K., Higashioka, K., Koyamada, R., & Okada, S. (2016). Current cigarette smoking is a reversible cause of elevated white blood cell count: Cross-sectional and longitudinal studies. Preventive Medicine Reports, 4, 417–422. https://doi.org/10.1016/j.pmedr.2016.08.009

Khanna, A., Guo, M., Mehra, M., & Royal, W., III. (2013). Inflammation and oxidative stress induced by cigarette smoke in Lewis rat brains. Journal of Neuroimmunology, 254(1–2), 69–75. https://doi.org/10.1016/j.jneuroim.2012.09.006

Lee, S. R., Lee, S. Y., Park, E. J., Lee, Y., Choi, J. I., Kwon, R. J., Son, S. M., Lee, J. G., Yi, Y. H., Tak, Y. J., Lee, S. H., Kim, G. L., Ra, Y. J., & Cho, Y. H. (2025). Association between cumulative pack-year smoking exposure and sarcopenia: A KoGES cohort study. International Journal of Epidemiology, 54(3), dyaf035. https://doi.org/10.1093/ije/dyaf035

Malenica, M., Prnjavorac, B., Bego, T., Dujic, T., Semiz, S., Skrbo, S., Gusic, A., Hadzic, A., & Causevic, A. (2017). Effect of cigarette smoking on haematological parameters in healthy population. Medical Archives, 71(2), 132–136. https://doi.org/10.5455/medarh.2017.71.132-136

Marzouk, H., Mostafa, N., Khalifa, I., Badawi, N., & Sabry, N. I. M. F. (2020). Red cell distribution width (RDW) as a marker of subclinical inflammation in children with familial Mediterranean fever. Current Rheumatology Reviews, 16(4), 298–303. https://doi.org/10.2174/1573397116666200312142709

Sehlikoğlu, Ş., Yıldız, S., Kazğan Kılıçaslan, A., Kurt, O., Göçüm, E., & Han Almiş, B. (2024). Evaluation of complete blood cell count parameters and their role in inflammation in patients with methamphetamine and synthetic cannabis use disorder. Psychiatry and Clinical Psychopharmacology, 34(2), 134–143. https://doi.org/10.5152/pcp.2024.23803

Sharafi, M., Haghjoo, E., Bagheri, P., Chijan, M. R., Baeradeh, N., Afrashteh, S., & Mouseli, A. (2025). Association between smoking status and complete blood cell parameters in baseline data from the Fasa adult’s cohort study. Scientific Reports, 15(1), 38340. https://doi.org/10.1038/s41598-025-22324-4

Siggins, R. W., Hossain, F., Rehman, T., Melvan, J. N., Zhang, P., & Welsh, D. A. (2014). Cigarette smoke alters the hematopoietic stem cell niche. Medical Sciences, 2(1), 37–50. https://doi.org/10.3390/medsci2010037

Smith, C. J., Kluck, L. A., Ruan, G. J., Ashrani, A. A., Marshall, A. L., Pruthi, R. K., Shah, M. V., Wolanskyj-Spinner, A., Gangat, N., Litzow, M. R., Hogan, W. J., Sridharan, M., & Go, R. S. (2021). Leukocytosis and tobacco use: An observational study of asymptomatic leukocytosis. The American Journal of Medicine, 134(1), e31–e35. https://doi.org/10.1016/j.amjmed.2020.06.014

Yuan, M., Chen, H., Liu, Z., Zheng, Y., Liu, S., Zhang, G., & Yang, G. (2026). Platelet indices as prognostic biomarkers in lung cancer: A meta-analysis and Mendelian randomization study. Medicine, 105(6), e47550. https://doi.org/10.1097/MD.0000000000047550

Zhao, S., Fu, P., Lin, L., Zhou, H., Huang, Y., Li, Y., & Tang, C. (2026). Exploring the association between complete blood cell count-derived inflammatory biomarkers and cancer incidence through interpretable machine learning models: A study based on NHANES 1999–2016. Medicine, 105(3), e46941. https://doi.org/10.1097/MD.0000000000046941

Details