Association between cigarette & shisha smoking and the severity of polycythemia: A cross sectional study

Abstract

Tobacco cigarette smoking is assumed to be a key reason of death all over the world. Smoking had both severe as well long-lasting effects on hematological constraints. As per the data available from World Health Organization, every year nearly 5 million individuals die around the world due to the diseases triggered by smoking. Cigarette smoking is linked with an elevated risk of cardiovascular diseases. To examine the association between shisha or cigarette smoking and the severity of polycythemia, present study is a cross-sectional organized at King Saud University Medical City during the period from October 2017 to April 2018. Participants were patients who have hemoglobin level above 160 g/L on multiple reading in KSUMC between May 2015-February 2018. The sample size (227 patients) was computed on single proportion formula, Data were collected through questionnaires and from medical record of the patients. A pilot study was conducted to evaluate the validity of the questionnaire. A statistical analysis was performed using SPSS 21.0 version. A p-value of ≤ 0.05 considered as statistically significant. Out of 227 study subjects, 86 (37.8%) were smokers, (61.6%) were cigarette smokers while (29%), shisha smokers. Total (9.3%) were smoking both cigarette and Shisha. 29% patients had high normal hemoglobin between the ranges of (160–168 g/L), 17.6% patients had pre-polycythemic hemoglobin between the range of (169–171 g/L) and 53% patients were having polycythemic hemoglobin (>172 g/L). The hemoglobin level in non-smokers was 168.74 g/L, hemoglobin level in cigarette smokers was170.7 g/L, hemoglobin level in shisha smokers was 171.4 g/L while hemoglobin level in those who smokes both cigarette and shisha was 175 g/L. Smoking has adverse effects on hemoglobin. Shisha or cigarette Smoking is associated with increase in the hemoglobin levels and the severity of polycythemia. The findings may help in raising the awareness of tobacco smokers.

Anemia prevalence, severity, types, and correlates among adult women and men in a multiethnic Iranian population: the Khuzestan Comprehensive Health Study (KCHS)

“…Hookah has already been recognized as a stimulant of HGB production due to induced hypoxemia, [ 38 ] and the lower prevalence of anemia among hookah smokers in our study may be attributed to this reason. This result is also consistent with a study conducted in Taif city in Saudi Arabia, which was found that shisha or cigarette smoking cause increased HGB levels and secondary polycythemia [ 39 ]. Although the cigarette smoking contributed to the same correlation in univariate analysis, it was not found significant in multivariate model.…”

Analysis between Cigarette and Shisha Smokers for Early Atherogenesis: A Cardiovascular Disease

“…The significant increase in Hb in smokers is correlated with previous studies [10,13]. An increase in hemoglobin concentration is believed to be mediated by exposure to carbon monoxide, and that the increase in Hb in smokers is a compensatory mechanism.…”

“…Various studies have also suggested that the continuous cigarette smoking has a serious negative impact on hematological parameters such as complete blood cell count, differential count, and endothelial dysfunction [10][11][12]. These effects may be linked to higher risks of developing early atherogenesis, chronic obstructive pulmonary disease, and/or cardiovascular diseases (CVDs) [12,13]. Moreover, non-communicable diseases are the major cause of mortality (73%) in Saudi Arabia, where 37% of deaths are accounted by CVDs.…”

Polycythemia-Related Proliferative Ischemic Retinopathy Managed with Smoking Cessation: A Case Report

“…As a response to the hypoxic status, there is an increase in the hematological parameters. As reported in several studies, cigarette smoking causes an elevated level of hemoglobin [11,[13][14][15], hematocrit [11,15], mean corpuscular volume (MCV) [13,15], and mean corpuscular hemoglobin concentration [13]. It can also cause an elevated level of white blood cells, especially in the sequence of immune responses due to alveolar tissue inflammation and vascular injury [13].…”