Context:Evidence for an association of smoking status with cortisol secretion is mixed.Objective: The objective of the study was to assess the relationship between smoking status and salivary cortisol.Design: This was a cross-sectional study of smoking status and cortisol secretion from phase 7 (2002-2004) of the Whitehall II study.Setting: An occupational cohort was originally recruited in [1985][1986][1987].
Participants:The study population consisted of 3103 men (1514 never-smokers, 1278 ex-smokers, and 311 smokers) and 1128 women (674 never-smokers, 347 ex-smokers, and 107 smokers). Information was collected on smoking status, average number of cigarettes smoked, and additional covariates.Outcome Measures: Saliva samples were taken on waking; waking ϩ 0.5, 2.5, 8, and 12 h; and bedtime for the assessment of cortisol.
Results:Smoking status was significantly associated with increased salivary cortisol release throughout the day (P Ͻ 0.001) adjusted for covariates; this was apparent for the cortisol awakening response (P Ͻ 0.001) when examined separately. Compared with never-smokers, smokers had higher release of total cortisol (P ϭ 0.002), whereas no difference was observed between never-smokers and ex-smokers (P ϭ 0.594): mean release per hour (nanomoles per liter), neversmokers, 4.13 [confidence interval (CI) 4.02-4.24]; ex-smokers, 4.21 (CI 4.08 -4.35); smokers, 4.63 (CI 4.35-4.93). There was no significant relationship between number of cigarettes smoked and total cortisol release. However, a difference was observed for the cortisol awakening response: mean release by tertiles of cigarettes smoked (nanomoles per liter): high, 13.49 medium, low,, P ϭ 0.029.
Conclusion:Salivary cortisol is increased in current smokers, compared with nonsmokers; no differences were observed between exsmokers and never-smokers, suggesting that smoking has a shortterm effect on the neuroendocrine system.